Prograf: check versions, indication and price. Are you generic?

According to the Brazilian Transplant Registry (RBT), between January and September 2019, 17,717 organ transplants were performed in Brazil. Still, there are a huge number of people waiting for a transplant.

And because it is an extremely delicate procedure, a lot of care is needed. Among them, there is the use of medications indicated to prevent the body from rejecting the organ received.

Now we will talk about Prograf, which fulfills this function in cases of allogeneic transplants (that is, in cases of receiving an organ from another donor) of kidneys and liver.

Also, in March 2019, Anvisa also approved its use for cases of allogeneic heart transplantation.


What is Prograf?

Prograf is one of the trade names of the drug whose active ingredient is Tacrolimus (immunosuppressant). As indicated in the package insert, this remedy may be recommended by the medical team after heart, liver or kidney transplants.

It acts to prevent the organism from rejecting the transplanted organ. It is also common that it is used together with corticosteroid medications (anti-inflammatory steroids).

It is currently available in three versions:

  • Prograf Capsules;
  • Prograf XL;
  • Injectable Prograf.

What does Prograf XL mean?

The Prograf XL fulfills the same function as the conventional one. However, the drug had a change in its formulation and release mechanism. It is possible to identify this due to the acronym “XL”.

There are several abbreviations, but “XL” in particular means that it is a medicine with extended release, which remains acting for a longer time in the body.

What is Prograf and Prograf XL for?

As mentioned, the package insert indicates that Prograf should be used in cases of liver or kidney transplantation. It is an immunosuppressant, that is, it acts by reducing the body’s immune reactions, so that the new organ is not rejected.

Since the immune system tends to recognize and protect the body against infections and rejects anything strange, the medicine is very important.

To avoid rejection, it is necessary to use immunosuppressive medication for life. At the beginning, the dosage is higher and then decreases little by little according to medical advice. In addition, it is essential to follow the recommendation regarding the dose and frequency of use of the medicine.

What is Tacrolimo Monohydrate?

Tacrolimo Monohydrate is the active ingredient of the drug Tacrolimo ( ointment ), indicated to treat some cases of atopic dermatitis .

Basically, a monohydrate medicine always has a molecule of water attached to a molecule of the substance. That is, it is the same active substance as Prograf, however, with other processing.

In this case, Tacrolimus monohydrate acts as an immunomodulator – a substance that acts directly on the immune system, making adjustments. As an example, it can stimulate or inhibit the way a chemical or cell behaves.

It is worth mentioning that not all monohydrated medication is ointment.

What is Tacrolimo ointment for?

Tacrolimo ointment is used in cases of atopic dermatitis ( eczema ), when the patient does not have a good response or has intolerance to conventional treatments. Thus, it acts providing relief from the symptoms of the disease.

The drug is available in a version with 0.03% (adult and child use) and 1% (adult use only) of the principle.

The use of the active ingredient Tacrolimo, in ointment, makes it act locally inhibiting the immune system, helping against dermatitis . Thus, the medication does not act in a systemic way (in the whole body).

Is tacrolimus for cancer?

No . Despite acting on the immune system, in order to stimulate its functioning or inhibit, Tacrolimus is not a cancer treatment drug . In its different forms (ointment, capsule, injection) it is used mainly in two cases: prevention of transplant organ rejection and atopic dermatitis .

Tacrolimo serve to treat Vitiligo?

-Yeah . Studies show that Tacrolimus has achieved success of up to 75% with regard to the repigmentation of the dermis in cases of Vitiligo . However, these same studies reinforce that by using Tacrolimo ointment together with other treatments, more success can be achieved.

However, it is worth noting that there are no indications in the package insert for this use. Thus, medical follow-up is essential in order to provide a safe treatment for your clinical case.

How does Tacrolimus work?

Tacrolimus acts directly on the cells of the immune system. It can act as an immunosuppressant or immunomodulator, differing in relation to its use.

When used in the form of an ointment, it acts as an immunomodulator . That is, it adjusts (or, as the name suggests, “models”) the action of the immune system locally, directly in the affected area. This adjustment can be both to reduce and to stimulate the body’s action.

When used in capsule or injection form, Tacrolimus acts as an immunosuppressant, reducing immune responses in general. This is necessary to prevent the transplanted organ from being rejected.

How to use Prograf?

Currently, Prograf is marketed in a capsule and injectable version. Next, we will explain how to administer the drug in each of its forms. Check out:


It is always important to remember that any medication must have medical advice, which must be followed completely. In case of doubt, consult your doctor.

The directions for use are that the Prograf capsule is taken twice a day, 12 hours apart, orally.

To achieve maximum absorption of the medicine, it is recommended that it be ingested with liquid (preferably water) and on an empty stomach or, at least, 1 hour before the meal or 2/3 hours after.


Prograf can also be administered by injection. The application and preparation must always be carried out by a specialized professional.

In general, the use of the injectable medicine is recommended only for patients who cannot use the capsules. In addition, Prograf is always applied by intravenous infusion.

