Date: September 2021, Version 3

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,


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.


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.


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.

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.