Tacrolimus
What is it?
Tacrolimus is known as an immunosuppressant as it dampens the immune response. It is taken in tablet form to prevent organ rejection in people who have received a transplant. It is also available as an ointment that is applied to the skin to treat eczema and psoriasis. Brand names include: Envarsus, Adoport, Prograf, Advagraf, Dailiport, Modigraf, and Protopic,
Benefits
What are the benefits of using tacrolimus in pregnancy?
Tacrolimus helps to stop your body rejecting a transplanted organ. When used in ointment form, it can improve symptoms in women with eczema and psoriasis.
Risks
What are the risks of using tacrolimus in pregnancy?
There are no known risks of using tacrolimus ointment in pregnancy.
Only a small number of pregnant women taking tacrolimus tablets have been studied but the available information does not raise concern that its use causes problems. Ongoing research is ideally required.
Alternatives
Are there any alternatives to using tacrolimus in pregnancy?
Yes, other medicines can also be used in pregnancy to prevent rejection of a transplanted organ or to treat eczema and psoriasis, but if tacrolimus was working well before pregnancy, a woman may be advised by her doctor to continue taking it.
Women who accidentally conceive while taking tacrolimus should arrange to see their doctor or specialist to ensure that tacrolimus is still the best treatment and to make sure the dose is correct.
No treatment
What if I prefer not to take tacrolimus during pregnancy?
To stop organ rejection after a transplant it is very important to continue taking tacrolimus or a similar immunosuppressant. Some women with severe skin conditions may also need to continue treatment during pregnancy. Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.
Please do not stop tacrolimus without speaking to your midwife, GP or specialist.
Will I or my baby need extra monitoring?
As part of routine antenatal care, most women will be offered a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No additional monitoring is required due to taking tacrolimus in pregnancy, although transplant recipients are likely to be offered additional blood tests and monitoring of the baby’s wellbeing.
Are there any risks to my baby if the father has used tacrolimus?
There is currently no evidence that tacrolimus used by the father can harm the baby through effects on the sperm.
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.