Prograf and Nephrotic Syndrome

Prograf for Nephrotic Syndrome

Prograf is an immunosuppressant medication approved to prevent organ rejection in people who have received a kidney, liver, or heart transplant. It is sometimes used "off-label" for the treatment of nephrotic syndrome.
Off-label use is when a drug is used in a way that has not been officially approved by the United States Food and Drug Administration (FDA). It is also sometimes called an "unapproved" or "nonapproved" use. Off-label use is legal, and many medicines are used appropriately and safely for off-label purposes.
Prograf has been studied for the treatment of nephrotic syndrome in adults and children. In one study, Prograf was shown to be more effective than a placebo (a "sugar pill" that does not contain any active ingredients) in adults with membranous nephropathy. Specifically, 82 percent of people who were taking Prograf had little or no nephrotic symptoms (were in remission) after 12 months, compared with 24 percent of people taking the placebo.
Prograf has been shown to work as well as cyclosporine (Gengraf®, Neoral®, Sandimmune®), another immunosuppressant medication, in children with nephrotic syndrome. In this study, 86 percent of children who were taking Prograf went into remission, compared with 80 percent of those who were taking cyclosporine. In addition, children who were using Prograf were less likely to experience a return of their symptoms (called a relapse).

What to Expect From Prograf Use

Prograf is normally taken by mouth twice a day. Doses need to be taken 12 hours apart to help maintain an even level of the drug in the bloodstream. You can take your doses with or without food; however, it is important to take the medicine exactly the same way (either with or without food) each day.
You may experience side effects while taking Prograf. Some of the more common, bothersome side effects include but are not limited to:
Prograf is associated with potentially serious side effects as well, including kidney problems. Kidney problems are more likely to occur with high doses. Therefore, your healthcare provider will monitor your kidney function and your Prograf blood levels. Your blood levels will need to be high enough for the medicine to work, but not so high that it causes kidney damage.
Your healthcare provider will also monitor you for other possible Prograf side effects, such as high blood pressure, diabetes, and blood cell problems (including anemia). Make sure to keep all of your appointments with your healthcare provider and laboratory. You will need to follow specific instructions for how to take your medicine before your lab visits.
Because Prograf suppresses the immune system, you may be more susceptible to infections. This medicine can also increase your risk for certain types of cancer, especially skin cancer and lymphoma (cancer of the lymph nodes). It is important to contact your healthcare provider if you experience symptoms of an infection, notice any skin changes, or develop lumps in your neck, underarms, or groin area.
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