Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Tacrolimus
Drug ID BADD_D02105
Description Tacrolimus (also FK-506 or Fujimycin) is an immunosuppressive drug whose main use is after organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It is also used in a topical preparation in the treatment of severe atopic dermatitis, severe refractory uveitis after bone marrow transplants, and the skin condition vitiligo. It was discovered in 1984 from the fermentation broth of a Japanese soil sample that contained the bacteria Streptomyces tsukubaensis. Tacrolimus is chemically known as a macrolide. It reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP-12 (FK506 binding protein) creating a new complex. This FKBP12-FK506 complex inhibits calcineurin which inhibits T-lymphocyte signal transduction and IL-2 transcription.
Indications and Usage For use after allogenic organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It was first approved by the FDA in 1994 for use in liver transplantation, this has been extended to include kidney, heart, small bowel, pancreas, lung, trachea, skin, cornea, and limb transplants. It has also been used in a topical preparation in the treatment of severe atopic dermatitis.
Marketing Status Prescription; Discontinued
ATC Code D11AH01; L04AD02
DrugBank ID DB00864
KEGG ID D00107
MeSH ID D016559
PubChem ID 445643
TTD Drug ID D06OMK
NDC Product Code 16729-041; 0781-2104; 70748-219; 52972-0040; 0168-0416; 70748-220; 70377-014; 16729-043; 43353-317; 68254-0002; 49629-022; 0469-1330; 68084-450; 49629-020; 70518-3022; 68462-534; 69452-153; 55111-527; 55111-525; 47848-018; 16714-098; 65897-1010; 38779-2698; 62250-665; 68084-449; 52928-006; 0904-6623; 50222-211; 49629-021; 68992-3075; 45802-700; 43817-423; 63629-8726; 70748-221; 68254-5005; 68462-685; 0781-2103; 69452-154; 50090-2245; 69452-155; 0469-3016; 54288-135; 0904-7097; 0904-6425; 68254-0020; 0378-2047; 73377-010; 60429-378; 50090-5596; 65050-0321; 50222-203; 0781-2102; 16729-042; 68084-451; 0168-0417; 0378-2045; 63629-8725; 0904-6624; 55154-4080; 55486-1576; 45802-390; 51927-0092; 0469-0607; 68308-703; 68254-5004; 60429-377; 68462-686; 64380-721; 0469-0617; 0378-2046; 62991-3072; 67877-278; 43817-421; 64380-720; 51079-028; 64380-722; 70518-3216; 51079-818; 68254-2502; 51187-0006; 55111-526; 70377-015; 70518-2996; 67877-279; 0469-1230; 68254-5006; 65727-009; 0469-0657; 70377-016; 70518-2593; 16729-422; 51079-817; 60429-379; 16729-421; 68992-3040; 16714-100; 70518-2124; 63629-8723; 72572-761; 67877-280; 55500-0010; 50090-5581; 68992-3010; 51552-1403; 72572-760; 16714-099; 68462-687; 82160-124; 70518-3388; 43817-422; 52076-6222
Synonyms Tacrolimus | Prograf | Prograft | FR-900506 | FR 900506 | FR900506 | Anhydrous Tacrolimus | Tacrolimus, Anhydrous | Tacrolimus Anhydrous | Anhydrous, Tacrolimus | FK-506 | FK 506 | FK506
Chemical Information
Molecular Formula C44H69NO12
CAS Registry Number 104987-11-3
SMILES CC1CC(C2C(CC(C(O2)(C(=O)C(=O)N3CCCCC3C(=O)OC(C(C(CC(=O)C(C=C(C1)C)CC=C)O)C)C(=CC 4CCC(C(C4)OC)O)C)O)C)OC)OC
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Nephropathy toxicCalcineurin subunit B type 1P63098Not Available8591053; 7694398; 7592869; 7533090
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Cardiovascular disorder24.03.02.009; 02.01.01.001--Not Available
Carpal tunnel syndrome17.09.02.001--Not Available
Cataract06.06.01.001--
Cellulitis23.09.01.001; 11.02.01.001--Not Available
Cerebellar ataxia17.02.02.013; 08.01.02.0060.002129%Not Available
Cerebellar atrophy17.11.01.0080.001419%Not Available
Cerebellar syndrome17.02.02.0020.001419%Not Available
Cerebral haemorrhage24.07.04.001; 17.08.01.003--Not Available
Cerebral infarction24.04.06.002; 17.08.01.004--Not Available
Cerebral ischaemia24.04.06.003; 17.08.01.0050.002129%
Cerebral palsy17.19.03.002; 03.10.03.002; 18.04.04.0040.002839%Not Available
Cerebrovascular accident24.03.05.001; 17.08.01.007--
Cerebrovascular disorder24.03.05.002; 17.08.02.0020.000555%Not Available
Cervical dysplasia21.06.01.0020.001419%Not Available
Cheilitis23.03.03.025; 07.05.01.0010.001419%
Chest discomfort22.02.08.001; 02.02.02.009; 08.01.08.019--Not Available
Chest pain22.02.08.003; 08.01.08.002; 02.02.02.011--Not Available
Chest X-ray abnormal13.19.02.0010.002129%Not Available
Chills08.01.09.001; 15.05.03.016--
Cholangitis09.02.01.0020.011355%Not Available
Cholangitis sclerosing10.04.09.002; 09.02.01.0030.000741%Not Available
Cholecystitis09.03.01.0010.005678%
Cholecystitis acute09.03.01.0030.001419%Not Available
Cholecystitis chronic09.03.01.0040.002129%Not Available
Cholelithiasis09.03.01.0020.007807%Not Available
Cholestasis09.01.01.0010.022710%Not Available
Chronic myeloid leukaemia16.01.07.001; 01.10.07.0010.000555%Not Available
Chronic obstructive pulmonary disease22.03.01.007--Not Available
Cirrhosis alcoholic09.01.04.005--Not Available
Clostridium difficile colitis11.02.02.004; 07.19.01.0040.011355%Not Available
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