Fujigraf 2mg Capsule (Tacrolimus): Complete Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Fever, chills, or other signs of infection
- Decreased urine output or swelling in the legs
- Severe headache, confusion, seizures, or visual changes
- Chest pain, shortness of breath, or irregular heartbeat
- Severe abdominal pain, especially radiating to the back
- Unusual bleeding or bruising
- Yellowing of the skin or eyes (jaundice)
- Severe rash or swelling of the face, lips, or throat
If experiencing severe symptoms, call emergency services immediately.
What is nephrolimus 2mg capsule used for?
This medicine contains tacrolimus, an immunosuppressant used to prevent organ rejection after transplant. It works by blocking T-cell activation. It must be taken exactly as prescribed, with regular blood tests to monitor levels and organ function.
- Generic Name: Tacrolimus (2mg)
- Manufacturer: Nephrostar Healthcare Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 nephrolimus 2mg capsule के बारे में (Hindi Summary)
उपयोग: यह दवा टैक्रोलिमस नामक एक इम्यूनोसप्रेसेंट है, जिसका उपयोग अंग प्रत्यारोपण के बाद अंग को अस्वीकार होने से बचाने के लिए किया जाता है। यह शरीर की प्रतिरक्षा प्रणाली को दबाकर काम करती है। यह कैप्सूल मुँह से ली जाती है। इसका उपयोग कुछ ऑटोइम्यून बीमारियों में भी किया जा सकता है।
साइड इफेक्ट्स: आम दुष्प्रभावों में सिरदर्द, कंपन, दस्त, मतली, उच्च रक्तचाप और बढ़ा हुआ रक्त शर्करा शामिल हैं। गंभीर दुष्प्रभावों में गुर्दे की क्षति, गंभीर संक्रमण और दुर्लभ मस्तिष्क स्थिति शामिल हैं। किसी भी असामान्य लक्षण की तुरंत रिपोर्ट करें।
सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। इसे अचानक बंद न करें। संक्रमण से बचने के लिए सावधानी बरतें। नियमित रक्त परीक्षण कराएं। टीकों के बारे में डॉक्टर से पूछें।
💊 nephrolimus 2mg capsule Uses & Benefits
- [{"condition":"Prophylaxis of organ rejection in kidney transplant","description":"Used to prevent rejection of a transplanted kidney.
- It is often part of a combination regimen with other immunosuppressants.","evidence":"Well-established"},{"condition":"Prophylaxis of organ rejection in liver transplant","description":"Used to prevent rejection of a transplanted liver.
- It is a standard part of immunosuppressive therapy.","evidence":"Well-established"},{"condition":"Prophylaxis of organ rejection in heart transplant","description":"Used to prevent rejection of a transplanted heart.
- It is used in combination with other medicines.","evidence":"Well-established"},{"condition":"Prophylaxis of organ rejection in lung transplant","description":"Used to prevent rejection of a transplanted lung.
- It is part of standard immunosuppressive protocols.","evidence":"Well-established"},{"condition":"Atopic dermatitis (eczema)","description":"Topical tacrolimus is used for moderate to severe atopic dermatitis when other treatments are not effective.
- This capsule form is not for topical use.","evidence":"Well-established for topical form"}]
Off-label uses: [{"condition":"Uveitis","description":"Sometimes used off-label for severe uveitis that has not responded to other treatments.","evidence":"Limited"},{"condition":"Myasthenia gravis","description":"Occasionally used off-label as a steroid-sparing agent in myasthenia gravis.","evidence":"Limited"},{"condition":"Nephrotic syndrome","description":"May be used off-label in some cases of nephrotic syndrome, especially in children.","evidence":"Limited"}]
Primary treatment for: Organ transplant rejection prophylaxis
Also treats: Atopic dermatitis (topical form), Uveitis, Myasthenia gravis, Nephrotic syndrome
📋 Drug Information
| Generic Name(s) | Tacrolimus (2mg) |
| Brand Name | nephrolimus 2mg capsule |
| Manufacturer | Nephrostar Healthcare Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | ANTI NEOPLASTICS |
| Action Class | Immunosuppressant- Calcineurin inhibitors |
| Route of Administration | Oral |
| Storage | Store at room temperature between 20°C and 25°C (68°F to 77°F). Keep in the original container. Protect from light and moisture. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
Tacrolimus binds to the immunophilin FKBP-12, forming a complex that inhibits calcineurin, a phosphatase required for T-cell activation. This inhibition prevents the transcription of interleukin-2 and other cytokines, thereby suppressing T-lymphocyte proliferation and the immune response against the transplanted organ.
