Prospect: information for the patient
Tacrólimus Stadafarma 0.5mg capsulesof prolonged-release EFG
Tacrólimus Stadafarma 1mg capsulesof prolonged-release EFG
Tacrólimus Stadafarma 3mg capsulesof prolonged-release EFG
Tacrólimus Stadafarma 5mg capsulesof prolonged-release EFG
Read this prospect carefully before starting to take this medication, as it contains important information for you.
1. What isTacrólimus Stadafarmaand for what it is used
2. What you need to know before starting to takeTacrólimus Stadafarma
3. How to takeTacrólimus Stadafarma
4. Possible adverse effects
5. Storage ofTacrólimus Stadafarma
6. Contents of the package and additional information
Tacrólimus Stadafarmacontains the active ingredient tacrólimus. It is an immunosuppressant. After organ transplantation (liver, kidney), the immune system of your body will attempt to reject the new organ. Tacrólimus is used to control the immune response of your body, allowing you to accept the transplanted organ.
You may also receive tacrólimus to treat a rejection that is occurring in your liver, kidney, heart, or other transplanted organ, when any previous treatment you were following, fails to control this immune response after your transplant.
Tacrólimusis used in adults.
Do not take Tacrólimus Stadafarma
-if you are allergic to tacrolimus or any of the other components of this medication (listed in section6).
-if you are allergic to sirolimus or any macrolide antibiotic (e.g., erythromycin, clarithromycin, josamycin).
Warnings and precautions
Tacrolimus immediate-release capsules and tacrolimus prolonged-release capsules both contain the active ingredient tacrolimus. However, tacrolimus prolonged-release capsules are taken once a day, while immediate-release capsules are taken twice a day. This is because tacrolimus capsules allow for prolonged release (slower release over a longer period of time) of tacrolimus.
Tacrolimus prolonged-release capsules and tacrolimus in immediate-release capsulesare not interchangeable.
Inform your doctor if any of the following occur:
Please avoid taking any herbal preparations, e.g., St. John's Wort (Hypericum perforatum), as this may affect the efficacy and dose of tacrolimus you need to receive.
If you have any doubts, please consult your doctor before taking any herbal product or preparation.
Your doctor may need to adjust your tacrolimus dose.
You should maintain regular contact with your doctor.Occasionally, to establish the appropriate dose of tacrolimus, your doctor may need to perform blood and urine tests, cardiac tests, eye tests.
You should limit your exposure to sunlight and UV (ultraviolet) while taking tacrolimus, as immunosuppressants may increase the risk of skin cancer. Wear protective clothing and use a high-factor sunscreen.
Precautions for handling:
Avoid contact with any part of your body, such as skin or eyes, as well as breathing near the powder contained in the capsules. If such contact occurs, wash your skin and eyes.
Children and adolescents
Tacrolimus is not recommended for use in children and adolescents under 18years.
Other medications and Tacrólimus Stada
Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication.
Tacrolimus should not be used with cyclosporine (another medication used to prevent organ transplant rejection).
If you need to visit a doctor other than your transplant specialist, tell the doctor that you are taking tacrolimus.Your doctor may need to consult with your transplant specialist if you need to use another medication that may increase or decrease your tacrolimus blood levels..
Tacrolimus blood levels may be affected by other medications you are taking, and the blood levels of other medications may be affected by tacrolimus administration, which may require the interruption, increase, or decrease of tacrolimus dose.
Some patients have experienced increased tacrolimus blood levels while taking other medications.This could cause severe adverse effects, such as kidney problems, nervous system problems, and heart rhythm disorders (see section4).
