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This medication requires a prescription from your doctor.
Tacrolimus 2mg/60mL, 4mg/60mL Enemas
Tacrolimus is a calcineurin inhibitor that is prescribed for treating ulcerative colitis, especially when the disease does not respond to other treatments. Tacrolimus enemas can be made by a compounding pharmacy for topical administration, which may be preferable to oral administration and have fewer adverse effects. Calcineurin inhibitors can inhibit lymphocyte proliferation and activation while leaving microbial defense intact.
Patients Who Fail Other Treatments
The most common drugs used for treating ulcerative colitis are 5-aminosalicylic acids, steroids, immunosuppressants, and infliximab. In one small study of patients who failed to achieve disease control with any of these drugs, 6 out 8 participants achieved remission of their symptoms with tacrolimus. In another study, after 4 weeks, 13 of 19 patients showed clinical improvement with tacrolimus enema treatment. While the 5-ASAs and steroids often are effective they do not work for every patient. In addition, it is often beneficial to decrease the amount of steroids being taken as these drugs can have more significant side effects. A tacrolimus enema may be able to reduce the dosages of steroids needed to control the disease.
Side Effects of Tacrolimus Enema
There are few side effects associated with tacrolimus enemas. The main concern with a drug like this is that it will systemically inhibit the immune response. With topical administration in an enema, blood levels of the drug are kept low enough that this does not occur. The drug is easily absorbed topically but does not result in significantly elevated blood levels.
In addition to enemas, our pharmacy also makes this medication in the form of suppositories.
The use of traditional and newer calcineurin inhibitors in inflammatory bowel disease. – Journal of Gastroenterology
Topical Agents for Idiopathic Distal Colitis and Proctitis. – Journal of Gastroenterology and Hepatology
Simple novel tacrolimus enemas are very effective in severe refractory proctitis – Journal of Crohn’s and Colitis