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Reading this I become a little confused on some items (aka I think this article could be clarified a little more than what it is at the moment). Since I'm not a medical professional (nor am I in the pharmacy profession) I'm coming to this article with just the knowledge of a 3 yr post transplant patient on this drug.
Anyway disregarding that I'll start at the introduction. I get the part where FK is introduced as both an immunosuppressent and then a topical cream but after the topical introduction "It has also been used after bone marrow transplants and for severe refractory uveitis." is somewhat thrown in there. Is the topical used after bone marrow transplants somehow, or is it used as an immunosuppressent in pill form? Same goes for the refractory uveitis. For the Contraindications and Precautions, is that for both the immunosuppressent or the topical or both? Additionally I notice it says "Black patients" (personal curiosity) under that heading, I'm curious as to why that is, it perhaps could be clarified in the article (I assume this has something to do with the topical cream and perhaps skin reactions?) Or does it even belong in there at all? I understand that a contraindication is a 'condition or factor that increases the risk involved in using a particular drug' but to include that with precautions just leaves me a bit confused, especially when seeing 'children' in there. Maybe I'm not reading that particular section right, but like I said I'm not in the medical field so..
Pretty much my last topic to hit in this section is the "Cancer risks" is this talking about the immunosuppressent or the topical or both (personally I've been warned that my skin cancer risks go up because I'm on this and a bunch of other immunosuppressents)? This doesn't really seem clear and the whole paragraph is vague at best until you get to the part about "UK dermatologists." So that's about it, I just thought I would throw that out there in case others come across this article and are as confused as I am. Although I must note that if I were to be looking for information on the medications that I take wikipedia would not be the first place I check, I just came across this article while bored and randomly typing in items to learn about. Anyway whoever clarifies this/answers these questions, thanks! -- ImmortalGoddezz 23:52, 10 August 2006 (UTC)
It would be very foolish to use this strong, possibly risky drug any more than absolutely necessary. Certainly not every day, without a damn good reason. - 69.87.204.151 01:28, 3 March 2007 (UTC)
I was sad to hear about the risk a couple years ago. I used this every day for my eczema and it was the wonder drug. Doctors couldn't find anything else that worked for me. Now that I haven't used it for a couple years, I am still suffering from constant scratching from the horrible itchiness. The more I scratch the itchier it gets.
Azn Clayjar
18:19, 12 April 2007 (UTC)
I think I'm going to soon edit the sentence that defines tacrolimus as a macrolide antibiotic. chemically, it is a macrolide but not an antibiotic (doesn't kill bacteria in anyway, nor is that it's aim, quite the contrary as a side effect usually).
I checked out the tacrolimus page recently since I personally have pretty severe eczema and had tried Protopic soon after it was approved for clinical use. I put a test amount on the inside of my elbows and immediately felt a hot, burning sensation. This was quickly followed by an intense, unusual headache that lasted for hours. I never used the stuff again.
It was pretty disappointing, especially since the failure meant it was back to the old steroids. (Tried pimecrolimus too, and it had no effects good or bad.) Of course drug reactions depend on the individual, but I was surprised to find the industry trials had only found headaches in ~20% of patients and they wrote it off as being comparable to controls. I refuse to write the headache off as a psychological effect because I had no idea what to expect. Who'd expect to get a headache from a topical cream? Wonder why it only happens in some people? Anyway-- just did a PubMed search to back up my edits.
As I understand it the cancer risk isn't super-high, and may be specific to the species of lab animals they tested it on. Wouldn't be enough to stop me from using Protopic if it actually worked without giving me a headache. Eczema's no fun and I'd trade a few years of my life for relief. Scerevisiae 15:49, 13 June 2007 (UTC)
Sorry to ask, but I'm terrible at adding references. Mine in particular is for tactrolimuses use in treating ulcerative colitis. If anyone would be so kind as to add this link as a reference to this use it would be greatly appreciated:
http://www.springerlink.com/content/g2kjwecu3dthb3l2/
I have some other sources for its use against UC if this one is not sufficient enough.
DO NOT USE PROTOPIC!! I AM SERIOUS!! http://www.washingtonpost.com/ac2/wp-dyn/A17568-2005Feb11?language=printer
instead, use vanos for strong eczema, cloderm for medium, and atopiclair (non-steroidal) for mild eczema. i have eczema too. also, use herb medicene if you want to cure it "safely." XU-engineer 13:40, 11 August 2007 (UTC)
From the first paragraph: "It is a 23-membered macrolide lactone discovered in 1984". From the second paragraph: "Tacrolimus was discovered in 1987 by a Japanese team". Neither of these assertions are sourced. (I have undergone two liver transplants, and tacrolimus/Prograf is my primary immunosuppressant.) Emptyshell 04:52, 3 October 2007 (UTC)
I, for one (in the UK), don't have 'severe atopic dermatitis', but I'm being treated with Tacrolimus.