The effect on tacrolimus blood levels can occur very soon after starting another medication, so it may be necessary to monitor tacrolimus blood levels frequently and continuously during the first days of use of another medication and with frequency while continuing its use.Some other medications may cause tacrolimus blood levels to decrease, which may increase the risk of organ transplant rejection.Particularly, you should inform your doctor if you are taking or have taken recently medications such as:
-antifungals and antibiotics, especially macrolide antibiotics, used to treat infections, e.g., ketoconazole, fluconazole, itraconazole, posaconazole, voriconazole, clotrimazole, isavuconazole, miconazole, caspofungin, telithromycin, erythromycin, clarithromycin, josamycin, azithromycin, rifampicin, rifabutin, isoniazid, and flucloxacillin
-letermovir, used to prevent diseases caused by human cytomegalovirus (CMV)
-protease inhibitors for HIV (e.g., ritonavir, nelfinavir, saquinavir), the pharmacopotentiator cobicistat, and combined tablets, or non-nucleoside reverse transcriptase inhibitors for HIV (efavirenz, etravirine, nevirapine) used to treat HIV infections
-protease inhibitors for HCV (e.g., telaprevir, boceprevir, the combination ombitasvir/paritaprevir/ritonavir, with or without dasabuvir,elbasvir/grazoprevir, and glecaprevir/pibrentasvir), used to treat HCV infection
-nilotinib and imatinib,idelalisib, ceritinib, crizotinib, apalutamide, enzalutamide, or mitotane(used to treat certain types of cancer)
-micophenolic acid, used to suppress the immune system as a transplant rejection prevention
-medications for stomach ulcers and acid reflux (e.g., omeprazole, lansoprazole, or cimetidine)
-antiemetics, used to treat nausea and vomiting (e.g., metoclopramide)
-cisapride or antacids containing magnesium hydroxide and aluminum, used to treat acid reflux
-oral contraceptives or other hormonal treatments with ethinylestradiol, hormonal treatments with danazol
-medications used to treat high blood pressure or heart problems (e.g., nifedipine, nicardipine, diltiazem, and verapamil)
-antiarrhythmic medications (amiodarone) used to control irregular heartbeats
-statins used to treat high cholesterol and triglycerides
-carbamazepine, phenytoin, or phenobarbital, used to treat epilepsy
-metamizole, used to treat pain and fever
-steroid prednisolone or methylprednisolone, belonging to the class of corticosteroids used to treat inflammation or suppress the immune system (e.g., transplant rejection)
-nefazodone, used to treat depression
-herbal preparations containing St. John's Wort (Hypericum perforatum) or Schisandra sphenanthera extracts.
-cannabidiol (its use includes, among others, the treatment of epilepsy)
Inform your doctor if you are receiving treatment for hepatitis C. The pharmacological treatment for hepatitis C may change your liver function and may affect tacrolimus blood levels. Tacrolimus blood levels may decrease or increase depending on the medications prescribed for hepatitis C. Your doctor may need to closely monitor tacrolimus blood levels and make the necessary adjustments to the tacrolimus dose after starting hepatitis C treatment.
Inform your doctor if you are taking or need to take ibuprofen (used to treat fever, inflammation, and pain), antibiotics (cotrimoxazole, vancomycin, or aminoglycoside antibiotics such as gentamicin), amphotericin B (used to treat fungal infections), or antivirals (used to treat viral infections, e.g., aciclovir, ganciclovir, cidofovir, foscarnet).These medications may worsen kidney or nervous system problems when taken with tacrolimus.
Inform your doctor if you are taking sirolimus or everolimus.When tacrolimus is taken with sirolimus or everolimus, the risk of microangiopathic hemolytic anemia, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome may increase (see section 4).
Your doctor also needs to know if you are taking potassium supplements or certain diuretics used for heart failure, hypertension, and nephropathy (e.g., amiloride, triamterene, or spironolactone), or the antibiotics trimethoprim and cotrimoxazole that may increase potassium levels in your blood,nonsteroidal anti-inflammatory drugs (NSAIDs, e.g., ibuprofen) used to treat fever, inflammation, and pain,anticoagulants (which prevent blood clotting), or oral medications for diabetes treatment while taking tacrolimus.
If you plan to be vaccinated, consult your doctor.
Taking Tacrólimus Stada with food and drinks
Avoid grapefruit (also in juice) while taking tacrolimus, as it may affect your blood levels.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, or think you may be pregnant, or plan to become pregnant, consult your doctor before using this medication.
Tacrolimus passes into breast milk. Therefore, do not breastfeed while taking tacrolimus.
Driving and operating machinery
Do not drive and do not operate tools or machines if you feel dizzy or drowsy, or have difficulty seeing clearly after taking tacrolimus. These effects are more frequent if you also take alcohol.
Tacrolimus Stada contains lactose and red iron oxide (E129)
This medication contains lactose. If your doctor has told you that you have a certain sugar intolerance, consult with him before taking this medication.
This medication contains red iron oxide (E129).
It may cause allergic reactions.
Follow exactly the administration instructions of this medication as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again. This medication should only be prescribed by a doctor with experience in treating patients with transplants.
Make sure you receive the same tacrolimus medication every time you pick up your prescription, unless your transplant specialist has agreed to switch to a different medication with tacrolimus. This medication should be taken once a day. If the appearance of this medication is not the same as usual, or if the dosing instructions have changed, consult your doctor or pharmacist as soon as possible to ensure you have the correct medication.
The initial dose to prevent rejection of your transplanted organ will be set by your doctor, calculated according to your body weight. The initial daily doses immediately after the transplant will generally be within the range of
0.10-0.30mg per kg of body weight per day
depending on the transplanted organ. To treat rejection, these same doses may be used.
