The prices in Internet drugstores:
from 1600 rub.
Advagraf – highly active immunodepressive medicine; inhibitor of a kaltsinevrin.
Dosage form of drug – the capsule of the prolonged action: gelatinous firm, filled with white powder (on 10 pieces in blisters from PVC / aluminum foil, in the aluminum soldered package on 5 blisters, 1 package in a cardboard pack):
1 capsule of the prolonged action contains:
Advagraf is shown to use for adult patients for the prevention of rejection of allotransplant of a kidney or a liver and for therapy of rejection of allotransplant, resistant to the standard modes of immunosuppressive therapy.
As safety of use of a takrolimus at pregnancy is not established adequately, therapy by drug during this period is allowed only in the absence of safer alternative way of treatment, and only in case of considerable exceeding of advantage for mother over potential risk for a fruit.
According to clinical observations такролимус gets into breast milk thereof for the period of therapy by Advagraf breastfeeding should be interrupted.
At heavy hepatic dysfunction, perhaps, reduction of a dose of drug will be required.
At a renal failure there is no need of correction of doses of a takrolimus, but because of its nephrotoxic potential it is recommended to control carefully function of kidneys – concentration of serumal creatinine, the clearance of creatinine (CC) and amount of the emitted urine.
Capsules of the prolonged action Advagraf accept inside right after extraction from the blister, entirely, washing down with liquid (preferably water). The daily dose is recommended to be taken for 1 time, in the morning, on an empty stomach – for 1 h to food or in 2-3 h after meal (for achievement of the maximum absorption of a takrolimus). The passed dose is accepted as soon as possible, it is desirable on the same day, it is not necessary to accept a double dose the next morning.
It is necessary to warn patients about existence in packaging of a bag of silica gel for moisture absorption which is not intended for the use.
Reception duration Advagrafa is not limited as the condition of immunosuppression for prevention of graft rejection needs to be supported constantly.
The recommended dosing mode (1 time a day, in the mornings):
For stopping of graft rejection increase in a dose of a takrolimus, short courses of therapy by antibodies (моно-/polyclonal), therapy strengthening by glucocorticosteroids is recommended; in case of signs of toxicity of a takrolimus (the expressed undesirable side effects) Advagraf dose decline can be required.
Eventually after transplantation of a liver or a kidney of a dose of drug usually reduce, also transition to monotherapy with cancellation of the accompanying immunodepressants is possible. With improvement of a condition of the patient the pharmacokinetics of a takrolimus can change that demands additional correction of doses.
At the choice of doses of drug it is necessary to consider clinical assessment of individual portability of drug and probability of graft rejection, and also data of monitoring of concentration in blood of a takrolimus. In most cases, according to clinical trials, therapy is successful if this indicator ≥ 20 ng/ml.
Therapeutic concentration in blood of a takrolimus at the initial stage:
Correction of doses for achievement of equal minimum concentration of a takrolimus at separate categories of patients:
Careful control at therapy by Advagraf from medical personnel of the corresponding qualification is required and existence of the necessary equipment. Drug can be appointed only by the doctor having experience of performing immunosuppressive therapy at patients with transplanted organs.
In case of clinical signs of rejection the question of need of correction of dosing of immunosuppressive therapy has to be considered.
Precisely it is difficult to establish a profile of undesirable reactions of immunodepressants because of features of a basic disease and large amount of the medicines used after organ transplantation.
Most often (> 10%) the following side effects are noted: renal failure, tremor, hyperglycemia, diabetes mellitus, infections, hypertension, hyperpotassemia, sleeplessness.
At Advagraf's use in therapeutic doses the following side effects from bodies and systems are possible (distribution on frequency according to the following gradation: very often –> 1/10, it is frequent –> 1/100-<1/10, infrequently –> 1/1000-<1/100, is rare –> 1/10 000-<1/1000, is very rare – <1/10 000, uncertain frequency – there are not enough data for establishment):
Many undesirable reactions are reversible and/or decrease at reduction of a dose of a takrolimus.
Mistakes in appointment and delivery of drugs of a takrolimus, including accidental, unreasonable or uncontrolled substitutions of one dosage form with another were noted, and also the related cases of graft rejection were registered (data for frequency assessment insufficiently).
Without implementation of appropriate control transfer of patients from one drug of a takrolimus on another (including on capsules of the prolonged action from ordinary capsules) is unsafe. Graft rejection or increase in frequency of side effects (including hypo - or hyper immunosuppression) because of clinically significant distinctions in exposure of a takrolimus can be a consequence of it. Change of the mode of dosing or a dosage form is carried out only under control of the doctor-transplantologist. After transfer careful monitoring of concentration of a takrolimus is carried out to blood and the drug dose for maintenance of system exposure of substance at the adequate level is adjusted.
At first after transplantation it is required to carry out regular monitoring of the following parameters: ECG, arterial pressure, neurologic status, condition of sight, concentration of electrolytes (especially potassium), concentration of glucose on an empty stomach, indicators of function of kidneys and liver, hematologic indicators, koagulogramma, existence in plasma of proteins. In case of clinically significant changes it is recommended to carry out correction of immunosuppressive therapy.
At diarrhea perhaps considerable change of concentration of a takrolimus in blood therefore at the speeded-up defecation it is necessary to control this indicator carefully.
As ink for marking of capsules of Advagraf contains soy lecithin, with hypersensitivity to soy or a peanut it is important to patients to compare risk of an allergy with advantage of use of a takrolimus.
Takrolimus, especially in combination with ethanol, is capable to cause neurologic and visual frustration that should be considered when performing types of the works demanding the increased concentration of attention and speed of psychomotor reactions.
Test tubes, syringes and other equipment which is used at preparation of suspension from the powder which is contained in capsules Advagraf should not contain polyvinylchloride (PVC) as такролимус with it it is incompatible.
To store at a temperature up to 25 °C in original packaging. To protect from children.
Period of validity – 3 years. After opening of an aluminum package drug is stored 1 year.
Name of drug
Advagraf of 0,5 mg of n50 капс piece capsules 0,5mg 50
Advagraf of the capsule 1 of mg of 50 pieces
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