يستعمل دواء بروتوبيك 0.1% مرهم 30جمprotopic 0.1 % oint. 30 gm immunosuppressant immunosuppressant

about tacrolimus -calcineurin inhibitor a macrolide immunosuppressant for prevention of graft rejection. -mechanism of action of tacrolimus -it binds to specific receptors on t cells. it reduces peptidyl-prolyl isomerase activity by forming a complex with immunophilin fkbp-12 (fk506 binding protein).this leads to an increase in intracellular calcium that in turn causes a series of reactions inhibiting the transcription of several genes mainly the cytokines (il-2 il-4 and il-5). it also decreases the production of il-8 receptor genes and inhibits the production of receptors for ige molecules. -indications for tacrolimus -1. prophylaxis of organ rejection in patients receiving allogenic liver or kidney transplants -interactions for tacrolimus -increased nephrotoxicity may result if tacrolimus is given with other potentially nephrotoxic drugs like cyclosporin. -avoid concomitant use of potassium-sparing diuretics. concomitant use of drugs which inhibit the cytochrome p450 (cyp3a)