Hello! We dispense a standard bag size for all adult patients on tacrolimus IV (2.5 mg/250 mL). It is built as a continuous infusion to allow for dose adjustments as soon as the level comes back in the morning. We also have this med on our Time Critical List and a standard administration time of 1800 (new bag is hung at 1800 regardless of how much is left in the bag). We are running into issues since the continuous infusion build in Epic does not put due times on the MAR and the med occasionally is being administered late.

Our hospital would like to start giving tacrolimus via the SL route for patients unable to swallow the capsule.
Does anyone administer tacrolimus sublingually in their hospital and has a policy or process to share on how it is being administered, respecting that it is listed as a Group 2 hazardous medication on NIOSH's hazardous drug list?

Thank you! Alex