Mechanism Steps
💡 How to Take nephrolimus 2mg capsule
Strength: Tacrolimus 2 mg immediate-release capsule
Dosage Information
| Adult Dosage | The dose of this medicine must be individualized by a qualified clinician based on the type of transplant, patient's weight, renal and hepatic function, and concomitant medications. It is usually taken twice daily, approximately 12 hours apart, on an empty stomach. Blood levels are monitored to adjust the dose. Do not change the dose without consulting your doctor. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients may be more susceptible to the side effects of tacrolimus, especially nephrotoxicity and neurotoxicity. Dose selection should be cautious, and renal function should be monitored closely. |
| Renal Impairment | Tacrolimus is primarily metabolized by the liver, so renal impairment does not significantly affect its clearance. However, because tacrolimus can cause nephrotoxicity, renal function should be monitored closely, and dose adjustments may be necessary. |
| Hepatic Impairment | In patients with hepatic impairment, the clearance of tacrolimus is reduced, leading to increased blood levels. Dose reduction and close monitoring of tacrolimus levels are recommended. |
| Maximum Daily Dose | The maximum daily dose is individualized based on blood levels and clinical response. Do not exceed the dose prescribed by your doctor. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of nephrolimus 2mg capsule
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Ketoconazole | Major | |
| Erythromycin | Major | |
| Rifampin | Major | |
| St. John's wort | Major | |
| Grapefruit juice | Major | |
| Diltiazem | Moderate | |
| Fluconazole | Moderate | |
| Clarithromycin | Moderate | |
| Antacids | Minor | |
| Cimetidine | Minor |
🚨 Major Interactions
- Ketoconazole
- Erythromycin
- Rifampin
- St. John's wort
- Grapefruit juice
⚡ Moderate Interactions
- Calcium channel blockers (e.g., diltiazem, verapamil)
- Antifungals (e.g., fluconazole, itraconazole)
- Macrolide antibiotics (e.g., clarithromycin)
🍷 Alcohol Interaction
Alcohol may increase the risk of liver toxicity and can affect tacrolimus levels. It is advisable to avoid alcohol while taking this medicine.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Hypersensitivity to tacrolimus or any component of the formulation","Concomitant use with live vaccines","Severe hepatic impairment","Pregnancy (relative contraindication; use only if benefit outweighs risk)"]
⚠️ Warnings & Precautions
["Increased risk of serious infections due to immunosuppression.","Increased risk of lymphoma and other malignancies.","Nephrotoxicity: monitor kidney function regularly.","Neurotoxicity: may cause tremor, headache, seizures, and PRES.","Hyperkalemia: monitor potassium levels.","Hypertension: monitor blood pressure.","Hyperglycemia: monitor blood glucose.","Avoid live vaccines during therapy.","Avoid grapefruit juice and St. John's wort.","Use with caution in patients with hepatic impairment."]
🤱 Lactation Safety
Tacrolimus is excreted in human breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
💊 Overdose Management
There is no specific antidote for tacrolimus overdose. Treatment should be symptomatic and supportive. Monitor vital signs and clinical status. Due to the potential for delayed toxicity, patients should be observed for several days. Hemodialysis is not effective in removing tacrolimus from the bloodstream.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Additional Safety Advice
Take this medicine exactly as prescribed, at the same times each day. Do not stop taking it suddenly, as this can lead to organ rejection. Avoid contact with people who have contagious infections. Wash your hands frequently. Do not receive live vaccines while taking this medicine. Keep all scheduled blood tests to monitor drug levels and organ function. Inform all your healthcare providers that you are taking this medicine.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients may be more susceptible to the side effects of tacrolimus, especially kidney and neurological effects. Close monitoring of renal function and drug levels is recommended.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before conception. Tacrolimus may harm the unborn baby. Effective contraception should be used during treatment. Your doctor will weigh the benefits and risks of continuing the medicine during pregnancy.