If the patient begins to tolerate oral medication, it is recommended to change immediately – excluding the injection. This is because the package insert highlights that the intravenous medication can not continue for more than 7 days.

As with the medicine administered in capsules, it is always necessary to follow medical advice regarding its use.

What are the side effects of Prograf?

Like any medicine, Prograf also has possible side effects due to its use. There are different cases, so it may be that no effect is manifested or until you have more than one of them.

Thus, it is essential to carry out medical monitoring. It is worth mentioning that, in the case of Prograf, the use of a capsule or injection does not alter the side effects – they are the same for both.

See below the list of possible adverse reactions caused by the drug:

Very common

The very common side effects are those that manifest in more than 10% of patients who use Prograf:

  • High blood glucose;
  • Insulin dependent and non-insulin dependent diabetes mellitus ;
  • High level of potassium in the blood;
  • Difficulty sleeping ;
  • Tremor and headache;
  • High blood pressure;
  • Abnormal liver function tests;
  • Diarrhea, nausea;
  • Kidney problems.


Common effects can also manifest, that is, those that occur between 1% and 10% of cases:

  • Change in the count of blood cells in the blood;
  • Reduced level of magnesium, phosphate, potassium, calcium or sodium in the blood – causing excessive fluid consumption;
  • Reduced appetite and uric acid;
  • Symptoms of anxiety, depression, hallucinations, changes in mood, nightmares, mental disorders, confusion and disorientation;
  • Attacks, disturbances in consciousness, tingling and numbness (sometimes painful) in the hands and feet, dizziness, impaired writing ability, nervous system disorders;
  • Blurred vision and high sensitivity to light;
  • Ringing in the ears;
  • Faster heartbeat – caused by reduced blood flow in the heart’s vessels;
  • Bleeding, partial (or complete) blockage of blood vessels – causing low blood pressure;
  • Disorders of the lung’s respiratory tissues, accumulation of fluids around the lung, inflammation of the pharynx, cough, flu-like symptoms;
  • Stomach problems (inflammation or ulcer) – causing abdominal pain or diarrhea – bleeding from the stomach, inflammation or ulcer in the mouth, accumulation of fluids in the abdomen, vomiting, constipation, gas or bloating;
  • Bile duct disorders, yellowing of the skin due to liver problems and inflammation in the liver;
  • Itching, rash, hair loss, acne or high sweating;
  • Joint pain, cramps or muscle spasms;
  • Insufficient renal production – causing reduced urine production – impaired or painful urination;
  • General weakness, fever, accumulation of fluids in the body, pain and discomfort, increased alkaline phosphatase enzyme in the blood, weight gain and sensation of unregulated temperature;
  • Insufficient function of the transplanted organ;
  • Disturbed perception of body temperature.

Uncommon, rare and very rare

In addition, complications called “Uncommon”, “Rare” and “Very rare” can also occur, due to their low incidence (affecting a maximum of 1% of patients).

To find out what these reactions are, you can choose to read the package leaflet or consult a doctor to answer any questions you may have about it.

Prograf Price

The price * of Prograf varies according to its version and milligram:

  • Prograf Capsule : the price is between R $ 379 (1mg) and R $ 3,000 (5mg) per box;
  • Prograf XL : the price is between R $ 650 (1mg) and R $ 3,300 (5mg) per box;
  • Injectable Prograf : the price can reach almost R $ 7,000 a box with 10 ampoules (1mL each).

* Prices consulted in January 2020. Prices may change.

Is Prograf generic?

-Yeah . The medicine Prograf has generic versions and, in addition to them, it also has similar versions. Check out:

  • Tacrolimo Germed Pharma (genérico);
  • Tacrolimo Lifal (generic);
  • Tacrolimus FURP (generic);
  • Tacrolimus EMS (generic);
  • Tacrolimo Fiocruz (generic);
  • Tacrolimo Legrand (generic);
  • Tacrofort (similar interchangeable);
  • Tarfic (similar interchangeable);
  • Tacrolil (similar interchangeable).

Does SUS supply the substance Tacrolimus?

-Yeah . Tacrolimo is present in the List of Essential Medicines (RENAME) of 2020. Therefore, it must be provided by the Unified Health System (SUS).

In all cases, it is only possible to access the medicine with a medical indication.

How to make a budget?

In situations of non-availability of the drug via SUS, patients with a medical report can make a judicial request to receive the medicine through the Unified Health System or Health Plan – if applicable.

For this, it is necessary to open a process according to the stipulated requests. Among them is the delivery of documents that include:

  • Medical report;
  • Exams;
  • Standard requirement;
  • Budget of 3 pharmacies .

In such cases, it is possible to count on the assistance of a high-cost medication quotation advisory, which provides a personalized quote in an easy way.

When accessing the link , you must complete your registration, stating some personal data and the medication in question. At the end, just click on “request quotes” and wait for the return.

Organ transplantation is a reality. Therefore, drugs like Prograf are very important in the lives of thousands of patients, since they prevent rejection of the transplanted organ.

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