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Do not take PROGRAF if you are allergic to tacrolimus or any of the ingredients in PROGRAF.

ISMP Canada received a report of a medication incident in which Advagrafan extended-release formulation of tacrolimus for oral administrationwas dispensed to a patient instead of the intended Prografan immediate-release oral formulation of the same drugRecent reports from the United Kingdom 12 and Europe 34 have documented mix-ups between Prograf and Advagraf and have outlined concerns about the outcomes of such incidentsAccording to these warningsmix-ups between Prograf and Advagraf have led to serious harmincluding cases of biopsy-confirmed acute rejection of transplanted organs and toxic effects due to overexposureAlthough this incident occurred in a community pharmacyit is an important alert for hospital pharmacists about the potential for serious patient harm if these drugs are mistakenly interchanged.

Tell your healthcare provider right away if you get any of these symptoms of heart problems while taking PROGRAF:

Dosing should be titrated based on clinical assessments of rejection and tolerabilityLower Prograf dosages than the recommended initial dosage may be sufficient as maintenance therapyAdjunct therapy Silvitra over the counter with adrenal corticosteroids is recommended early post-transplant.

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