Maybe the first paragraph should be changed to 'moderate to severe atopic dermatitis'?
Sam Dutton ( talk) 22:21, 28 February 2008 (UTC)
I believe the structure has the wrong stereochemistry and this is the correct structure
http://www.chemspider.com/Chemical-Structure.4976056.html
The name is: (3S,4R,5S,8R,9E,12S,14S,15R,16S,18R,19R,26aS)-5,19-dihydroxy-3-{(1E)-1-[(1S,3R,4R)-4-hydroxy-3-methoxycyclohexyl]prop-1-en-2-yl}-14,16-dimethoxy-4,10,12,18-tetramethyl-8-(prop-2-en-1-yl)-5,6,8,11,12,13,14,15,16,17,18,19,24,25,26,26a-hexadecahydro-3H-15,19-epoxypyrido[2,1-c][1,4]oxazacyclotricosine-1,7,20,21(4H,23H)-tetrone -- ChemSpiderMan ( talk) 00:41, 30 May 2008 (UTC)
3D or 2D molfile? I've got the 3D structure from the x-ray study - will this be the same?
Have emailed you.
Cheers
Ben ( talk) 00:04, 31 May 2008 (UTC)
(1R,9S,12S,13R,14S,17R,18E,21S,23S,24R,25S,27R)-1,14-dihydroxy-12-{(1E)-1-[(1R,3R,4R)-4-hydroxy-3-methoxycyclohexyl]prop-1-en-2-yl}-23,25-dimethoxy-13,19,21,27-tetramethyl-17-(prop-2-en-1-yl)-11,28-dioxa-4-azatricyclo[22.3.1.0~4,9~]octacos-18-ene-2,3,10,16-tetrone In terms of how I concluded the article was wrong it was not using the name. It was by careful visual inspection of every structure as part of the curation process. See here: http://www.chemconnector.com/chemunicating/dedicating-christmas-time-to-the-cause-of-curating-wikipedia.html I AGREE with this observation: the R group and the MeO group should both be pointing in the same direction, while the OH group is pointing in the opposite direction. —Preceding unsigned comment added by ChemSpiderMan ( talk • contribs) 15:49, 31 May 2008 (UTC)
Sorry to hear about your surgery, best wishes for a speedy recovery.
I still believe the current image has the correct (R),(R),(R) stereochemistry: see this image annotated with stereo, stereo calculated automatically in ChemDraw. However, the current image would better if the hashed bonds were wedged, to show their directionality, in line with the 2006 IUPAC guidelines, and as I did when I made the 2D original.
The crystal structure shows that the R and the OH are not pointing in the same direction
Ben ( talk) 13:54, 1 June 2008 (UTC)
tacrolimus : US patent 5,260,301 expired in Feb 28, 2011 - Not sure what it actually covers though. Rod57 ( talk) 22:49, 1 March 2011 (UTC)
Also USP 5,385,907 expires Jan 31, 2012 . - Rod57 ( talk) 03:18, 8 February 2012 (UTC)
I am currently taking Tacrolimus for liver transplant; I am in rejection and terminal; I am looking for the pharmaceutical company who makes this drug as I can no longer afford the co-pay for procuring this drug, can you help? — Preceding unsigned comment added by 69.242.224.125 ( talk) 16:27, 12 August 2013 (UTC)
Wiki says now: "It has similar immunosuppressive properties to cyclosporin, but is much more potent. Immunosuppression with tacrolimus was associated with a significantly lower rate of acute rejection compared with ciclosporin-based immunosuppression (30.7% vs 46.4%) in one study. Clinical outcome is better with tacrolimus than with ciclosporin during the first year of liver transplantation. LONG-term outcome has not been improved to the same extent". QUESTIONS:
Is the outcome better then?
Is Tacrolimus safer for kidneys?
ee1518 ( talk) 16:52, 4 July 2015 (UTC)
What is the FK protein naming scheme? If you Google "FK505", "FK504", etc they exist, but what does "FK" stand for? 92.184.117.163 ( talk) 14:33, 18 December 2022 (UTC)
In my view, the name FK506 should be included in the lead (not solely in the infobox), because it is NOT an obsolete or former name. For example, it is used as the primary name in this 2023 paper. Robert.Allen ( talk) 19:44, 21 January 2023 (UTC)
This is the
talk page for discussing improvements to the
Tacrolimus article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
This article is rated C-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Tacrolimus.
|
Reading this I become a little confused on some items (aka I think this article could be clarified a little more than what it is at the moment). Since I'm not a medical professional (nor am I in the pharmacy profession) I'm coming to this article with just the knowledge of a 3 yr post transplant patient on this drug.
