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Advagraf ER

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Product Details

Description

Buy Advagraf ER Online from Licensed Canadian Pharmacies

Advagraf ER contains tacrolimus, which is a powerful immunosuppressant. This type of medicine helps in lowering the activity of your immune system so it does not attack a transplanted organ.

ER in Advagraf ER stands for extended release (formulation that works for a longer duration), and it is available in 4 different strengths with 50 capsules per pack. You can order Advagraf ER from Canada safely with a prescription that you can obtain from a qualified health care provider.

When you take this medicine, it prevents kidney transplant rejection in people who receive an allogeneic kidney transplant, usually in combination with other anti-rejection medicines.

You take these capsules once a day, as part of your complete transplant regimen. Take it regularly so that tacrolimus levels stay steady for over 24 hours. This will keep your kidney safe, reduce the risk of rejection episodes, and support graft survival for a longer duration.

Note: This medicine is not approved for liver transplant prophylaxis in the U.S.

Drug Summary

Generic NameTacrolimus
Brand NameAdvagraf ER
FormsOral extended-release capsules
Strengths Available0.5 mg, 1 mg, 3 mg, 5 mg
Packaging50 capsules per pack
Requires PrescriptionPrescription only (Rx)
Ships to the U.S.Yes
Uses and Benefits

What Is Advagraf ER Used For?

Advagraf ER is used to prevent organ rejection in transplant recipients.

What Are the Benefits of Advagraf ER?

  • This medicine is also used in liver transplants to help prevent rejection in some cases.
  • Improves the success rate of transplants by reducing the immune response that can attack new organs.
  • Tacrolimus, the active ingredient, is often more effective than other immunosuppressants in preventing rejection in kidney and liver transplant recipients.
  • Reduce the need for high-dose corticosteroids in transplant patients, which minimizes the risk of steroid-related side effects.
Dosage

Advagraf ER Dosage

Dosage of Advagraf ER for Preventing Organ Rejection

For adults:

  • Starting dose: 0.075 to 0.2 mg/kg per day.
  • It is given as a single dose, usually in the morning.
  • Adjustments: Your dose may be adjusted based on tacrolimus blood levels and kidney function.
  • After a few weeks, the dose is typically adjusted based on clinical response and blood test results.

For children: Dosing in children is typically based on body weight, and the initial dose may range from 0.075 to 0.2 mg/kg per day.

Maintenance dose: Once the transplant has stabilized, the dose is typically reduced to the maintenance dose of 3 to 5 mg daily.

Usage Guide

How Do You Take Advagraf ER Capsules?

To correctly use Advagraf ER, follow these guidelines:

  • Always take Advagraf with food and at the same time each day to maintain consistent blood levels.
  • Capsules are usually taken on an empty stomach, either at least:
  • 1 hour before breakfast or
  • 2 hours after a meal
  • Don’t crush, open, chew, or dissolve the capsules. Simply swallow them with a glass of water.
  • Take the medicine exactly as your health care team prescribes, and do not change the dose or stop taking it on your own.
  • Do not suddenly change the dosage or stop taking the medication without consulting your provider.
How It Works

How Advagraf ER Works

Advagraf ER contains tacrolimus, a calcineurin inhibitor. Calcineurin is an enzyme inside certain immune cells (T-cells) that helps turn on genes for powerful immune signals, including interleukin-2 (IL-2). IL-2 is one of the key “go” signals that tell T-cells to multiply and attack.

Tacrolimus first binds to an inside cell protein called FKBP-12. This tacrolimus–FKBP-12 complex blocks calcineurin. When calcineurin is blocked, T-cells make less IL-2 and other inflammatory substances, so they are less able to attack the transplanted kidney.

Advagraf ER is an extended-release capsule that gradually releases tacrolimus throughout the day, which further keeps blood levels more stable.

That steady immunosuppression helps protect the graft while reducing big peaks and valleys in drug levels that can contribute to side effects or rejection.

Side Effects

What Are the Side Effects of Advagraf ER?

