as someone on tacrolimus goddamn this is terrifying
When Hannah’s pharmacy began filling her tacrolimus prescription with a generic version, the lung transplant patient didn't know something very important:
Months earlier, an FDA-commissioned study concluded that this generic was not equivalent to the brand drug -- and that her life was at risk.
Months earlier, an FDA-commissioned study concluded that this generic was not equivalent to the brand drug -- and that her life was at risk.
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
December 19, 2025 at 2:50 PM
as someone on tacrolimus goddamn this is terrifying
In 2021, Hannah Goetz’s pharmacy began filling her tacrolimus prescription with a generic made by Accord.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
(Published Dec. 2025)
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
(Published Dec. 2025)
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
March 7, 2026 at 10:00 PM
In 2021, Hannah Goetz’s pharmacy began filling her tacrolimus prescription with a generic made by Accord.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
(Published Dec. 2025)
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
(Published Dec. 2025)
titrating tacrolimus to thrush
October 2, 2025 at 2:59 AM
titrating tacrolimus to thrush
Well before transplant patient Hannah Goetz began taking tacrolimus, there’d been concerns at the FDA about whether generic versions of the drug were being made correctly, said the agency’s former director of product quality research for drugs.
(Published Dec. 2025)
(Published Dec. 2025)
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
April 10, 2026 at 10:08 PM
Well before transplant patient Hannah Goetz began taking tacrolimus, there’d been concerns at the FDA about whether generic versions of the drug were being made correctly, said the agency’s former director of product quality research for drugs.
(Published Dec. 2025)
(Published Dec. 2025)
Hannah Goetz was 17 when she had a double lung transplant.
Her tacrolimus medication was supposed to help her body accept her new lungs.
She died at just 21 years old.
Her tacrolimus medication was supposed to help her body accept her new lungs.
She died at just 21 years old.
Her Daughter Died After Taking a Generic Version of a Lifesaving Drug. This Is What She Wants You to Know.
Hannah Goetz was 17 when she had a double lung transplant. Her tacrolimus medication was supposed to help her body accept her new lungs. She died at just 21 years old.
www.propublica.org
January 17, 2026 at 10:00 PM
Hannah Goetz was 17 when she had a double lung transplant.
Her tacrolimus medication was supposed to help her body accept her new lungs.
She died at just 21 years old.
Her tacrolimus medication was supposed to help her body accept her new lungs.
She died at just 21 years old.
In 2021, Hannah Goetz’s pharmacy began filling her tacrolimus prescription with a generic made by Accord.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
From our “Rx Roulette” series, a 2026 Pulitzer finalist:
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
From our “Rx Roulette” series, a 2026 Pulitzer finalist:
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
May 7, 2026 at 3:36 PM
In 2021, Hannah Goetz’s pharmacy began filling her tacrolimus prescription with a generic made by Accord.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
From our “Rx Roulette” series, a 2026 Pulitzer finalist:
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
From our “Rx Roulette” series, a 2026 Pulitzer finalist:
In 2021, Hannah Goetz’s pharmacy began filling her tacrolimus prescription with a generic made by Accord.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
January 11, 2026 at 5:00 PM
In 2021, Hannah Goetz’s pharmacy began filling her tacrolimus prescription with a generic made by Accord.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
What she didn’t know: An FDA-commissioned study concluded months earlier that Accord’s generic was not equivalent to the brand drug.
While transplant patients can research to pick and choose doctors and hospitals, they generally have no control over which generic version of critical drug tacrolimus they get from the pharmacy.
That can make a difference between life and death.
That can make a difference between life and death.
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
December 22, 2025 at 4:00 AM
While transplant patients can research to pick and choose doctors and hospitals, they generally have no control over which generic version of critical drug tacrolimus they get from the pharmacy.
That can make a difference between life and death.
That can make a difference between life and death.