🏥 Post-Surgery Considerations
After surgery, this medicine is often started to prevent organ rejection. It may also be used in other surgeries requiring immunosuppression. Follow your surgeon's instructions carefully.
🦷 Dental Procedures
Inform your dentist that you are taking this medicine, as it can increase the risk of infections and bleeding. You may need antibiotics before dental procedures. Good oral hygiene is important.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Regular exercise is encouraged, but avoid activities that could cause trauma or injury, especially contact sports. Consult your doctor before starting any new exercise program.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause tremors, headache, or fatigue, which can affect your ability to drive or operate machinery. Avoid driving or operating heavy machinery until you know how this medicine affects you. Discuss any work-related concerns with your doctor.
🛑 When to Stop This Medicine
Do not stop taking this medicine without consulting your transplant doctor. Stopping suddenly can lead to organ rejection. Your doctor will determine if and when it is safe to discontinue.
📅 Long-Term Use Effects
Long-term use of this medicine is usually necessary to prevent organ rejection. It increases the risk of infections, kidney damage, and certain cancers. Regular monitoring of kidney function, blood levels, and overall health is essential. Do not stop the medicine without consulting your doctor.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Another calcineurin inhibitor used for immunosuppression after transplant.
Evidence: Well-establishedAn antimetabolite used in combination with other immunosuppressants.
Evidence: Well-establishedAn mTOR inhibitor used as an alternative or in combination.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
Live vaccines should be avoided while taking this medicine due to the risk of infection. Inactivated vaccines may be given, but the immune response may be reduced. Consult your doctor before any vaccination.
📦 Storage Guide
✅ DO
Store at room temperature (20-25°C)
❌ DON'T
Do not refrigerate
✅ DO
Keep in the original container
❌ DON'T
Do not transfer to another container
✅ DO
Keep away from direct sunlight and moisture
❌ DON'T
Do not store in the bathroom
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid loss or temperature extremes. If crossing time zones, consult your doctor about adjusting the dosing schedule. Ensure you have enough supply for the entire trip. Check customs regulations for carrying prescription medications.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: The immunosuppressive effects take several days to weeks to fully develop. Blood levels are monitored to ensure the dose is adequate.
A: It is best taken on an empty stomach, at least 1 hour before or 2 hours after a meal, to ensure consistent absorption.
A: Avoid grapefruit juice, St. John's wort, and live vaccines. Also avoid close contact with people who have infections.
A: If you miss a dose, take it as soon as you remember if less than 6 hours have passed. If more than 6 hours, skip it and continue with your regular schedule. Do not double dose.
A: Tacrolimus is Pregnancy Category C. It should be used during pregnancy only if the benefit outweighs the risk. Use effective contraception while taking it.
🤔 Common Patient Concerns
🔄 Substitutes for nephrolimus 2mg capsule
View AllAlternative brands with exact same active ingredient:
-
loprolif 2mg capsuleEast West Pharma ₹604.69 16.2% CHEAPER
-
Tacrotaj 2mg CapsuleTaj Pharma India Ltd ₹608.44 15.7% CHEAPER
-
procept 2mg capsuleEntero Healthcare Solutions Pvt Ltd ₹670.00 7.2% CHEAPER
-
tacrorite 2mg capsuleCelera Healthcare Pvt. Ltd. ₹678.75 6% CHEAPER
-
imunotac 2mg capsuleRPG Life Sciences Ltd ₹724.35 0.3% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: Tacrolimus can be stopped once the transplant is stable.
Fact: Tacrolimus is usually required lifelong to prevent rejection. Stopping it can lead to organ loss. - Myth: Tacrolimus is safe to take with any other medication.
Fact: Tacrolimus interacts with many drugs. Always check with your doctor or pharmacist before taking any new medicine. - Myth: You can take tacrolimus with grapefruit juice.
Fact: Grapefruit juice can increase tacrolimus levels and cause toxicity. Avoid it.
🔄 Alternative Options
Generic Alternatives
- Tacrolimus 2 mg capsule (generic)
Brand Alternatives
- Fujigraf 2mg capsule