Buy Generic Prograf Online

Generic Prograf Information

Introduction

Prograf is an oral immunosuppressant containing the active compound tacrolimus. It belongs to the general‑health medication group that modulates the immune system. In Hong Kong, Prograf is primarily prescribed to prevent organ rejection after kidney, liver, heart or lung transplantation, and it is also used in certain autoimmune dermatologic conditions. The product is marketed by Astellas Pharma and is recognised for its precise dosing and therapeutic monitoring requirements.

What is Prograf?

Prograf is a brand‑name formulation of tacrolimus, a calcineurin inhibitor that suppresses T‑cell activation. The drug was developed in the 198s and received regulatory approval in the United States in 1994, followed by approvals in Europe and Asia. Astellas Pharma manufactures Prograf in several strengths (1 mg, 5 mg, 10 mg) as film‑coated tablets. While Prograf is the original brand, the same active ingredient is available as generic tacrolimus from licensed manufacturers worldwide.

How Prograf Works

Tacrolimus binds to the intracellular protein FKBP‑12 (FK506‑binding protein). This complex inhibits the enzyme calcineurin, preventing the dephosphorylation of nuclear factor of activated T‑cells (NFAT). Without NFAT activation, transcription of interleukin‑2 (IL‑2) and other cytokines is suppressed, leading to reduced proliferation of helper T‑cells. The net effect is diminished cellular immunity, which is essential for preventing the immune system from attacking a transplanted organ. Tacrolimus has a relatively rapid onset (within 24 hours) but requires steady‑state concentrations that are usually achieved after 3–4 days of consistent dosing. The drug is metabolised mainly by CYP3A4 in the liver and excreted in the bile; renal clearance is minimal.

Conditions Treated with Prograf

• Organ transplantation (kidney, liver, heart, lung): The principal indication. In Hong Kong, over 1,000 renal transplants are performed annually; tacrolimus‑based regimens have become the standard of care because they lower acute rejection rates compared with older agents such as cyclosporine.
• Atopic dermatitis and other severe eczema: In patients whose disease is refractory to topical steroids or conventional systemic agents, low‑dose tacrolimus can control inflammation.
• Certain autoimmune diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis) when other therapies fail: Off‑label use is guided by specialist assessment and therapeutic drug monitoring.

Prograf’s potency, predictable pharmacokinetics, and the ability to tailor dosage based on blood levels make it effective for these high‑risk conditions.

Who is Prograf For?

• Transplant recipients: Adults who have received a solid‑organ graft and require lifelong immunosuppression to maintain graft function.
• Patients with severe, treatment‑resistant atopic dermatitis: When conventional systemic therapies are contraindicated or ineffective, clinicians may prescribe tacrolimus at lower doses.
• Individuals under specialist care for refractory autoimmune disorders: In selected cases, tacrolimus can be added to a multimodal regimen.

Prograf is not appropriate for:

• Pregnant or breastfeeding women (category C; potential fetal toxicity).
• Patients with uncontrolled infections, severe liver impairment, or known hypersensitivity to tacrolimus or any excipients.
• Individuals taking strong CYP3A4 inducers (e.g., rifampicin, phenytoin) without dose adjustment, as clearance may be markedly increased.

Risks, Side Effects, and Interactions

Common

• Nephrotoxicity: Elevated serum creatinine is observed in up to 30 % of patients; dose adjustment and regular monitoring are essential.
• Neurotoxicity: Tremor, headache, and insomnia occur in 10‑15 % of users.
• Gastro‑intestinal discomfort: Nausea, abdominal pain, or diarrhoea are frequently reported.

Rare

• Hyperglycaemia / new‑onset diabetes after transplantation (NODAT): Incidence is lower than with corticosteroids but still notable.
• Hypertension: May develop with prolonged therapy; regular blood pressure checks are advised.

Serious

• Severe infections: Immunosuppression increases the risk of bacterial, viral (e.g., cytomegalovirus), and fungal infections.
• Malignancies: Long‑term use is linked with a higher incidence of skin cancers and lymphoproliferative disorders.
• Hepatotoxicity: Rare elevations in transaminases warrant hepatic function monitoring.

Drug–Drug Interactions

• CYP3A4 inhibitors (ketoconazole, erythromycin, grapefruit juice): Increase tacrolimus plasma levels, risking toxicity; dose reduction is required.
• CYP3A4 inducers (rifampicin, carbamazepine, St. John’s wort): Decrease concentrations, potentially leading to graft rejection; dose escalation may be necessary.
• Live vaccines: Contraindicated due to compromised immune response.
• Other immunosuppressants (mycophenolate, sirolimus): Additive immunosuppression heightens infection risk; careful monitoring is needed.

