Drug ID:Drug70
Drug Name:Tacrolimus
CID:445643
DrugBank ID:DB00864
Modality:Small Molecule
Groups:approved|investigational
US Approved:YES
Other Approved:YES
Identifier: NCT00643071, , NCT00514982, , NCT02954159, , NCT06867042, , NCT00347048
Molecular Formula:C44H69NO12
Molecular Weight:804.0 g/mol
Isomeric SMILES:C[C@@H]1C[C@@H]([C@@H]2[C@H](C[C@H]([C@@](O2)(C(=O)C(=O)N3CCCC[C@H]3C(=O)O[C@@H]([C@@H]([C@H](CC(=O)[C@@H](/C=C(/C1)\\C)CC=C)O)C)/C(=C/[C@@H]4CC[C@H]([C@@H](C4)OC)O)/C)O)C)OC)OC
Synonyms:tacrolimus; 104987-11-3; Fujimycin; Prograf; Tsukubaenolide; Tacrolimus anhydrous; Protopic; Anhydrous Tacrolimus; Advagraf; Modigraf
Phase 0: 14
Phase 1: 178
Phase 2: 466
Phase 3: 223
Phase 4: 390
Description:Tacrolimus (also FK-506 or Fujimycin) is an immunosuppressive drug whose main use is after organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It is also used in a topical preparation in the treatment of severe atopic dermatitis, severe refractory uveitis after bone marrow transplants, and the skin condition vitiligo. It was discovered in 1984 from the fermentation broth of a Japanese soil sample that contained the bacteria Streptomyces tsukubaensis. Tacrolimus is chemically known as a macrolide. It reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP-12 (FK506 binding protein) creating a new complex. This FKBP12-FK506 complex interacts with and inhibits calcineurin thus inhibiting both T-lymphocyte signal transduction and IL-2 transcription.

Molecular Structure

2D Molecular Structure

Knowledge Graph

dtIDCIDCompound NameGene IDGene NameSpeciesPubMed IDsAction
dt593 445643 Tacrolimus 3558 IL2 Homo sapiens (human) None
dt594 445643 Tacrolimus 221785 ZSCAN25 Homo sapiens (human) None
dt595 445643 Tacrolimus 3290 HSD11B1 Homo sapiens (human) None
dt596 445643 Tacrolimus 1565 CYP2D6 Homo sapiens (human) None
dt597 445643 Tacrolimus 2609 GAPDHP67 Homo sapiens (human) Inhibitor
dt598 445643 Tacrolimus 79054 TRPM8 Homo sapiens (human) Activator
dt599 445643 Tacrolimus 2280 FKBP1A Homo sapiens (human) None
dt600 445643 Tacrolimus 6696 SPP1 Homo sapiens (human) None
dt601 445643 Tacrolimus 387082 SUMO4 Homo sapiens (human) None

  • No data available

Phase Distribution
Phase Description
  • Phase 0: Exploratory trials to assess drug behavior in humans
  • Phase 1: Safety trials to determine safe dosage range
  • Phase 2: Efficacy trials to evaluate therapeutic effects
  • Phase 3: Large-scale trials to confirm efficacy and safety
  • Phase 4: Post-marketing surveillance for long-term safety and efficacy

