Tacrolimus

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Date: July 2025, Version 4.0

Quick read

Tacrolimus can be used in pregnancy if recommended by a specialist.

What is it?

Tacrolimus (Envarsus®, Adoport®, Prograf®, Advagraf®, Dailiport®, Modigraf®, Protopic®) lowers the immune response. It is most commonly used in tablet form after an organ transplant to prevent rejection. Tacrolimus ointment is used to treat eczema and psoriasis.

Benefits

What are the benefits of taking tacrolimus in pregnancy?

Tacrolimus reduces the chance of organ rejection in people with an organ transplant. Rejection can be life-threatening and can lead to pregnancy complications.

Tacrolimus ointment can improve quality of life by controlling the symptoms of eczema and psoriasis.

Risks

Are there any risks of taking tacrolimus during pregnancy?

Only a small number of pregnant women taking tacrolimus tablets have been studied. While no obvious problems have been noted, more women need to be studied to rule out any ill-effects. 

There are no studies of pregnant women using tacrolimus ointment. In general, treatments applied to the skin are thought to be unlikely to reach your baby in amounts that could cause harm.

Alternatives

Are there any alternatives to taking tacrolimus?

Possibly. If you are taking tacrolimus and planning a pregnancy or find out you are pregnant, you should speak to your doctor to see if you need to switch to a different medicine. For some women, continuing tacrolimus in pregnancy may be necessary to prevent the rejection of a transplanted organ or to control eczema or psoriasis.

No treatment

What if I prefer not to take medicines during pregnancy?

It is very important to take any medicines prescribed to prevent organ rejection. Not having the correct treatment can be dangerous to you and can also lead to pregnancy complications. 

Severe eczema and psoriasis can affect your sleep, quality of life, and mental health. It is important to keep these conditions well-controlled in pregnancy to ensure your wellbeing.

Your doctor will only prescribe medicines when necessary and will be happy to talk through any concerns. 

Do not stop tacrolimus without speaking to your midwife, GP or specialist.

Will my baby need extra monitoring?

Women in the UK will be offered a very detailed scan at around 20 weeks of pregnancy as part of routine antenatal care. No additional monitoring is required due to taking tacrolimus in pregnancy, although if you’ve had a transplant, you are likely to be offered additional blood tests and monitoring of your baby’s wellbeing.

Are there any risks to my baby if the father has taken tacrolimus?

We do not expect any increased risk to your baby if the father takes tacrolimus.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.