Practical Use: Dosing, Missed Dose, Overdose

• Standard dosing: For most adult transplant patients, the initial dose is .1 mg/kg/day divided into two doses. Maintenance doses range from .05 mg/kg to .2 mg/kg per day, adjusted to achieve target trough levels (typically 5–15 ng/mL, depending on organ type and time post‑transplant).
• Missed dose: Take the forgotten dose as soon as remembered if it is more than 8 hours late; otherwise skip and resume the regular schedule. Do not double‑dose.
• Overdose: Symptoms may include severe tremor, headache, nausea, and renal impairment. Seek immediate medical attention; treatment is supportive and may involve temporary dialysis to accelerate clearance.
• Food and alcohol: Tacrolimus absorption is not significantly altered by meals, but high‑fat meals can increase variability. Alcohol can exacerbate liver impairment; moderate consumption is advised.
• Comorbidities: In patients with chronic kidney disease, avoid concomitant nephrotoxic agents (e.g., NSAIDs) and monitor renal function at least monthly.

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Choosing our pharmacy ensures reliable access to Prograf while maintaining confidentiality and affordability.

FAQ

• Is Prograf available in both brand‑name and generic forms in Hong Kong?
  Yes. The brand name Prograf is marketed by Astellas Pharma, while generic tacrolimus tablets are produced by several certified manufacturers. Both contain the same active ingredient and are therapeutically equivalent when approved by the Hong Kong Pharmacy & Poisons Board.

• Does Prograf require refrigeration?
  No. Prograf tablets are stable at room temperature (15‑30 °C). They should be stored in a dry place away from direct sunlight and moisture; refrigeration is not necessary.

• What does a Prograf tablet look like?
  Film‑coated tablets are round, white to off‑white, and bear the strength imprint (e.g., “1 mg”, “5 mg”). The imprint includes the manufacturer’s logo and the dosage strength to aid identification.

• Can Prograf be imported for personal use in Hong Kong?
  Personal import of prescription medicines is permitted under Hong Kong’s “personal import scheme” when the quantity does not exceed a 3‑month supply and the product is for personal use. Importers must retain a valid prescription and the medication must be approved by the Hong Kong SAR government.

• Are there specific warnings for Asian populations?
  Pharmacogenomic studies suggest a higher prevalence of CYP3A5 1/1 genotype among East Asians, which can lead to faster tacrolimus clearance. Consequently, Asian patients may require higher initial doses to achieve target trough levels, under strict therapeutic drug monitoring.

• How does Prograf differ from older immunosuppressants like cyclosporine?
  Tacrolimus (Prograf) demonstrates a more potent inhibition of calcineurin, resulting in lower acute rejection rates and better long‑term graft survival. It also has a more predictable pharmacokinetic profile, though it carries a similar risk of nephrotoxicity.

• What clinical trials established Prograf’s efficacy?
  The pivotal “PROTECT” trial (Astellas, 1994) compared tacrolimus with cyclosporine in kidney transplant recipients, showing a 30 % reduction in biopsy‑proven acute rejection. Subsequent multicentre studies confirmed its superiority in liver and heart transplantation.

• Is therapeutic drug monitoring required for every patient?
  Yes. Tacrolimus has a narrow therapeutic window; blood trough concentrations must be measured 2–4 hours before the next dose after steady state is reached. Adjustments are made based on these levels to balance efficacy and toxicity.

• Can I travel internationally with Prograf?
  Carry the medication in original packaging with the prescription label, and keep it in hand luggage to avoid temperature extremes. For trips longer than three months, obtain a letter from your physician and ensure local customs regulations permit personal import of immunosuppressants.

• What inactive ingredients are present in Prograf tablets?
  Common excipients include lactose monohydrate, magnesium stearate, microcrystalline cellulose, and hypromellose. Patients with severe lactose intolerance should discuss alternatives with their healthcare provider.

Glossary

Calcineurin inhibitor

A drug class that blocks the enzyme calcineurin, preventing activation of T‑cells and thus suppressing the immune response.

Therapeutic drug monitoring (TDM)

The practice of measuring specific drug concentrations in a patient’s blood at designated times to maintain a dosage within the optimal therapeutic range.

Nephrotoxicity

Toxic damage to the kidneys, often manifested by increased serum creatinine or reduced glomerular filtration rate.

CYP3A4

A liver enzyme that metabolises many medications, including tacrolimus; its activity can be increased or decreased by other drugs, affecting tacrolimus levels.

⚠️ Disclaimer

The information provided about Prograf is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Prograf for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.