Trial IDTitlePhaseStatusSponsorIndicationsInterventions
NCT00347048 Tacrolimus (FK506) Study in Moderate to Severe Refractory Ulcerative Colitis Patients PHASE3 COMPLETED Astellas Pharma Inc Ulcerative Colitis DRUG: tacrolimus|DRUG: Placebo Details
NCT00643071 Tacrolimus (FK506) P-III, Open-label Study in Refractory Ulcerative Colitis Patients PHASE3 COMPLETED Astellas Pharma Inc Ulcerative Colitis DRUG: Tacrolimus Details
NCT00514982 Medical Treatment of Colitis in Patients With Hermansky-Pudlak Syndrome PHASE2 WITHDRAWN National Institute of Allergy and Infectious Diseases (NIAID) Hermanski-Pudlak Syndrome|Colitis|Cytokines|Lymph… DRUG: Mesalamine|DRUG: Infliximab|DRUG: Corticost… Details
NCT06867042 Tacrolimus Lipid Suspension for Enema in Adult Subjects with Mild to Moderately Active Left-sided/Distal Ulcerative Colitis Who Had an Inadequate Response to the Treatment PHASE2 NOT_YET_RECRUITING Jina Pharmaceuticals Inc. Ulcerative Colitis (UC)|Ulcerative Colitis, Activ… DRUG: Tacrolimus Lipid Suspension for enema|DRUG:… Details
NCT02954159 Vedolizumab Monotherapy Vs Combination Therapy With Tacrolimus in UC PHASE3 TERMINATED Medical College of Wisconsin Ulcerative Colitis DRUG: Tacrolimus|DRUG: Vedolizumab|OTHER: Placebo Details
CTRI/2021/10/037641 An open label study to compare the efficacy and safety of tofacitinib compared to corticosteroids for inducing remission in moderately severe active ulcerative colitis PHASE4 Recruiting Dayanand Medical College and Hospital Ludhiana Disease.2. Total mayo clinic score <6 or >9. 3.… Health Condition 1: K51- Ulcerative colitis Details
NCT03204136 Tacrolimus Versus Methotrexate as Rescue Therapy for Refractory Inflammatory Bowel Disease: an Open-label, Retrospective Study Not Available Not recruiting Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, China Inflammatory Bowel Diseases;Inflammatory Bowel Di… None Details
NCT01418131 Rectal Tacrolimus in the Treatment of Resistant Ulcerative Proctitis PHASE4 COMPLETED The University of Western Australia Ulcerative Colitis DRUG: Rectal tacrolimus|DRUG: Placebo Details

Disease IDDisease NameDefinitionCategoryRelated DrugsMechanism
No data available

Strategy IDTherapeutic StrategySynonymsRelated DrugsMechanism
S02 Immunosuppression Classic immunosuppressive drugs azathioprine; 6-mercaptopurine; methotrexate; ciclosporin-A; tacrolimus Ciclosporin-A and tacrolimus bind to specific intracellular… Details

Histologic Features of Tacrolimus-induced Colonic Injury

PMID: 34138798
Year: 2022
Relationship Type: Treatment Score: 6.5

Tacrolimus is a common immunosuppressant used in solid organ transplant recipients. Although most patients develop diarrheal symptoms, data regarding…

The impact of cytochrome P450 3A genetic polymorphisms on tacrolimus pharmacoki…

PMID: 33886687
Year: 2021
Relationship Type: Treatment Score: 6.5

Tacrolimus (Tac) is an effective remission inducer of refractory ulcerative colitis (UC). Gene polymorphisms result in interindividual variability in…

Combination of Vedolizumab With Tacrolimus Is More Efficient Than Vedolizumab A…

PMID: 33847343
Year: 2021
Relationship Type: Treatment Score: 6.5

BACKGROUND: Vedolizumab is a widely used and safe therapy in inflammatory bowel disease, particularly in ulcerative colitis (UC), making it a promisi…

3D printed tacrolimus suppositories for the treatment of ulcerative colitis

PMID: 33613734
Year: 2021
Relationship Type: Treatment Score: 6.5

Ulcerative colitis is a global health problem, affecting millions of individuals worldwide. As an inflammatory condition localised in the large intes…

3D Printed Tacrolimus Rectal Formulations Ameliorate Colitis in an Experimental…

PMID: 33276641
Year: 2020
Relationship Type: Treatment Score: 6.5

The aim of this study was to fabricate novel self-supporting tacrolimus suppositories using semisolid extrusion 3-dimensional printing (3DP) and to i…

Efficacy of infliximab, cyclosporine and tacrolimus on ulcerative colitis: A me…

PMID: 33126341
Year: 2020
Relationship Type: Treatment Score: 6.5

BACKGROUND: Positioning infliximab (IFX), cyclosporine and tacrolimus (TAC) for treating ulcerative colitis (UC) is in great debate. METHODS: A liter…

Comparative efficacy of antitumor necrosis factor agents and tacrolimus in naïv…

PMID: 32719413
Year: 2020
Relationship Type: Treatment Score: 6.5

While retrospective studies have compared the efficacy of anti-tumour necrosis factor (TNF) agents and tacrolimus (TAC) in ulcerative colitis (UC), i…

