Tacrolimus
Approved, for something elseMeasured in people, not heightBy mouthSmall moleculeAlso FK506
A transplant medicine. It grabs a small protein, and the pair switches off the enzyme that lets a cartilage transcription factor into the nucleus. That same small protein is also a catch on the bone-building receptor.
A macrolide immunosuppressant. It binds FKBP12, and the complex inhibits calcineurin, the phosphatase that strips the phosphates keeping NFAT out of the nucleus. The same FKBP12 restrains the BMP type I receptor, which is why the drug turns up in fibrodysplasia ossificans progressiva research. Approved for prophylaxis of organ rejection in adult and paediatric recipients of allogeneic kidney, liver, heart or lung transplants, in combination with other immunosuppressants.
Risks. Its label carries the strongest class of warning there is, for cancers and serious infections that can lead to hospital or death. It also damages the kidneys and the nerves, raises blood pressure and blood sugar, thickens the heart muscle and rules out live vaccines.
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Educational content, not medical advice. Nothing here is a recommendation to take or stop taking anything — talk to a doctor about your own situation.