Hormones thyroïdiennes : lévothyroxine
Immunosuppresseurs : évérolimus, tacrolimus, sirolimus
Inhibiteurs de la pompe à protons : oméprazole, ésoméprazole
Antibiotiques : rifampicine, rifabutine
Antifongiques : griséofulvine
Myorelaxants : tizanidine 5/
Immunosuppresseurs : évérolimus, tacrolimus, sirolimus
Inhibiteurs de la pompe à protons : oméprazole, ésoméprazole
Antibiotiques : rifampicine, rifabutine
Antifongiques : griséofulvine
Myorelaxants : tizanidine 5/
March 15, 2025 at 12:13 PM
Hormones thyroïdiennes : lévothyroxine
Immunosuppresseurs : évérolimus, tacrolimus, sirolimus
Inhibiteurs de la pompe à protons : oméprazole, ésoméprazole
Antibiotiques : rifampicine, rifabutine
Antifongiques : griséofulvine
Myorelaxants : tizanidine 5/
Immunosuppresseurs : évérolimus, tacrolimus, sirolimus
Inhibiteurs de la pompe à protons : oméprazole, ésoméprazole
Antibiotiques : rifampicine, rifabutine
Antifongiques : griséofulvine
Myorelaxants : tizanidine 5/
randomized trials for tacrolimus for idiopathic nephrotic syndrome
October 22, 2024 at 3:59 PM
randomized trials for tacrolimus for idiopathic nephrotic syndrome
“For years, tacrolimus was made by one company… When generic versions arrived 15 years later, none behaved in the body exactly like the original tacrolimus or like one another… Canada and the European Union both adopted tighter standards.” The US did not. www.propublica.org/article/fda-...
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
February 24, 2026 at 8:44 AM
“For years, tacrolimus was made by one company… When generic versions arrived 15 years later, none behaved in the body exactly like the original tacrolimus or like one another… Canada and the European Union both adopted tighter standards.” The US did not. www.propublica.org/article/fda-...
Tacrolimus, which helps prevent rejection of transplanted organs, only works if the dose is calibrated within a very narrow range.
Any amount outside that window can be dangerous.
But not all generic versions of the drug may meet that standard.
Any amount outside that window can be dangerous.
But not all generic versions of the drug may meet that standard.
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
December 29, 2025 at 11:00 PM
Tacrolimus, which helps prevent rejection of transplanted organs, only works if the dose is calibrated within a very narrow range.
Any amount outside that window can be dangerous.
But not all generic versions of the drug may meet that standard.
Any amount outside that window can be dangerous.
But not all generic versions of the drug may meet that standard.
When Hannah’s pharmacy began filling her tacrolimus prescription with a generic version, the lung transplant patient didn't know something very important:
Months earlier, an FDA-commissioned study concluded that this generic was not equivalent to the brand drug -- and that her life was at risk.
Months earlier, an FDA-commissioned study concluded that this generic was not equivalent to the brand drug -- and that her life was at risk.
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
December 19, 2025 at 1:17 PM
When Hannah’s pharmacy began filling her tacrolimus prescription with a generic version, the lung transplant patient didn't know something very important:
Months earlier, an FDA-commissioned study concluded that this generic was not equivalent to the brand drug -- and that her life was at risk.
Months earlier, an FDA-commissioned study concluded that this generic was not equivalent to the brand drug -- and that her life was at risk.
NEW: After a lung transplant, Hannah Goetz’s life depended on the generic version of tacrolimus, a critical drug to prevent organ rejection.
It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ensure that’s the case.
It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ensure that’s the case.
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ensure that’s the case.
www.propublica.org
December 19, 2025 at 1:00 PM
NEW: After a lung transplant, Hannah Goetz’s life depended on the generic version of tacrolimus, a critical drug to prevent organ rejection.
It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ensure that’s the case.
It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ensure that’s the case.
13/ A Dr. Reddy’s spokesperson said in a statement that the company’s version of tacrolimus was approved based on rigorous studies, that all batches sold in the United States have met FDA specifications and FDA studies didn’t reveal any problems with its tacrolimus.