Anyway disregarding that I'll start at the introduction. I get the part where FK is introduced as both an immunosuppressent and then a topical cream but after the topical introduction "It has also been used after bone marrow transplants and for severe refractory uveitis." is somewhat thrown in there. Is the topical used after bone marrow transplants somehow, or is it used as an immunosuppressent in pill form? Same goes for the refractory uveitis. For the Contraindications and Precautions, is that for both the immunosuppressent or the topical or both? Additionally I notice it says "Black patients" (personal curiosity) under that heading, I'm curious as to why that is, it perhaps could be clarified in the article (I assume this has something to do with the topical cream and perhaps skin reactions?) Or does it even belong in there at all? I understand that a contraindication is a 'condition or factor that increases the risk involved in using a particular drug' but to include that with precautions just leaves me a bit confused, especially when seeing 'children' in there. Maybe I'm not reading that particular section right, but like I said I'm not in the medical field so..
Pretty much my last topic to hit in this section is the "Cancer risks" is this talking about the immunosuppressent or the topical or both (personally I've been warned that my skin cancer risks go up because I'm on this and a bunch of other immunosuppressents)? This doesn't really seem clear and the whole paragraph is vague at best until you get to the part about "UK dermatologists." So that's about it, I just thought I would throw that out there in case others come across this article and are as confused as I am. Although I must note that if I were to be looking for information on the medications that I take wikipedia would not be the first place I check, I just came across this article while bored and randomly typing in items to learn about. Anyway whoever clarifies this/answers these questions, thanks! -- ImmortalGoddezz 23:52, 10 August 2006 (UTC)
It would be very foolish to use this strong, possibly risky drug any more than absolutely necessary. Certainly not every day, without a damn good reason. - 69.87.204.151 01:28, 3 March 2007 (UTC)
I was sad to hear about the risk a couple years ago. I used this every day for my eczema and it was the wonder drug. Doctors couldn't find anything else that worked for me. Now that I haven't used it for a couple years, I am still suffering from constant scratching from the horrible itchiness. The more I scratch the itchier it gets.
Azn Clayjar
18:19, 12 April 2007 (UTC)
I think I'm going to soon edit the sentence that defines tacrolimus as a macrolide antibiotic. chemically, it is a macrolide but not an antibiotic (doesn't kill bacteria in anyway, nor is that it's aim, quite the contrary as a side effect usually).
I checked out the tacrolimus page recently since I personally have pretty severe eczema and had tried Protopic soon after it was approved for clinical use. I put a test amount on the inside of my elbows and immediately felt a hot, burning sensation. This was quickly followed by an intense, unusual headache that lasted for hours. I never used the stuff again.
It was pretty disappointing, especially since the failure meant it was back to the old steroids. (Tried pimecrolimus too, and it had no effects good or bad.) Of course drug reactions depend on the individual, but I was surprised to find the industry trials had only found headaches in ~20% of patients and they wrote it off as being comparable to controls. I refuse to write the headache off as a psychological effect because I had no idea what to expect. Who'd expect to get a headache from a topical cream? Wonder why it only happens in some people? Anyway-- just did a PubMed search to back up my edits.
As I understand it the cancer risk isn't super-high, and may be specific to the species of lab animals they tested it on. Wouldn't be enough to stop me from using Protopic if it actually worked without giving me a headache. Eczema's no fun and I'd trade a few years of my life for relief. Scerevisiae 15:49, 13 June 2007 (UTC)
Sorry to ask, but I'm terrible at adding references. Mine in particular is for tactrolimuses use in treating ulcerative colitis. If anyone would be so kind as to add this link as a reference to this use it would be greatly appreciated:
http://www.springerlink.com/content/g2kjwecu3dthb3l2/
I have some other sources for its use against UC if this one is not sufficient enough.
DO NOT USE PROTOPIC!! I AM SERIOUS!! http://www.washingtonpost.com/ac2/wp-dyn/A17568-2005Feb11?language=printer
instead, use vanos for strong eczema, cloderm for medium, and atopiclair (non-steroidal) for mild eczema. i have eczema too. also, use herb medicene if you want to cure it "safely." XU-engineer 13:40, 11 August 2007 (UTC)
From the first paragraph: "It is a 23-membered macrolide lactone discovered in 1984". From the second paragraph: "Tacrolimus was discovered in 1987 by a Japanese team". Neither of these assertions are sourced. (I have undergone two liver transplants, and tacrolimus/Prograf is my primary immunosuppressant.) Emptyshell 04:52, 3 October 2007 (UTC)
I, for one (in the UK), don't have 'severe atopic dermatitis', but I'm being treated with Tacrolimus.