Common Advagraf ER side effects may include:

  • Headache
  • Nausea or vomiting
  • Diarrhea or constipation
  • Loss of appetite
  • Tremors or shaking
  • Fatigue or weakness
  • High blood pressure (hypertension)

These side effects are rare, but if any of them occur, contact your primary caregiver immediately:

  • Severe allergic reactions (Anaphylaxis)
  • Kidney problems
  • Infections
  • Liver damage
  • High potassium levels (also known as hyperkalemia)
  • Tremors, seizures, or confusion
  • Increased risk of cancer, especially skin cancer, due to long-term immunosuppressive therapy
Warnings

Advagraf ER Warnings

Black box warning: Advagraf ER may increase the risk of serious infections and malignancies (including lymphoma and skin cancer) in transplant patients.

Other important warnings:

  • Advagraf ER should be used only under the supervision of transplant specialists.
  • Tacrolimus extended-release capsules are not approved for liver transplantation due to an observed mortality in female patients with liver transplants.
  • These health conditions require special caution and close monitoring:
  • Pre-existing kidney disease
  • Uncontrolled high blood pressure
  • Diabetes
  • Serious neurologic problems
  • This medicine is not interchangeable with immediate-release tacrolimus or other tacrolimus extended-release forms.
  • Therapeutic drug monitoring is essential because both low levels (risk of rejection) and high levels (risk of toxicity, seizures, kidney injury, QT prolongation) can be dangerous.
  • Patients should limit their sun and UV exposure and use strong sun protection, as long-term immunosuppression increases the risk of certain skin cancers.
  • Use of Advagraf ER capsules during pregnancy or breastfeeding must be carefully considered. Tacrolimus can potentially harm the fetus. Decisions should be individualized.
Safety Guide

Advagraf ER Precautions

Take these precautions while using Advagraf ER:

  • Keep all scheduled blood tests to check tacrolimus trough levels, kidney function, blood pressure, and blood sugar.
  • Never change your dose, skip doses, or stop the medicine without talking to your doctor.
  • Tell every healthcare provider, dentist, or pharmacist that you are taking Advagraf ER.
  • Protect your skin by using high-SPF sunscreen and wearing protective clothing.
Missed Dose

Advagraf ER Missed Dose

If you forget a dose of Advagraf ER, take the missed dose as soon as you recall within about 14 hours of your usual time, then return to your normal schedule the next day.

But, if more than roughly half a day has passed, skip the dose that you missed and take the next dose at the usual time the following morning.

Overdose

Advagraf ER Overdose

Taking too much Advagraf ER can raise the levels of tacrolimus in your blood and lead to serious problems like:

Kidney failure

Severe high blood pressure

Dangerous infections

Seizures

Heart rhythm changes

If you think you or someone else has taken an overdose, whether accidentally or on purpose, call your local emergency medical care right away, or contact the Poison Control Center at their number 1-800-222-1222, which is toll-free.

Do not wait for symptoms to appear, and do not try to treat an overdose on your own.

Storage Guide

How to Store Advagraf ER

  • When you buy Advagraf ER capsules online from Canada, store them at room temperature.
  • Do not use past the expiration date.
  • Dispose of the capsules carefully as per your local guidelines.
Interactions

Advagraf ER Interactions

Drug CategoryExamplesEffect or Precaution
CYP3A4 InhibitorsKetoconazole, Itraconazole, Clarithromycin, RitonavirGreatly increase the tacrolimus in your blood. Dose reduction and close monitoring are required.
CYP3A4 InducersRifampin, Carbamazepine, Phenytoin, St. John’s WortSignificantly decrease tacrolimus levels, which increases the risk of organ rejection. Avoid co-use or adjust dose.
Nephrotoxic MedicationsNSAIDs (ibuprofen), Aminoglycosides, Amphotericin B, IV contrast dyesAdditive kidney toxicity. Use alternatives or monitor renal function closely.
Potassium-Increasing DrugsSpironolactone, ACE inhibitors (lisinopril), ARBs (losartan), and Potassium supplementsHigh potassium risk increases. Monitor potassium levels and avoid unnecessary potassium intake.
Other ImmunosuppressantsSirolimus, Everolimus, CyclosporineMay increase toxicity or alter absorption. Cyclosporine, especially, should NOT be used at the same time.
Live VaccinesMMR, Varicella, Yellow feverAvoid live vaccines because tacrolimus suppresses the immune system. Vaccines may be ineffective or cause infection.
GrapefruitGrapefruit fruit, juice, extractsPotently increases tacrolimus blood concentration. Avoid entirely to prevent toxicity.
QT-Prolonging DrugsOndansetron, Fluoroquinolones (levofloxacin), AmiodaroneTacrolimus may prolong QT, and combining with QT-prolonging agents raises arrhythmia risk. ECG and electrolyte monitoring advised.
Alternatives

