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

Delivery of tacrolimus with cationic lipid-assisted nanoparticles for ulcerativ…

PMID: 29850666
Year: 2018
Relationship Type: Treatment Score: 6.3

Oral drug delivery with nanoparticles has demonstrated great potential for drugs with poor bioavailability. Efficient delivery is possible by overcom…

Tacrolimus therapy in moderate to subacute ulcerative proctocolitis: a large si…

PMID: 29588844
Year: 2018
Relationship Type: Treatment Score: 6.3

OBJECTIVE: To explore the 'real world' effectiveness of tacrolimus therapy for refractory ulcerative proctocolitis (UC). DESIGN: Retrospective cohort…

Outcome of tacrolimus and vedolizumab after corticosteroid and anti-TNF failure…

PMID: 29527316
Year: 2018
Relationship Type: Treatment Score: 6.3

BACKGROUND: Severe colitis flare from ulcerative colitis (UC) or Crohn's disease (CD) may be refractory to corticosteroids and antitumour necrosis fa…

Tacrolimus Dose Optimization Strategy for Refractory Ulcerative Colitis Based o…

PMID: 29393157
Year: 2018
Relationship Type: Treatment Score: 6.3

BACKGROUND: In the tacrolimus treatment for refractory ulcerative colitis (UC), dose adjustment is necessary because the required doses to keep appro…

Comparison of Safety and Efficacy of Tacrolimus versus Infliximab for Active Ul…

PMID: 29050007
Year: 2018
Relationship Type: Treatment Score: 6.3

BACKGROUND: This narrative review was to determine which medication, tacrolimus (TAC) or infliximab (IFX), is safer and more effective in the managem…

Medium to long-term efficacy and safety of oral tacrolimus in moderate to sever…

PMID: 28617029
Year: 2017
Relationship Type: Treatment Score: 6.3

BACKGROUND AND OBJECTIVE: Oral tacrolimus is an effective drug that induces clinical remission in patients with moderate to severe ulcerative colitis…

Rapid Induction Therapy with Oral Tacrolimus in Elderly Patients with Refractor…

PMID: 28411286
Year: 2017
Relationship Type: Treatment Score: 6.3

BACKGROUND Tacrolimus is reportedly effective for the treatment of refractory ulcerative colitis (UC). At our hospital, there has been an increase in…

EFFICACY OF TACROLIMUS FOR INDUCTION OF REMISSION IN PATIENTS WITH MODERATE-TO-…

PMID: 28327826
Year: 2017
Relationship Type: Treatment Score: 6.3

BACKGROUND: There is evidence that shows that calcineurin inhibitors may be useful for the treatment of severe ulcerative colitis. However, evidence …

A comparison of short-term therapeutic efficacy between infliximab and tacrolim…

PMID: 28222041
Year: 2017
Relationship Type: Treatment Score: 6.3

INTRODUCTION: Both infliximab (IFX) and tacrolimus (Tac) are effective for inducing clinical remission in patients with ulcerative colitis (UC). Howe…

ATP-binding cassette subfamily B member 1 1236C/T polymorphism significantly af…

PMID: 28135009
Year: 2017
Relationship Type: Treatment Score: 6.3

BACKGROUND AND AIM: Tacrolimus is now considered to be one of the main therapeutic options for refractory ulcerative colitis. Both cytochrome P-450 3…

Tacrolimus-associated Diffuse Gastrointestinal Ulcerations and Pathergy: A Case…

PMID: 28104141
Year: 2017
Relationship Type: Treatment Score: 6.3

Tacrolimus is a common immunosuppressive modality with a range of therapeutic applications, including for rheumatologic disease, nephrotic syndrome, …

The effect of CYP3A5 genetic polymorphisms on adverse events in patients with u…

PMID: 27717793
Year: 2017
Relationship Type: Treatment Score: 6.3

BACKGROUND: Tacrolimus is an immunosuppressive agent, used in the remission induction therapy of ulcerative colitis (UC). AIMS: We investigated the c…

Tacrolimus Exerts Only a Transient Effectiveness in Refractory Pediatric Crohn …

PMID: 27429426
Year: 2017
Relationship Type: Treatment Score: 6.3

OBJECTIVES: Tacrolimus is an immunosuppressive agent that has been proposed in the treatment of severe ulcerative colitis. The present study examined…

Comparison of the therapeutic efficacy and safety between tacrolimus and inflix…

PMID: 26818468
Year: 2016
Relationship Type: Treatment Score: 6.3

OBJECTIVE: Both tacrolimus (Tac) and infliximab (IFX) are effective for moderate-to-severe ulcerative colitis (UC). The aim of this study was to comp…

Tacrolimus vs. anti-tumour necrosis factor agents for moderately to severely ac…

PMID: 26762838
Year: 2016
Relationship Type: Treatment Score: 6.3

BACKGROUND: There have been no comparative studies of tacrolimus vs. anti-tumour necrosis factor (anti-TNF) agents to determine which treatment is sa…

Successful use of infliximab and tacrolimus combination therapy in a patient wi…

PMID: 26754306
Year: 2016
Relationship Type: Treatment Score: 6.3

OBJECTIVE: To report of a case successful use of infliximab (IFX) and tacrolimus (TAC) in a patient with ulcerative colitis (UC). CASE SUMMARY: A 22-…

Efficacy and Safety of Tacrolimus Therapy for Active Ulcerative Colitis; A Syst…

PMID: 26645641
Year: 2016
Relationship Type: Treatment Score: 6.3

BACKGROUND: Approximately 25% of patients with ulcerative colitis [UC] experience a severe flare requiring steroid therapy to avoid colectomy. We per…

Long-term Outcomes in Steroid-refractory Ulcerative Colitis Treated with Tacrol…

PMID: 26419459
Year: 2016
Relationship Type: Treatment Score: 6.3

BACKGROUND AND AIMS: Tacrolimus is recommended for the treatment of steroid-refractory ulcerative colitis (UC). Concomitantly started purine analogue…

[Efficiency of tacrolimus therapy for perianal Crohn's disease]

PMID: 26281201
Year: 2015
Relationship Type: Treatment Score: 6.3

AIM: To determine the efficacy of 0.1% tacrolimus ointment in patients with perianal Crohn's disease (CD). SUBJECTS AND METHODS: This prospective ran…

Successful use of infliximab and tacrolimus in a patient with Crohn's disease

PMID: 25997551
Year: 2015
Relationship Type: Treatment Score: 6.3

OBJECTIVE: To report a case of successful use of infliximab (IFX) and tacrolimus (TAC) in a patient with Crohn's disease (CD). CASE SUMMARY: A 42-yea…

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