Relationship between mucosal healing by tacrolimus and relapse of refractory ul…

PMID: 32590945
Year: 2020
Relationship Type: Treatment Score: 6.5

BACKGROUND: Tacrolimus (TAC) is a powerful remission-inducing drug for refractory ulcerative colitis (UC). However, it is unclear whether mucosal hea…

CYP3A5 Genotype as a Potential Pharmacodynamic Biomarker for Tacrolimus Therapy…

PMID: 32570960
Year: 2020
Relationship Type: Treatment Score: 6.5

Tacrolimus has been used to induce remission in patients with steroid-refractory ulcerative colitis. It poses a problem of large individual differenc…

Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Pati…

PMID: 32517388
Year: 2020
Relationship Type: Adverse Effect Score: 6.5

BACKGROUND: Tacrolimus (TAC) is used for the management of ulcerative colitis (UC). However, there are few reports on the effectiveness of its long-t…

Colon-Targeted Therapy of Tacrolimus (FK506) in the Treatment of Experimentally…

PMID: 31940656
Year: 2020
Relationship Type: Treatment Score: 6.5

BACKGROUND/AIMS: Inflammatory bowel disease is a chronic or remitting/relapsing intestinal inflammation, which comprises Crohn's disease and ulcerati…

Azathioprine Is Useful for Maintaining Long-term Remission Induced by Tacrolimu…

PMID: 31118391
Year: 2019
Relationship Type: Treatment Score: 6.5

Objective The need for and efficacy of immunomodulators for maintaining remission after tacrolimus therapy have not been sufficiently defined. This s…

Appropriate Timing of Discontinuation of Tacrolimus Therapy for Refractory Ulce…

PMID: 31065933
Year: 2019
Relationship Type: Treatment Score: 6.5

BACKGROUND AND OBJECTIVES: Tacrolimus is very effective at inducing remission in patients with refractory ulcerative colitis. However, the optimal ti…

Therapeutic Efficacy and Adverse Events of Tacrolimus in Patients with Crohn's …

PMID: 30982208
Year: 2019
Relationship Type: Treatment Score: 6.5

BACKGROUND: Only a few randomized controlled trials (RCTs) and some uncontrolled trials have reported the efficacy and adverse events (AEs) of tacrol…

Tacrolimus Therapy in Steroid-Refractory Ulcerative Colitis: A Review

PMID: 30980713
Year: 2020
Relationship Type: Treatment Score: 6.5

Inflammatory bowel diseases are known for a chronic inflammatory process of the gastrointestinal tract and include Crohn's disease and ulcerative col…

Pretreatment neutrophil-to-lymphocyte ratio predicts clinical relapse of ulcera…

PMID: 30845259
Year: 2019
Relationship Type: Treatment Score: 6.5

OBJECTIVES: Although tacrolimus is useful as an induction therapy in patients with ulcerative colitis (UC), information regarding the long-term outco…

Tacrolimus Suppositories in Therapy-Resistant Ulcerative Proctitis

PMID: 30820433
Year: 2019
Relationship Type: Treatment Score: 6.5

BACKGROUND: Ulcerative proctitis may often be managed with topical salicylates or steroids alone, but in some patients, symptoms are persistent and s…

Rapid attainment of target trough concentrations of tacrolimus for early improv…

PMID: 30604428
Year: 2019
Relationship Type: Treatment Score: 6.5

WHAT IS KNOWN AND OBJECTIVE: The target trough concentration of tacrolimus for ulcerative colitis is recommended to be 10-15 ng/mL in the initial two…

Long-lasting immunosuppressive effects of tacrolimus-loaded micelle NK61060 in …

PMID: 30277135
Year: 2018
Relationship Type: Pharmacology Score: 6.3

AIM: Tacrolimus (TAC) is an important drug for inflammatory diseases. However, TAC has several limitations, such as variable trough concentrations am…

Pooled analysis of the comparative efficacy between tacrolimus and infliximab f…

PMID: 30095612
Year: 2018
Relationship Type: Treatment Score: 6.3

BACKGROUND: Acute moderate-to-severe steroid-refractory ulcerative colitis (UC) has a poor prognosis and requires optimal rescue therapy. A pooled an…

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