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

Effects of oral tacrolimus as a rapid induction therapy in ulcerative colitis

PMID: 25684955
Year: 2015
Relationship Type: Treatment Score: 6.3

AIM: To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis (UC…

Tacrolimus for remission induction in ulcerative colitis: Mayo endoscopic subsc…

PMID: 25682993
Year: 2015
Relationship Type: Treatment Score: 6.3

BACKGROUND: Tacrolimus has shown efficacy in patients with ulcerative colitis. AIMS: To evaluate the efficacy of tacrolimus as remission induction th…

Severe diffuse duodenitis successfully treated with intravenous tacrolimus afte…

PMID: 25366006
Year: 2014
Relationship Type: Treatment Score: 6.3

We encountered a rare case of severe diffuse duodenitis associated with ulcerative colitis (UC). A 23-year-old man underwent total proctocolectomy wi…

Oral tacrolimus for the treatment of refractory inflammatory bowel disease in t…

PMID: 23615528
Year: 2013
Relationship Type: Treatment Score: 6.1

BACKGROUND: Patients with inflammatory bowel disease who are refractory to standard therapies frequently require surgery. The long-term efficacy of t…

[A case of tacrolimus plus intensive LCAP therapy combination for refractory ul…

PMID: 23558127
Year: 2013
Relationship Type: Treatment Score: 6.1

A 30-year-old woman was referred to our hospital with recurrent refractory ulcerative colitis. She also suffered from avascular necrosis of the left …

Tacrolimus salvage in anti-tumor necrosis factor antibody treatment-refractory …

PMID: 23518805
Year: 2013
Relationship Type: Treatment Score: 6.1

BACKGROUND: Several small retrospective studies have reported encouraging response rates in patients with Crohn's disease (CD) treated with tacrolimu…

The efficacy of oral tacrolimus in patients with moderate/severe ulcerative col…

PMID: 23291669
Year: 2013
Relationship Type: Treatment Score: 6.1

OBJECTIVE: The calcineurin inhibitor tacrolimus has been shown to be safe and effective as salvage therapy for steroid-refractory ulcerative colitis …

Short-term efficacy of tacrolimus in steroid-refractory ulcerative colitis - ex…

PMID: 23121200
Year: 2013
Relationship Type: Treatment Score: 6.1

BACKGROUND: Steroid-refractory ulcerative colitis (UC) remains a challenging condition warranting surgery upon failure of pharmacological treatment. …

Combination therapy of tacrolimus and infliximab reduces inflammatory response …

PMID: 22167049
Year: 2012
Relationship Type: Treatment Score: 6.1

BACKGROUND: Intestinal transplantation initiates a functionally relevant inflammatory response by activation of resident macrophages within the muscu…

Systematic review: the role of tacrolimus in the management of Crohn's disease

PMID: 21999607
Year: 2011
Relationship Type: Treatment Score: 6.1

BACKGROUND Several published studies have evaluated the efficacy of tacrolimus in the management of Crohn's disease with variable conclusions. AIM …

Double-blind, placebo-controlled trial of oral tacrolimus (FK506) in the manage…

PMID: 21887732
Year: 2012
Relationship Type: Treatment Score: 6.1

BACKGROUND: We report a multicenter study of oral tacrolimus (FK506) therapy in steroid-refractory ulcerative colitis (UC). METHODS: In a placebo-con…

ABCB1 single-nucleotide polymorphisms determine tacrolimus response in patients…

PMID: 21289623
Year: 2011
Relationship Type: Treatment Score: 6.1

Tacrolimus (Tac) is effective in the treatment of steroid-refractory ulcerative colitis (UC); however, nonresponse and unpredictable side effects are…

Two cases of fatal Pneumocystis jirovecii pneumonia as a complication of tacrol…

PMID: 21122569
Year: 2010
Relationship Type: Treatment Score: 6.1

Here we report 2 cases of fatal Pneumocystis jirovecii pneumonia in patients with severe ulcerative colitis receiving combination immunosuppression i…

Topical tacrolimus for parastomal pyoderma gangrenosum: a report of two cases

PMID: 20855912
Year: 2010
Relationship Type: Treatment Score: 6.1

Pyoderma gangrenosum (PG) is an idiopathic, ulcerative, inflammatory dermatologic condition that occurs in patients with systemic diseases such as i…

Immunosuppressive effects of tacrolimus on macrophages ameliorate experimental …

PMID: 20848491
Year: 2010
Relationship Type: Association Score: 6.1

BACKGROUND: Tacrolimus is a novel immunomodulator for inflammatory bowel diseases. Immunosuppressive effects of tacrolimus on T cells are well known;…

Outcomes and adverse events in children and young adults undergoing tacrolimus …

PMID: 20722055
Year: 2011
Relationship Type: Treatment Score: 6.1

BACKGROUND: Children with severe corticosteroid-resistant ulcerative colitis either need to undergo surgery or be treated with more intensive immunos…

Efficacy and safety of infliximab as rescue therapy for ulcerative colitis refr…

PMID: 20546441
Year: 2010
Relationship Type: Treatment Score: 6.1

BACKGROUND AND AIM: Little is known about the efficacy and safety of infliximab for ulcerative colitis refractory to tacrolimus. The aim of this stud…

Infliximab as rescue medication for patients with severe ulcerative/indetermina…

PMID: 20175769
Year: 2010
Relationship Type: Treatment Score: 6.1

BACKGROUND: The calcineurin inhibitor tacrolimus and the anti-TNF-antibody infliximab are established options in steroid-refractory ulcerative coliti…

Tacrolimus (FK506): Safety and Applications in Reconstructive Surgery

PMID: 19363638
Year: 2010
Relationship Type: Treatment Score: 6.1

Tacrolimus (FK506) is a macrolide immunosuppressive drug that is approved for the prevention of allograft rejection. It is a standard component of im…

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