Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Tacrolimus (Prograf) and sirolimus (Rapamune) are both immunosuppressants used to prevent organ rejection, but they have some key differences. Tacrolimus is a calcineurin inhibitor that used to prvent organ rejection after organ transplant. It lowers the activity of the immune system to prevent it from attacking the new organ and is used for kidney, liver, heart, and lung transplants. Sirolimus also lowers the activity of the immune system, but is only approved to prevent organ rejection after a kidney transplant. It is not recommended for liver and lung transplants due to higher risks of serious complications. Additionally, sirolimus can be used for a condition called lymphangioleiomyomatosis (LAM). Tacrolimus is available in both immediate-release and extended-release forms, while sirolimus comes as tablets or an oral solution. Both medications can cause high blood pressure. Additionally, tacrolimus can also cause side effects like tremors and alter electrolyte levels, whereas sirolimus can lead to high cholesterol levels and slow wound healing. Both medications require regular blood tests to monitor levels, but sirolimus has a long duration in the body, allowing for once-daily dosing.
Tacrolimus (Prograf)
Sirolimus (Rapamune)
Tacrolimus (Prograf)
Sirolimus (Rapamune)
Summary of Prograf vs. Rapamune
Summary for Immunosuppressant
Prescription only
Tacrolimus (Prograf) is a medication used to prevent organ rejection after an organ transplant. The immediate-release (IR) capsules are available as a lower-cost generic medication, whereas the IR granules (Prograf) and extended-release (ER) capsules (Astagraf XL) are only available as brand-name medications. Tacrolimus (Prograf) is taken by mouth, typically twice daily. Your provider will check your tacrolimus level through blood work and adjust your dose if needed. Common side effects of tacrolimus (Prograf) include tremors, headache, diarrhea, and nausea.
Summary for Immunosuppressant
Prescription only
Sirolimus (Rapamune) lowers the activity of your immune system to prevent rejection after a kidney transplant. It can also help with a condition that affects your lymphatic system, which is related to your immune system. Your provider will check the levels of sirolimus (Rapamune) in your blood, and this will help guide the dosing. Sirolimus (Rapamune) is available as tablets and as an oral solution, and it's usually only taken once a day. Common side effects include changes in your lab values (e.g., more cholesterol and fat in the blood, change in kidney labs), which is another reason to get your blood checked regularly while taking this medication.
Indications of Prograf vs. Rapamune
Indications for
Prevention of organ transplant rejection, including: