Your Pharmacy Is Out of Tacrolimus — Now What?

You show up to pick up your Tacrolimus refill and hear the words no transplant patient wants to hear: "We don't have it in stock." Your heart sinks. This medication keeps your transplanted organ safe, and you can't afford to miss doses.

The good news? There are proven strategies to find Tacrolimus quickly, even when your usual pharmacy can't help. In this guide, we'll walk you through the best tools and tips for locating Tacrolimus in stock near you.

Why Tacrolimus Can Be Hard to Find

Before we dive into solutions, it helps to understand why this happens. Tacrolimus is a specialty immunosuppressant that comes in multiple non-interchangeable formulations — Prograf (immediate-release), Astagraf XL (extended-release capsules), and Envarsus XR (extended-release tablets). Not every pharmacy stocks all formulations and strengths. Supply chain disruptions, manufacturer production issues, and limited pharmacy inventory can all contribute to temporary stockouts.

For a deeper look at the reasons behind these shortages, see our article on why Tacrolimus is so hard to find.

Tip 1: Use Medfinder to Search Pharmacy Availability

The fastest way to find Tacrolimus in stock is to use a real-time pharmacy search tool. Medfinder lets you search for medication availability at pharmacies near your zip code. Instead of spending hours calling pharmacies one by one, you can see which locations currently have Tacrolimus available — in seconds.

Here's how to use it:

1. Go to medfinder.com
2. Type in "Tacrolimus" and your zip code
3. Browse results to see which pharmacies near you have it in stock
4. Call the pharmacy to confirm before heading over

This is especially useful if your regular pharmacy is part of a chain that has limited stock. Medfinder checks across all types of pharmacies — chains, independents, and specialty pharmacies — so you get the fullest picture of what's available.

Want to learn more about checking pharmacy stock? Read our detailed guide on how to check if a pharmacy has Tacrolimus in stock.

Tip 2: Try Independent and Specialty Pharmacies

When big chain pharmacies don't have Tacrolimus, independent pharmacies are often your best bet. Here's why:

• More flexible ordering: Independent pharmacists can often order from multiple wholesalers and get medication faster than chains that use centralized ordering systems.
• Better personal service: They know their patients by name and will often go the extra mile to track down your medication.
• Specialty pharmacy expertise: Some independent pharmacies specialize in transplant medications and always keep Tacrolimus in stock.

If you've been using a chain pharmacy, ask your transplant team if they recommend a specific specialty pharmacy. Many transplant centers partner with pharmacies that prioritize immunosuppressant medications.

Tip 3: Time Your Refills Strategically

Timing matters more than you might think. Here are some practical tips:

• Refill early: Don't wait until you're down to your last few capsules. Most insurance plans let you refill 7 to 10 days before you run out. Take advantage of this window.
• Call ahead: Before driving to the pharmacy, call and confirm they have your specific formulation and strength in stock.
• Go off-peak: Pharmacies tend to be busiest on Mondays and at the end of the month. If you have flexibility, try picking up your medication mid-week or earlier in the month when supply tends to be better.
• Ask about 90-day supplies: If your insurance covers it, a 90-day supply means fewer trips to the pharmacy and less chance of running into a stockout.

What If You Still Can't Find Tacrolimus?

If you've tried the tips above and still can't locate your medication, here's what to do next:

Contact Your Transplant Coordinator

Your transplant center has dealt with this before. Your coordinator can often arrange for you to get a temporary supply from the hospital pharmacy or help transfer your prescription to a pharmacy with confirmed stock.

Ask Your Doctor About Formulation Flexibility

If one formulation is unavailable — for example, generic Tacrolimus immediate-release capsules — your doctor may be able to switch you to a brand-name version or a different extended-release formulation. Important: Never switch formulations on your own. The different versions of Tacrolimus are not interchangeable and require dose adjustments and blood level monitoring.

Look Into Mail-Order and Specialty Pharmacies

Specialty mail-order pharmacies that focus on transplant medications often have more reliable stock than retail pharmacies. Ask your insurance company or transplant center about specialty pharmacy options. Many offer home delivery, which can be more convenient too.

Check Manufacturer Programs

Astellas (the manufacturer of Prograf and Astagraf XL) offers the Astellas Cares program, which may be able to help in urgent situations. Visit astellascares.com for more information.

Don't Miss a Dose

This is the most important point: never skip or stop taking Tacrolimus without talking to your transplant team first. Even missing one or two doses can raise your risk of organ rejection. If you're running low and can't find a refill, call your transplant center immediately — they can almost always find a solution to bridge you until your prescription is filled.

Final Thoughts

Finding Tacrolimus shouldn't be a scramble, but when it is, having a plan makes all the difference. Start with Medfinder to check real-time availability, explore independent and specialty pharmacies, and always refill early.

If cost is also a concern, read our guide on how to save money on Tacrolimus. And if you're considering other options, check out alternatives to Tacrolimus.