This is a macrolide compound obtained from Streptomyces hygroscopicus with potent immunosuppressant properties.

Indications: prophylaxis of organ rejection in patients receiving renal transplants.

Cautions: monitor kidney function when given with cyclosporine; hepatic impairment, renal impairment.

Contra-indications: pregnancy; breastfeeding.

Side effect: gastrointestinal disturbances, tremor, acne, impaired renal function, hyperlipidaemia, peripheral oedema, headache, pain, asthenia and hypertension.

Dose: initial 6mg after surgery, then 2mg once daily.