Maybe the first paragraph should be changed to 'moderate to severe atopic dermatitis'?
Sam Dutton ( talk) 22:21, 28 February 2008 (UTC)
I believe the structure has the wrong stereochemistry and this is the correct structure
http://www.chemspider.com/Chemical-Structure.4976056.html
The name is: (3S,4R,5S,8R,9E,12S,14S,15R,16S,18R,19R,26aS)-5,19-dihydroxy-3-{(1E)-1-[(1S,3R,4R)-4-hydroxy-3-methoxycyclohexyl]prop-1-en-2-yl}-14,16-dimethoxy-4,10,12,18-tetramethyl-8-(prop-2-en-1-yl)-5,6,8,11,12,13,14,15,16,17,18,19,24,25,26,26a-hexadecahydro-3H-15,19-epoxypyrido[2,1-c][1,4]oxazacyclotricosine-1,7,20,21(4H,23H)-tetrone -- ChemSpiderMan ( talk) 00:41, 30 May 2008 (UTC)
3D or 2D molfile? I've got the 3D structure from the x-ray study - will this be the same?
Have emailed you.
Cheers
Ben ( talk) 00:04, 31 May 2008 (UTC)
(1R,9S,12S,13R,14S,17R,18E,21S,23S,24R,25S,27R)-1,14-dihydroxy-12-{(1E)-1-[(1R,3R,4R)-4-hydroxy-3-methoxycyclohexyl]prop-1-en-2-yl}-23,25-dimethoxy-13,19,21,27-tetramethyl-17-(prop-2-en-1-yl)-11,28-dioxa-4-azatricyclo[22.3.1.0~4,9~]octacos-18-ene-2,3,10,16-tetrone In terms of how I concluded the article was wrong it was not using the name. It was by careful visual inspection of every structure as part of the curation process. See here: http://www.chemconnector.com/chemunicating/dedicating-christmas-time-to-the-cause-of-curating-wikipedia.html I AGREE with this observation: the R group and the MeO group should both be pointing in the same direction, while the OH group is pointing in the opposite direction. —Preceding unsigned comment added by ChemSpiderMan ( talk • contribs) 15:49, 31 May 2008 (UTC)
Sorry to hear about your surgery, best wishes for a speedy recovery.
I still believe the current image has the correct (R),(R),(R) stereochemistry: see this image annotated with stereo, stereo calculated automatically in ChemDraw. However, the current image would better if the hashed bonds were wedged, to show their directionality, in line with the 2006 IUPAC guidelines, and as I did when I made the 2D original.
The crystal structure shows that the R and the OH are not pointing in the same direction
Ben ( talk) 13:54, 1 June 2008 (UTC)
tacrolimus : US patent 5,260,301 expired in Feb 28, 2011 - Not sure what it actually covers though. Rod57 ( talk) 22:49, 1 March 2011 (UTC)
Also USP 5,385,907 expires Jan 31, 2012 . - Rod57 ( talk) 03:18, 8 February 2012 (UTC)
I am currently taking Tacrolimus for liver transplant; I am in rejection and terminal; I am looking for the pharmaceutical company who makes this drug as I can no longer afford the co-pay for procuring this drug, can you help? — Preceding unsigned comment added by 69.242.224.125 ( talk) 16:27, 12 August 2013 (UTC)
Wiki says now: "It has similar immunosuppressive properties to cyclosporin, but is much more potent. Immunosuppression with tacrolimus was associated with a significantly lower rate of acute rejection compared with ciclosporin-based immunosuppression (30.7% vs 46.4%) in one study. Clinical outcome is better with tacrolimus than with ciclosporin during the first year of liver transplantation. LONG-term outcome has not been improved to the same extent". QUESTIONS:
Is the outcome better then?
Is Tacrolimus safer for kidneys?
ee1518 ( talk) 16:52, 4 July 2015 (UTC)
What is the FK protein naming scheme? If you Google "FK505", "FK504", etc they exist, but what does "FK" stand for? 92.184.117.163 ( talk) 14:33, 18 December 2022 (UTC)
In my view, the name FK506 should be included in the lead (not solely in the infobox), because it is NOT an obsolete or former name. For example, it is used as the primary name in this 2023 paper. Robert.Allen ( talk) 19:44, 21 January 2023 (UTC)