The principal adverse reactions of Seegraf are tremor, headache, diarrhea, hypertension, nausea and renal dysfunction. Diarrhea was sometimes associated with other gastrointestinal complaints eg, nausea and vomiting.
Hyperkalemia and hypomagnesemia have occurred in patients receiving tacrolimus therapy. Hyperglycemia has been noted in many patients; some may require insulin therapy.
Myocardial hypertrophy has been reported in association with the administration of tacrolimus, and is generally manifested by echocardiographically demonstrated concentric increases in left ventricular posterior wall and intraventricular septum thickness. Hypertrophy has been observed in infants, children and adults. This condition appears reversible in most cases following dose reduction or discontinuance of therapy. In a group of 20 patients with pre- and posttreatment echocardiograms who showed evidence of myocardial hypertrophy, mean tacrolimus whole blood concentrations during the period prior to diagnosis of myocardial hypertrophy ranged from 11-53 ng/mL in infants (N=10, age 0.4-2 years), 4-46 ng/mL in children (N=7, age 2-15 years) and 11-24 ng/mL in adults (N=3, age 37-53 years). In patients who develop renal failure or clinical manifestations of ventricular dysfunction while receiving Seegraf therapy, echocardiographic evaluation should be considered. If myocardial hypertrophy is diagnosed, dosage reduction or discontinuation of Seegraf should be considered.