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Tacrolimus is known to suppress the immune system, which may heighten your susceptibility to infections and certain cancers, including skin cancer and lymphoma. To minimize the risk of these serious side effects, use this medication at the lowest dose that is effective, following your doctor's instructions. It is important to attend all scheduled medical and laboratory appointments.

Please contact your doctor immediately if you experience any of the following symptoms:

• Unusual changes in your skin
• Alterations in the appearance or size of moles
• Unusual growths or lumps
• Swollen lymph nodes
• Night sweats
• Unexplained weight loss
• Signs of infection, such as a persistent sore throat or fever

You might experience some common side effects such as shaking, headache, diarrhea, nausea, vomiting, upset stomach, loss of appetite, trouble sleeping, or tingling sensations in your hands and feet. These are generally mild, but if they persist or worsen, it's important to inform your healthcare provider.

More serious side effects require prompt attention. These include mood changes, dizziness, signs of kidney issues like reduced urine output, a fast or pounding heartbeat, symptoms of heart failure such as breathlessness, swelling in your lower limbs, fatigue, or sudden weight gain. Hearing problems, unusual bruising or bleeding, muscle pain or weakness, and signs of liver problems like persistent nausea, yellowing skin or eyes, dark urine, or severe abdominal pain also need immediate medical consultation.

There is a rare risk of developing a serious brain infection known as progressive multifocal leukoencephalopathy (PML). Symptoms to watch for include clumsiness, loss of coordination, weakness, confusion, difficulty concentrating, speech problems, seizures, and vision changes. Seek medical help immediately if these occur.

Additionally, be vigilant for severe side effects such as fainting, irregular heartbeat, severe dizziness, chest pain, black stools, or vomit resembling coffee grounds. This medication can also elevate blood pressure, so regular monitoring is advised. If you notice elevated readings, discuss them with your healthcare provider, who may adjust your treatment.

Tacrolimus may increase the risk of diabetes. Symptoms like increased thirst, hunger, or frequent urination should be reported to your healthcare provider. Though rare, serious allergic reactions can occur, characterized by rash, swelling, severe dizziness, or breathing difficulties. Seek emergency medical help if these happen.

This summary does not cover all possible side effects. If you experience any unusual symptoms not mentioned, consult your healthcare provider promptly.

Certain medications can interact with this drug. These include antacids containing aluminum or magnesium, Cyclosporine, Sirolimus, temsirolimus, and Ziprasidone. Additionally, drugs that may increase potassium levels, like specific diuretics such as Amiloride and Spironolactone, or those that suppress the immune system and raise infection risk, such as natalizumab and rituximab, can also interact.

Furthermore, some medications may influence how tacrolimus is processed in your body, potentially impacting its effectiveness. These include azole antifungals like Itraconazole and Voriconazole, Cimetidine, Danazol, Ethinyl Estradiol, Methylprednisolone, Nefazodone, HIV protease inhibitors such as nelfinavir, rifamycins like Rifampin and Rifabutin, Ritonavir, St. John's wort, and certain anti-seizure medications like Phenobarbital and Phenytoin.