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Transplant patients - anyone get anemia or Parvo Virus?
Transplants | Last Active: 8 hours ago | Replies (68)Comment receiving replies
@caretakermom
What do you think of returning back to Envarsus XR snd Cellcept/Myfortic?
Other than the recurring CMV, was there any other reason they fid a full med change to Everolimus?
Is it possible that hubby would do fine returning back to Envarsus XR (TAC) and a lower dosage of Cellcept/Myfortic to avoid the CMV?
With diabetes, I am not crazy about putting hubby on prednisone is ot can be avoided.
Was a lower dose of Cellcept/Myfortic attempted? What dosage was he taking of Myfortic when the switch to Everolimus occurred?
Replies to "@caretakermom What do you think of returning back to Envarsus XR snd Cellcept/Myfortic? Other than the..."
The Myfortic dose prior to Everolimus, says take 180mg, e tablets, BID. So 540mg 2x/daily. I remember having to adjust down to 2 - 1 tablet while battling CMV. Then raised back up to 3 and CMV would recur. Never BK virus though. Adjusted for about 6 months finally Mayo switch to Everolimus in Dec 2022 I think.
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@hello1234
Hubby was never on Envarsus XR; he has been on Tacrolimus since transplanted.
The only reason they switched him from Myfortic to Everolimus was because of the CMV recurrence.
I don't remember what Mycophenolate dose hubby was taking - they switched to Myfortic on week 3 post txplant. Not sure if a lower dose of Myfortic is feasible for hubby either. I think Mayo switch med because they were not happy about the dose tolerated by hubby(without get CMV) - nurse said it didn't meet the standard dose.
Mayo's plan for hubby is to get off of Everolimus (if that is indeed the culprit of anemia) and get on predisone( not crazy about it ). Home neph was saying that even if we wanted to switch to a different txplant med, we couldn't just switch immediately - must be on prednisone for a time then switch.
Hopefully by discontinuing Everolimus, hubby's hemaglobin will improve and slowly recover from anemia. The hematologist is pretty certain Everolimus is to blame because all relevant labs point to bone marrow suppression. Don't think you even need a bone marrow biopsy to prove that the medicine is causing havoc. I mean, if we discontinue Everolimus and his CBC panel becomes normal - recovers from anemia, then common sense tells you that the medication is the cause, right? Anyways, Mayo Az wants bone marrow biopsy done and I have relayed the msg to hematologist. He can discuss with our home neph to determine if one is necessary.
Meantime, the home neph ordered 5mg prednisone to be taken daily along with normal dose of Tacrolimus. I suspect once hubby recovers from anemia our home neph will discuss with Mayo Az if he can return to Everolimus(dose/trough level TBD) or more feasible to switch to a different medication - the choices being Mycophenolate(no go because diarrhea) or Myfortic (perhaps on a lower dose). Then they can perhaps eliminate prednisone from the regimen.