December 20, 2025 at 1:56 PM
13/ A Dr. Reddy’s spokesperson said in a statement that the company’s version of tacrolimus was approved based on rigorous studies, that all batches sold in the United States have met FDA specifications and FDA studies didn’t reveal any problems with its tacrolimus.
11/ Dr. Reddy's tacrolimus wasn't the only problematic generic version of the drug that Hannah would end up getting from the pharmacy.
Read our full investigation here:
Read our full investigation here:
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
December 20, 2025 at 1:55 PM
11/ Dr. Reddy's tacrolimus wasn't the only problematic generic version of the drug that Hannah would end up getting from the pharmacy.
Read our full investigation here:
Read our full investigation here:
There's a recall of some batches of anti-rejection medications for organ transplant recipients. Some of the capsules are empty. Someone I know was NOT notified by their pharmacy as they claim to have not received the recall info yet. Please share. #news #health 🥽🧪🍎
www.fda.gov/safety/recal...
www.fda.gov/safety/recal...
Astellas Pharma US, Inc. Issues Voluntary Nationwide Recall of One Lot of PROGRAF® 0.5mg (Tacrolimus) and One Lot of ASTAGRAF XL® 0.5mg (Tacrolimus Extended-Release Capsules) Because Bottles Shipped t...
Astellas Pharma US, Inc. (Head of US Commercial: Michael Petroutsas, "Astellas") is voluntarily recalling one lot of PROGRAF® 0.5mg (tacrolimus) and one lot of ASTAGRAF XL® 0.5mg (tacrolimus extended-...
www.fda.gov
December 26, 2024 at 10:36 PM
There's a recall of some batches of anti-rejection medications for organ transplant recipients. Some of the capsules are empty. Someone I know was NOT notified by their pharmacy as they claim to have not received the recall info yet. Please share. #news #health 🥽🧪🍎
www.fda.gov/safety/recal...
www.fda.gov/safety/recal...
4/ Hannah’s transplant pharmacist, Adam Cochrane, knew the balancing act was a teeter-totter.
Too much tacrolimus, and the immune system would dip too weak to ward off infection. Too little tacrolimus, and the immune system would tip too strong and attack the transplanted organ.
Too much tacrolimus, and the immune system would dip too weak to ward off infection. Too little tacrolimus, and the immune system would tip too strong and attack the transplanted organ.
December 20, 2025 at 1:54 PM
4/ Hannah’s transplant pharmacist, Adam Cochrane, knew the balancing act was a teeter-totter.
Too much tacrolimus, and the immune system would dip too weak to ward off infection. Too little tacrolimus, and the immune system would tip too strong and attack the transplanted organ.
Too much tacrolimus, and the immune system would dip too weak to ward off infection. Too little tacrolimus, and the immune system would tip too strong and attack the transplanted organ.
Our household uses Tacrolimus.
"A team of Japanese scientists discovered tacrolimus in the 1980s, in a fungus found in the soil of a lush, purple-hued mountain north of Tokyo."
did not know that. wow.
"A team of Japanese scientists discovered tacrolimus in the 1980s, in a fungus found in the soil of a lush, purple-hued mountain north of Tokyo."
did not know that. wow.
“For years, tacrolimus was made by one company… When generic versions arrived 15 years later, none behaved in the body exactly like the original tacrolimus or like one another… Canada and the European Union both adopted tighter standards.” The US did not. www.propublica.org/article/fda-...
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
February 24, 2026 at 10:06 AM
Our household uses Tacrolimus.
"A team of Japanese scientists discovered tacrolimus in the 1980s, in a fungus found in the soil of a lush, purple-hued mountain north of Tokyo."
did not know that. wow.
"A team of Japanese scientists discovered tacrolimus in the 1980s, in a fungus found in the soil of a lush, purple-hued mountain north of Tokyo."
did not know that. wow.
5/ For years, tacrolimus was made by just one company, now called Astellas.
But when generic versions arrived 15 years later, none behaved in the body exactly like the original, or like each other.
But when generic versions arrived 15 years later, none behaved in the body exactly like the original, or like each other.
