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Hi there. Thanks for the question. I'm sorry to hear that your dog has gotten into some trouble. Yes, you should proceed to the vet right away to have them give activated charcoal. Tacrolimus is very toxic to dogs and causes severe vomiting as you have seen and then hypermotility of the intestines that can lead to a surgical problem called intussception where one part of the intestines telescopes into another. This is very serious. Please seek out emergency veterinary care. I hope this helps. Best wishes.