Drug-induced nutrient depletion

Tacrolimus & Nutrient Depletion

Also searched as Prograf (capsule), Prograf (injectable), Protopic. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.

Medical content reviewed by Dr. Brian Staiger, PharmD, BCPS · Last reviewed July 2026
1Nutrient association
Major DepletionHighest rating
The bottom line

Tacrolimus has been associated with depletion of MAGNESIUM. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Tacrolimus long-term, worth raising with your pharmacist or healthcare provider.

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Take more than one medication? Open the checker with Tacrolimus pre-loaded and add the rest to see overlapping nutrient signals.

The evidence

Reported nutrient depletions with Tacrolimus

Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.

MAGNESIUM

Major Depletion

TACROLIMUS (Prograf)

Tacrolimus increases magnesium losses in the urine.

Tacrolimus reduces renal tubular reabsorption of magnesium, producing increased magnesium wasting. This leads to hypomagnesemia in a significant proportion of people treated with tacrolimus. For information on foods that are rich in magnesium, see our chart.
Taking Tacrolimus? A supplement is needed for most patients. ⓘ
Dr. Brian Staiger, Pharm.D explains

Magnesium is a mineral your muscles, nerves, and heart rhythm depend on every day. Tacrolimus interferes with how the kidneys reclaim magnesium, so more of it gets lost in the urine than normal. Because this happens in a meaningful number of people on this medication, low magnesium levels are a real concern here, not just a theoretical one. If you take tacrolimus regularly, it is worth asking your doctor or pharmacist whether your magnesium level should be checked and whether a supplement makes sense for you.

What Magnesium does & food sources

Magnesium is involved in muscle and nerve function, heart rhythm, blood sugar control, and bone health.

Common food sources:

  • Nuts and seeds (almonds, pumpkin seeds)
  • Whole grains
  • Leafy green vegetables
  • Beans and legumes

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask whether a magnesium level is worth checking if you take an associated medication long-term — particularly with symptoms like muscle cramps, twitching, or palpitations. Blood levels do not always reflect total body stores, which is worth discussing too.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Magnesium supplements come in many forms and can cause loose stools at higher doses. They can also bind some medications in the gut (certain antibiotics, thyroid medication), so timing matters — check with your pharmacist.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Magnesium supplementation can be risky in kidney disease, where magnesium can accumulate — always check with a clinician first if your kidney function is reduced.

Learn more about this nutrient: Magnesium — uses, safety & interactions

References (2)
  1. Lote CJ, Thewles A, Wood JA, Zafar T. The hypomagnesaemic action of FK506: urinary excretion of magnesium and calcium and the role of parathyroid hormone. Clin Sci 2000;99:285-92.. DOI
  2. Niederstadt C, Steinhoff J, Erbsloh-Moller B, et al. Effect of FK506 on magnesium homeostasis after renal transplantation. Transplant Proc 1997;29:3161-2. PubMed
Important

This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.

Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.

© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
Keep exploring

More about Tacrolimus

Understand the basics

What drug-induced nutrient depletion means

Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.

Association is not deficiency

An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.

Evidence varies by pair

Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.

When to ask about labs

If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.

Don't self-supplement blindly

Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.

Never stop a medication over this

These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.

Food first, usually

For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.

Common questions

Tacrolimus & nutrients: FAQs

Does Tacrolimus deplete MAGNESIUM?
Tacrolimus has been associated with lower MAGNESIUM levels in the clinical literature — see the evidence rating and details above. An association is not a guarantee: dose, duration, diet, and your own health all matter. If you take Tacrolimus long-term, ask your healthcare provider whether checking your MAGNESIUM status is appropriate.
Should I take a supplement because I take Tacrolimus?
Not automatically. The right first step is usually a conversation with your pharmacist or provider — they can weigh your dose and duration, decide whether testing makes sense, and recommend food-first strategies or a supplement if genuinely needed. Some supplements can interact with medications, so do not add one without checking.
Should I stop taking Tacrolimus?
No — never stop a prescribed medication because of a nutrient association. Tacrolimus is prescribed for good reasons, and nutrient considerations are usually manageable with monitoring or diet. Any change to your medication belongs in a conversation with your prescriber.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English context is written and reviewed by licensed HelloPharmacist pharmacists.

Questions about Tacrolimus and your nutrition?

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Sources

Sources & How We Checked

Nutrient depletion records for Tacrolimus are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.