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===By mouth or intravenous use=== Side effects can be severe and include [[infection]], cardiac damage, [[hypertension]], [[blurred vision]], liver and [[kidney]] problems (tacrolimus [[nephrotoxicity]]),<ref name="pmid19218475">{{cite journal | vauthors = Naesens M, Kuypers DR, Sarwal M | title = Calcineurin inhibitor nephrotoxicity | journal = Clinical Journal of the American Society of Nephrology | volume = 4 | issue = 2 | pages = 481β508 | date = February 2009 | pmid = 19218475 | doi = 10.2215/CJN.04800908 | doi-access = free }}</ref> [[hyperkalemia]], [[hypomagnesemia]], [[hyperglycemia]], [[diabetes mellitus]], [[itch]]ing, lung damage ([[sirolimus]] also causes lung damage),<ref>{{cite journal | vauthors = Miwa Y, Isozaki T, Wakabayashi K, Odai T, Matsunawa M, Yajima N, Negishi M, Ide H, Kasama T, Adachi M, Hisayuki T, Takemura T | title = Tacrolimus-induced lung injury in a rheumatoid arthritis patient with interstitial pneumonitis | journal = Modern Rheumatology | volume = 18 | issue = 2 | pages = 208β211 | year = 2008 | pmid = 18306979 | doi = 10.1007/s10165-008-0034-3 | s2cid = 39537409 }}</ref> and various neuropsychiatric problems such as loss of appetite, [[insomnia]], [[posterior reversible encephalopathy syndrome]], confusion, weakness, [[Depression (mood)|depression]], vivid nightmares, [[cramp]]s, [[neuropathy]], [[seizure]]s, [[tremor]]s, and [[catatonia]].<ref>{{cite journal | vauthors = O'Donnell MM, Williams JP, Weinrieb R, Denysenko L | title = Catatonic mutism after liver transplant rapidly reversed with lorazepam | journal = General Hospital Psychiatry | volume = 29 | issue = 3 | pages = 280β281 | year = 2007 | pmid = 17484951 | doi = 10.1016/j.genhosppsych.2007.01.004 }} </ref> In addition, it may potentially increase the severity of existing fungal or infectious conditions such as [[varicella-zoster virus|herpes zoster]] or [[polyomavirus|polyoma]] viral infections.<ref name="AC" /> ====Carcinogenesis and mutagenesis==== In people receiving immunosuppressants to reduce transplant graft rejection, an increased risk of malignancy (cancer) is a recognised complication.<ref name="AC" /> The most common cancers are [[non-Hodgkin's lymphoma]]<ref>{{Cite web|url=https://www.cancer.org/cancer/non-hodgkin-lymphoma/about/key-statistics.html|title=Key Statistics for Non-Hodgkin Lymphoma|website=www.cancer.org|access-date=19 February 2020}}</ref> and [[skin cancer]]s. The risk appears to be related to the intensity and duration of treatment.
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