Tacrolimus is (DNB June 2010)
a. Ototoxicity is NOT a side effect of tacrolimus. There are three major locations where medications exert ototoxicity. The first location is the cochlea; medications that affect it are thought to exhibit cochlear toxicity.
b. Ototoxicityinvolving the cochlea produces hearing loss, usually commencing with high frequencies but often eventually progressing to the lower frequencies that encompass speech.
c. The hearing loss may be one-sided or bilateral and may fluctuate in severity. Cochlear damage may also manifest as tinnitus.
d. The tinnitus may be constant or fluctuate. Patients with preexisting tinnitus may notice the problem worsening or the appearance of a new sound that was not present before the medication was administered.
e. The vestibulum is a second site of action for ototoxic medications; these are known as vestibulotoxic medications. Vestibulotoxicity usually manifests as balance-related problems (e.g., disequilibrium).
f. The patient reports a spinning sensation that is often aggravated by motion and is associated with nausea. The stria vascularis is the third site of action for ototoxic medications.
g. The stria vascularis is a type of epithelium that is uniquely able to produce endolymph in the cochlea. Excessive endolymph is responsible for Meniere's syndrome.