Your dose will depend on your overall condition, and any other immunosuppressive medication you may be taking.
After starting your tacrolimus treatment, your doctor will perform frequent blood tests to determine the correct dose. Your doctor will need to perform regular blood tests to determine the correct dose, and to adjust the dose from time to time. Your doctor will usually reduce your tacrolimus doseonce your conditions have stabilized. Your doctor will tell you exactly how many capsules to take.
You will need to taketacrolimusevery day until you no longer need immunosuppression to prevent rejection of your transplanted organ. You should maintain regular contact with your doctor.
Tacrolimus is taken orally once a day, in the morning. Take tacrolimus with an empty stomach or2 to3hours after a meal.Wait at least one hour before the next meal.
Take the capsules immediately after removing them from the blister pack.The capsules should be swallowedwholewith a glass of water. Do not swallow the desiccant contained in the aluminum pouch.
If you take more Tacrolimus Stadafarma than you should
If you accidentally take too many capsules, contact your doctor or go to the nearest hospital emergency department.
If you forget to take Tacrolimus Stadafarma
If you have forgotten to take your capsules in the morning, take them as soon as possible on the same day. Do not take a double dose the next morning.
If you interrupt the treatment with Tacrolimus Stadafarma
Stopping your tacrolimus treatment may increase the risk of rejection of your transplanted organ. Do not stop treatment unless your doctor tells you to.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everyone will experience them.
Tacrolimus reduces the body's defense mechanisms (immune system), which will not work as well to fight off infections. Therefore, if you are taking tacrolimus, you will be more prone to infections.
Inform your doctor immediately if you have symptoms of an infection, including:
Severe side effects may occur, including allergic reactions and anaphylaxis. Cases of benign and malignant tumors have been reported after treatment with tacrolimus.
Severe side effects that are common (may affect up to 1 in 10 people):
Severe side effects that are uncommon (may affect up to 1 in 100 people):
Severe side effects that are rare (may affect up to 1 in 1,000 people):
Severe side effects that are very rare (may affect up to 1 in 10,000 people):
Severe side effects of unknown frequency (the frequency cannot be estimated from available data):
After receivingtacrolimusyou may also experience the following side effects, which can be severe:
Very common side effects(may affect more than 1 in 10 people)
Common side effects(may affect up to 1 in 10 people)
Uncommon side effects(may affect up to 1 in 100 people)
Rare side effects(may affect up to 1 in 1,000 people)
Very rare side effects(may affect up to 1 in 10,000 people)
Reporting of side effects
If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Vigilance of Medicines for Human Use: www.notificaRAM.es.By reporting side effects, you can contribute to providing more information on the safety of this medicine.
Keep this medication out of the sight and reach of children.
Do not use this medication after the expiration date that appears on the box and the blister pack after “CAD”.The expiration date is the last day of the month indicated.
Use all the prolonged-release hard capsules within the year following the opening of the aluminum packaging.
Store below 30 °C.
Medicines should not be disposed of through the drains or in the trash. Deposit the packaging and medicines you no longer need at the SIGRE collection pointat the pharmacy. Ask your pharmacist how to dispose of the packaging and medicines you no longer need. In this way, you will help protect the environment.
Composition of Tacrólimus Stadafarma
Each Tacrólimus Stadafarma 0.5 mg capsule contains 0.5 mg of tacrólimus (as monohydrate).
Each Tacrólimus Stadafarma 1 mg capsule contains 1 mg of tacrólimus (as monohydrate).
Each Tacrólimus Stadafarma 3 mg capsule contains 3 mg of tacrólimus (as monohydrate).
Each Tacrólimus Stadafarma 5 mg capsule contains 5 mg of tacrólimus (as monohydrate).
Capule content:ethylcellulose, butylhydroxytoluene, hypromellose, lactose monohydrate, magnesium stearate.
Capule coating: gelatin, titanium dioxide (E171), iron oxide red (E172), iron oxide yellow (E172).
Printing ink: shellac, aluminium lake red allura (E129), propylene glycol (E1520), titanium dioxide (E171).
Appearance of the product and contents of the package
Tacrólimus Stadafarma 0.5 mg are hard gelatin prolonged-release capsules, with yellow opaque body and orange opaque body, size 5, with a length of 11.2±0.5 mm, printed with "0.5 mg" in red ink on the cap.
Tacrólimus Stadafarma 0.5 mg is supplied in transparent PVC/PE/PVDC-aluminium foil or perforated unit-dose blisters, wrapped in an aluminium foil, including a desiccant incorporated in the film layer.