December 20, 2025 at 1:54 PM
5/ For years, tacrolimus was made by just one company, now called Astellas.
But when generic versions arrived 15 years later, none behaved in the body exactly like the original, or like each other.
But when generic versions arrived 15 years later, none behaved in the body exactly like the original, or like each other.
6/ When considering which generic versions of tacrolimus to allow, both Canada and the European Union adopted tighter standards due to how much precision the drug requires.
The U.S. instead started with a one-size-fits all approach.
The U.S. instead started with a one-size-fits all approach.
December 20, 2025 at 1:54 PM
6/ When considering which generic versions of tacrolimus to allow, both Canada and the European Union adopted tighter standards due to how much precision the drug requires.
The U.S. instead started with a one-size-fits all approach.
The U.S. instead started with a one-size-fits all approach.
induction with antithymocyte globulin followed by maintenance with tacrolimus plus sirolimus. About two million Americans have type 1 diabetes, which is caused when the immune system destroys islet cells. A subset of islet cells, the beta cells, secrete insulin. Without insulin, glucose cannot enter
June 23, 2025 at 4:03 PM
induction with antithymocyte globulin followed by maintenance with tacrolimus plus sirolimus. About two million Americans have type 1 diabetes, which is caused when the immune system destroys islet cells. A subset of islet cells, the beta cells, secrete insulin. Without insulin, glucose cannot enter
3/ But tacrolimus is part of a special category of drugs that work only if the dose is calibrated within a very narrow range.
Any amount outside that window can be dangerous, particularly for lung transplant patients, who face high rates of rejection.
Any amount outside that window can be dangerous, particularly for lung transplant patients, who face high rates of rejection.
December 20, 2025 at 1:53 PM
3/ But tacrolimus is part of a special category of drugs that work only if the dose is calibrated within a very narrow range.
Any amount outside that window can be dangerous, particularly for lung transplant patients, who face high rates of rejection.
Any amount outside that window can be dangerous, particularly for lung transplant patients, who face high rates of rejection.
"That month, a biopsy had confirmed that her body was rejecting her lungs, precisely what tacrolimus was supposed to prevent. The damage was irreversible."
“i fought so hard and this time luck just wasn’t on my side.”
Do you know where your generic drugs are coming from and are they safe?
#Pinks
“i fought so hard and this time luck just wasn’t on my side.”
Do you know where your generic drugs are coming from and are they safe?
#Pinks
Fighting for Breath: The FDA’s Lax Generic Drug Rules Put Her Life at Risk
Lung transplant patient Hannah Goetz’s life depended on the generic version of the critical drug tacrolimus. It was supposed to be equivalent to the brand-name medication — but the FDA doesn’t always ...
www.propublica.org
December 19, 2025 at 2:42 PM
"That month, a biopsy had confirmed that her body was rejecting her lungs, precisely what tacrolimus was supposed to prevent. The damage was irreversible."
“i fought so hard and this time luck just wasn’t on my side.”
Do you know where your generic drugs are coming from and are they safe?
#Pinks
“i fought so hard and this time luck just wasn’t on my side.”
Do you know where your generic drugs are coming from and are they safe?
#Pinks
8/ Almost from the start, some transplant doctors raised concerns that patients on one type of tacrolimus — produced by Indian generics maker Dr. Reddy’s — were faring worse.
The Cleveland Clinic was so alarmed it banned Dr. Reddy’s generic for its transplant patients in 2013.
The Cleveland Clinic was so alarmed it banned Dr. Reddy’s generic for its transplant patients in 2013.
December 20, 2025 at 1:55 PM
8/ Almost from the start, some transplant doctors raised concerns that patients on one type of tacrolimus — produced by Indian generics maker Dr. Reddy’s — were faring worse.
The Cleveland Clinic was so alarmed it banned Dr. Reddy’s generic for its transplant patients in 2013.
The Cleveland Clinic was so alarmed it banned Dr. Reddy’s generic for its transplant patients in 2013.