Side effects
Tacrolimus for liver and bowel conditions
Common side effects
Like all medicines, tacrolimus can cause side effects, although not everyone gets them. These common side-effects happen in more than 1 in 100 people:
- diarrhoea
- feeling sick (nausea)
- tummy (abdominal) cramps
- headaches
- changes to heart rate
- changes to vision and hearing
- changes to hair growth
- increased blood pressure
- increased blood sugar
- trembling
- sleep difficulties
Do not drive if you feel dizzy, sleepy or have problems seeing clearly.
Contact your healthcare team or a GP if you get:
- an unexplained sore throat
- a high temperature (fever)
- breathlessness
- unexplained bruising or bleeding
- yellowing of the skin or eyes
- diarrhoea that lasts for more than 1 day
- bad tummy pains
- any other symptoms that are new to you
These are not all the side effects of tacrolimus. For a full list, see the leaflet inside your medicine packet.
Cancer risk
There is a slightly increased risk of cancer for people taking tacrolimus.
This includes the risk of skin cancer. This is rare, but it’s best to start habits that lower your chances of getting skin cancer.
Do
- use SPF 50 sunscreen when you’re in the sun
- wear a hat, sunglasses and clothes that cover your skin when you’re in the sun
- check your skin regularly for any new spots, freckles or moles
See a GP if you have:
- a new mole on your skin
- a mole that has changed size, shape or colour
- a mole that’s painful or itchy
- a mole that’s inflamed, bleeding or crusty
Infection and vaccines
Tacrolimus affects your immune system. This means you might take longer to recover from an infection.
It’s important you get vaccinated to protect yourself from common infections. Ask a GP to book your:
- flu vaccine every winter
- COVID-19 vaccine every year
- pneumococcal vaccine every 5 years
Avoid vaccines that contain the virus they’re protecting against (live vaccines).
Live vaccines include the:
- BCG vaccine for tuberculosis
- MMR (measles, mumps and rubella) vaccine
- yellow fever vaccine
Some vaccines might not mix well with tacrolimus. Always check with your doctor or pharmacist before getting a vaccine.
Call 111 immediately if you:
- get chickenpox or shingles
- come into contact with someone who has chickenpox or shingles.
Chickenpox and shingles can be worse for people taking tacrolimus. We might prescribe you antiviral medicines to help you get better. Your doctor might tell you to stop taking tacrolimus temporarily.
Pregnancy and breastfeeding
If you’re planning to have children, or if you or your partner become pregnant while taking tacrolimus, talk with your doctor as soon as possible. We might need to adjust your treatment to make sure you can have a baby safely.
Tacrolimus can pass through to your breast milk. Talk to your healthcare team about the risks and benefits of breastfeeding while taking tacrolimus.
Resource number: 5550/VER1
Last reviewed: November 2025
Next review due: November 2028
