Prograf (Tacrolimus)

Prograf
4.428 ratingsReviews
Generic:
Tacrolimus
Indications:
organ rejection
Analogs:
Advagraf Envarsus XR Astagraf XL Modigraf Protopic Neoral Sandimmune Rapamune Zortress Nulojix Cellcept Cyclosporine Imuran Myfortic
AdultsPregnancyAllergiesDiabetesBreastfeedingChildrenDriving

Dosages

Prograf 0.5 mg

Quantity Price per tablet You save Total price
20 $5.75 - $115.00
30 $5.57 $5.50 $167.00
60 $5.12 $38.00 $307.00
90 $4.60 $103.50 $414.00
120 $4.27 $178.00 $512.00
180 $3.92 $329.00 $706.00
270 $3.59 $584.50 $968.00
360 $3.41 $842.00 $1,228.00

Prograf 1 mg

Quantity Price per tablet You save Total price
10 $9.10 - $91.00
20 $7.15 $39.00 $143.00
30 $6.47 $79.00 $194.00
60 $5.97 $188.00 $358.00
90 $5.69 $307.00 $512.00
120 $5.49 $433.00 $659.00
180 $5.09 $722.00 $916.00
270 $4.70 $1,188.00 $1,269.00
360 $4.31 $1,724.00 $1,552.00

Prograf 5 mg

Quantity Price per tablet You save Total price
10 $36.50 - $365.00
20 $30.50 $120.00 $610.00

Manufacturers

Astellas PharmaBharat Serums And Vaccines LimitedSandoz

Payment & Shipping

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Shipping Times
Shipping MethodEstimated delivery
Express Free for orders over $300.00Estimated delivery to the U.S.: 4-7 days
Standard Free for orders over $200.00Estimated delivery to the U.S.: 14-21 days
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Discount Coupons

  • Independence Day - July 4, 2026 10% JULY410
  • Labor Day - September 7, 2026 7% LABOR07
  • Thanksgiving - November 26, 2026 9% THANKS09

Brand Names

Also known as (by country):
CountryBrand Names
United States
Astagraf XL
United Kingdom
Adoport Advagraf
Canada
Advagraf
Australia
Advagraf

FAQ

In the United States, tacrolimus requires a prescription when purchased from local pharmacies. However, our store policy allows you to order tacrolimus capsules without submitting a prescription, and the product can be sent by mail.

Do not change the dose, take extra capsules, or extend treatment on your own. Tacrolimus dosing is individualized using whole-blood trough levels, and possible rejection or other treatment concerns need prompt assessment by the transplant care team.

A generic version contains tacrolimus, the same active ingredient as Prograf. The manufacturer, capsule appearance, and inactive ingredients can differ, so do not switch between tacrolimus products without the transplant prescriber's direction and appropriate blood-level monitoring.

Tacrolimus crosses the placenta, so use during pregnancy requires caution and specialist monitoring. It may be necessary to prevent transplant rejection, but the maternal benefit and potential fetal risks must be weighed individually. Tacrolimus is present in breast milk; breastfeeding requires a clinician-led decision that considers the need for treatment and possible effects on the infant.

Description

Immunosuppressants

Several drugs are particularly well-known in the pharmaceutical industry for their exceptional ability to treat various medical ailments. Prograf is among such medications. Prograf is frequently administered to patients undergoing transplantation and to those suffering from particular autoimmune illnesses. It is essential in suppressing the immune system to avoid organ rejection or lessen autoimmune disease symptoms.  

Prograf: What Is It? 

Prograf, sometimes referred to as tacrolimus in its generic form, is an immunosuppressive drug. It limits the body's immunological response by blocking the functioning of specific immune system cells. This immunosuppressive effect is essential in keeping the recipient's immune system from rejecting transplanted organs such as the liver, heart, kidneys, or lungs.

How Does Prograf Work? 

Prograf's capacity to connect to a protein known as FK-binding protein-12 (FKBP-12) is part of its mode of action. Then, this Prograf-FKBP-12 combination inhibits the calcineurin enzyme. The immune response is mediated by T-lymphocytes, a subset of white blood cells activated by calcineurin. Prograf reduces the activation of T-lymphocytes and their subsequent proliferation by blocking calcineurin, which in turn attenuates the immunological response.

TacrolimusUses of Prograf

  1. Prograf is mainly recommended for patients who have had liver, heart, kidney, or lung transplants to prevent organ rejection. It is usually taken as part of a thorough post-transplant protocol together with other immunosuppressive drugs. 
  2. Prograf is indicated not only for transplantation but also for the management of several autoimmune conditions, including eczema, psoriasis, and rheumatoid arthritis. It reduces tissue damage-causing aberrant immune response to help with symptoms in several illnesses. 

Dosage

Indication Initial Oral Dose Maintenance Oral Dose Range Monitoring
Kidney Transplantation 0.10 - 0.20 mg/kg/day in 2 divided doses 0.05 - 0.15 mg/kg/day in 2 divided doses, adjusted based on clinical response and tacrolimus trough levels Tacrolimus trough levels (e.g., 5-15 ng/mL) should be monitored regularly, typically 2-3 times per week initially, then less frequently
Liver Transplantation 0.10 - 0.20 mg/kg/day in 2 divided doses 0.05 - 0.15 mg/kg/day in 2 divided doses, adjusted based on clinical response and tacrolimus trough levels Tacrolimus trough levels (e.g., 5-20 ng/mL) should be monitored regularly, typically 2-3 times per week initially, then less frequently
Heart Transplantation 0.075 - 0.15 mg/kg/day in 2 divided doses 0.05 - 0.10 mg/kg/day in 2 divided doses, adjusted based on clinical response and tacrolimus trough levels Tacrolimus trough levels (e.g., 5-15 ng/mL) should be monitored regularly, typically 2-3 times per week initially, then less frequently
Lung Transplantation 0.075 - 0.15 mg/kg/day in 2 divided doses 0.05 - 0.10 mg/kg/day in 2 divided doses, adjusted based on clinical response and tacrolimus trough levels Tacrolimus trough levels (e.g., 5-15 ng/mL) should be monitored regularly, typically 2-3 times per week initially, then less frequently

Adverse Reactions to Prograf

Prograf has drawbacks even though it works wonders in controlling autoimmune disorders and preventing organ rejection. Among the most common adverse effects of using Prograf are:

  1. Increased susceptibility to infections: Individuals on Prograf are more likely to get infections because this medicine lowers the immune system. Since the immune system is weakened, this danger is exceptionally high in the early post-transplant phase.
  2. Renal toxicity: Extended usage of Prograf may damage the kidneys, which may manifest as reduced renal function or even renal failure. Renal function monitoring is crucial for individuals on Prograf therapy.
  3. Neurological adverse effects: Prograf, especially at higher doses, can produce neurological side effects such as tremors, migraines, and confusion. Usually, these symptoms can be reversed by changing the dosage or stopping the drug.
  4. Metabolic disturbances: Prograf may change how some chemicals are metabolized by the body, which can result in hyperglycemia (high blood sugar), hyperkalemia (high potassium levels), and electrolyte abnormalities. 

Prograf, or tacrolimus, is a potent immunosuppressive drug frequently used to treat autoimmune diseases and facilitate organ donation. Healthcare practitioners can maximize the use of this medication while lowering patient risks by being aware of its mechanism of action, indications, and possible side effects. In spite of its adverse effects, Prograf is still a vital weapon in the fight against autoimmune illnesses and organ rejection, providing countless people all over the world with hope for better results and a higher standard of living.

Medically reviewed by
Jennifer Bowles
Pharmacologist
Updated August 11, 2026

Customer questions

Asked by Monica Reynolds, Fort Worth, United States

I just received my tacrolimus order. What should I look for to make sure the ingredient and strength are correct?

Answered by Support team

Check the package label for "tacrolimus," the strength ordered - 0.5 mg, 1 mg, or 5 mg - and that it is an oral capsule. Also compare the dosage form, manufacturer name, lot number, expiration date, and any capsule imprint if present. Do not use the capsules until any mismatch is clarified.

Asked by David Carter, Washington, D.C., United States

Before I order, can you tell me how much shelf life the tacrolimus capsules will have left?

Answered by Support team

The exact expiration date depends on the package supplied and is printed on its label. We cannot promise a specific remaining shelf life before an order is received; check the labeled expiration date before use.

Asked by Angela Morris, Jacksonville, United States

My husband takes tacrolimus after a kidney transplant. Can he still have grapefruit juice with breakfast?

Answered by Support team
Medical reviewed by Jennifer Bowles

No. Grapefruit and grapefruit juice can raise tacrolimus blood levels and increase the risk of toxicity, including kidney and neurologic effects. He should avoid grapefruit products and keep the transplant team informed about dietary or medication changes.

Product specifications

Active ingredientTacrolimus
Drug classCalcineurin inhibitor immunosuppressant
Dosage formCapsule
Available strengths0.5 mg, 1 mg, 5 mg
RouteOral
StorageStore the capsules between 41°F and 77°F in the original container, protected from moisture.
ATC codeL04AD02

Regulatory information

United States: Prograf medicine status
FDA approval statusPrograf (tacrolimus) capsules, including 0.5 mg, 1 mg, and 5 mg strengths, are FDA-approved prescription medicines for prevention of organ-transplant rejection.
Prescription statusPrograf capsules are available in the United States by prescription only.
US NDA holderAstellas Pharma US, Inc. is the US NDA holder for Prograf.
Safety monitoringTacrolimus labeling carries a boxed warning for serious infections and lymphoma or other malignancies; whole-blood tacrolimus concentrations and kidney function require clinical monitoring.
Official prescribing informationThe current FDA-approved prescribing information and Medication Guide can be accessed through the DailyMed drug-label database.

More information