Increased risk for developing serious infections and malignancies with ENVARSUS XR or other immunosuppressants that may lead to hospitalization or death

Adverse Events/Product Complaints | Please See Additional Important Safety Information Below

Proven conversion dosing

Switching a kidney transplant patient from immediate-release tacrolimus is a straightforward process

1. Reduce by 20%

  • Start ENVARSUS XR at 80% of the total daily dose of immediate-release tacrolimus
  • Due to reduced clearance and prolonged half-life, patients with severe hepatic impairment (Child-Pugh ≥10) may require a lower starting dosage of ENVARSUS XR                   
  • African-American patients, compared to Caucasian patients, may need to be titrated to higher ENVARSUS XR dosages to attain comparable trough concentrations

2. Dose once a day

  • Administer the first dose in the morning, 12 hours after the last evening dose of immediate-release tacrolimus1  
  • There is no need to administer any other form of tacrolimus to achieve target trough levels after conversion
  • Monitor tacrolimus trough concentrations and titrate ENVARSUS XR 
dose to achieve the target trough level desired for each patient*

3. Educate your patients

  • Be sure they understand exactly how to take ENVARSUS XR and how it is different from the tacrolimus they had been taking. Download Patient Dosing Information Sheet
  • Take ENVARSUS XR on an empty stomach at the same time of the day, preferably in the morning (to ensure consistent and maximum possible drug exposure)
  • Swallow ENVARSUS XR whole with fluid (preferably water); do not chew, divide, or crush the tablets
  • If a dose is missed, take it as soon as possible within 15 hours after missing the dose; beyond the 15-hour time frame, wait until the usual scheduled time to take the next regular daily dose. Do not double the next dose
  • Avoid eating grapefruit, drinking grapefruit juice, or drinking alcohol while taking ENVARSUS XR

* Recommended target whole blood trough concentration range is 4 to 11 ng/mL.


When prescribed, your patients will receive
ENVARSUS XR with every refill

  • There is no generic equivalent for ENVARSUS XR
  • ENVARSUS XR cannot be automatically substituted at the pharmacy with any other tacrolimus brand or generic product

Available Strengths of ENVARSUS XR

0.75 mg Tablet
1 mg Tablet
4 mg Tablet
Tablets shown are not actual size.


1. ENVARSUS XR [prescribing information]. Edison, NJ:  Veloxis Pharmaceuticals; 2015.