Advagraf ER Alternatives

Alternative MedicationActive IngredientPotency LevelBest ForFormKey Advantage
PrografTacrolimus (Immediate-release)HighKidney, liver, and heart transplant rejection preventionCapsule / OralSame active drug as Advagraf ER, but offers flexible twice-daily dosing
Envarsus XRTacrolimus (Extended-release, MeltDose)HighKidney transplant maintenance immunosuppressionTablet (ER)Improved absorption with lower peak-to-trough variability. Often requires a lower total daily dose
Cyclosporine (Neoral, Gengraf, Sandimmune)CyclosporineHighKidney, liver, and heart transplant rejection preventionCapsule / Oral solutionCalcineurin inhibitor alternative for patients intolerant to tacrolimus or with tacrolimus-induced nephrotoxicity
RapamuneSirolimusMediumKidney transplant rejection prevention (often used with lower tacrolimus or after CNIs are reduced)Tablet / Oral solutionmTOR inhibitor with reduced nephrotoxicity compared to calcineurin inhibitors
Everolimus (Zortress)EverolimusMediumKidney and liver transplant maintenance therapyTabletLower toxicity alternative; reduces CNI exposure; useful for patients with CNI-related side effects
Myfortic / CellCeptMycophenolic acid / Mycophenolate mofetilMediumFirst-line combo therapy with tacrolimus or cyclosporine in kidney, liver, and heart transplantsTablet / CapsulePowerful antiproliferative agent used universally with tacrolimus to reduce rejection risk
AzathioprineAzathioprineLow–MediumAlternative immunosuppressant when mycophenolate cannot be used (pregnancy-safe option)TabletWell-tolerated, long history of safety, and safe in pregnancy compared to mycophenolate
BelataceptBelataceptMedium–High (biologic)Kidney transplant patients who cannot tolerate CNIs (tacrolimus/cyclosporine)IV infusionCalcineurin-inhibitor–free option with better long-term kidney function and lower nephrotoxicity
PrednisonePrednisoneLow (steroid)Universal adjunct in early post-transplant and rejection treatmentTabletEssential for induction and rejection treatment; reduces acute rejection risk when used with CNIs
Cost & Coupons

Why Buy Advagraf ER from Polar Bear Meds?

At Polar Bear Meds, we’re committed to making prescription medications like Advagraf ER more accessible and affordable for patients in the U.S. Our prices are significantly lower than typical U.S. pharmacy retail rates without compromising on safety or quality. Every order is sourced exclusively from licensed and trusted pharmacies and undergoes complete prescription verification to ensure compliance and authenticity. We offer discreet, trackable shipping to all U.S. states, along with refill support for ongoing treatment. Our friendly customer service team is here to help you.

Advagraf ER Cost & Coupons

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FAQ

Guarantee

At Polar Bear Meds, your safety is our priority. Every order is dispensed from a fully licensed Canadian pharmacy following strict standards for quality, security, and patient care. To conveniently buy Advagraf ER from Canada at a competitive cost, call us at 1-888-779-2193 toll-free.

Important Notice

The content provided on the Polar Bear Meds website serves to increase knowledge about healthcare products and medical conditions and is strictly for informational purposes. It should not replace professional medical advice. We urge you to consult with a qualified healthcare professional prior to utilizing any prescription or over-the-counter medication. Our platform grants access to an extensive array of products, sourced internationally, including Canada. We collaborates with a licensed pharmacy partner in Canada and trusted dispensing pharmacies globally. All affiliated fulfillment centers are accredited by the regulatory authorities of their respective countries.

Dr. Jackson Miller

Medically Reviewed by "Dr. Jackson Miller (M.D)"

Dr. Jackson Miller is a board-certified medicine physician & hospitalist. He is a healthcare professional with a strong background in patient care. With years of experience and a patient-first approach, he believes the foundation of good health is a patient who feels informed and empowered. He contributes to medical content review, drawing on his background in clinical practice and patient education. He focuses on presenting health information in a clear, accurate, and accessible way to help readers make informed decisions. His work emphasizes clarity, evidence-based guidance, and understandable explanations of medical topics.

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