The 30, 50 and 100 prolonged-release capsules are available in blisters and 30×1, 50×1 and 100×1 prolonged-release capsules are available in perforated unit-dose blisters.
Tacrólimus Stadafarma 1 mg are hard gelatin prolonged-release capsules, with white opaque body and orange opaque body, size 4, with a length of 14.1±0.5 mm, printed with "1 mg" in red ink on the cap.
Tacrólimus Stadafarma 1 mg is supplied in transparent PVC/PE/PVDC-aluminium foil or perforated unit-dose blisters, wrapped in an aluminium foil, including a desiccant incorporated in the film layer.
The 30, 50, 60 and 100 prolonged-release capsules are available in blisters and 30×1, 50×1, 60x1 and 100×1 prolonged-release capsules are available in perforated unit-dose blisters.
Tacrólimus Stadafarma 3 mg are hard gelatin prolonged-release capsules, with orange opaque body and orange opaque body, size 1, with a length of 19.1±0.5 mm, printed with "3 mg" in red ink on the cap.
Tacrólimus Stadafarma 3 mg is supplied in transparent PVC/PE/PVDC-aluminium foil or perforated unit-dose blisters, wrapped in an aluminium foil, including a desiccant incorporated in the film layer.
The 30, 50 and 100 prolonged-release capsules are available in blisters and 30×1, 50×1 and 100×1 prolonged-release capsules are available in perforated unit-dose blisters.
Tacrólimus Stadafarma 5 mg are hard gelatin prolonged-release capsules, with reddish-grey opaque body and orange opaque body, size 0, with a length of 21.4±0.5 mm, printed with "5 mg" in red ink on the cap.
Tacrólimus Stadafarma 5 mg is supplied in transparent PVC/PE/PVDC-aluminium foil or perforated unit-dose blisters, wrapped in an aluminium foil, including a desiccant incorporated in the film layer.
The 30, 50 and 100 prolonged-release capsules are available in blisters and 30×1, 50×1 and 100×1 prolonged-release capsules are available in perforated unit-dose blisters.
Only some package sizes may be commercially available.
Marketing authorization holder andresponsible manufacturer
Marketing authorization holder
Laboratorio STADA, S.L.
Frederic Mompou, 5
08960 Sant Just Desvern (Barcelona)
Spain
Responsible manufacturer
Pharmathen International S.A
Industrial Park Sapes,
Rodopi Prefecture, Block No 5
Rodopi
69300 Greece
or
Pharmathen SA
6 Dervenakion Str.
Pallini, Attiki
15351 Greece
or
STADA Arzneimittel AG
Stadastrasse 2-18
61118 Bad Vilbel
Germany
or
Centrafarm Services B.V.
Van de Reijtstraat 31 D
4814NE Breda
Netherlands
This medicinal product is authorized in the member states of the European Economic Area with the following names:
Danish:Tacrolimus Stada
German:Tacrolimus AL 0.5 mg Hartkapseln, retardiert
Tacrolimus AL 1 mg Hartkapseln, retardiert
Tacrolimus AL 3 mg Hartkapseln, retardiert
Tacrolimus AL 5 mg Hartkapseln, retardiert
Spanish:Tacrólimus Stadafarma 0.5 mg prolonged-release capsules EFG
Tacrólimus Stadafarma 1 mg prolonged-release capsules EFG
Tacrólimus Stadafarma 3 mg prolonged-release capsules EFG
Tacrólimus Stadafarma 5 mg prolonged-release capsules EFG
French:Tacrolimus EG 0.5 mg, gélule à libération prolongée
Tacrolimus EG 1 mg, gélule à libération prolongée
Tacrolimus EG 3 mg, gélule à libération prolongée
Tacrolimus EG 5 mg, gélule à libération prolongée
Hungarian:Tacrolimus Stada 0.5 mg retard kemény kapszula
Tacrolimus Stada 1 mg retard kemény kapszula
Tacrolimus Stada 3 mg retard kemény kapszula
Tacrolimus Stada 5 mg retard kemény kapszula
Italian:Tacrolimus EG
Dutch:Tacrolimus CF 0.5 mg, harde capsules met verlengde afgifte
Tacrolimus CF 1 mg, harde capsules met verlengde afgifte
Tacrolimus CF 3 mg, harde capsules met verlengde afgifte
Tacrolimus CF 5 mg, harde capsules met verlengde afgifte
Polish:Tacrolimus STADA
Last review date of thisleaflet:December 2023
The detailed information of this medicinal product is available on the website of the Spanish Agency of Medicines and Medical Devices (AEMPS) (http://www.aemps.gob.es/)
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