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← Return to Immunosuppression: Watching For and Managing Side Effects
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Immunosuppression: Watching For and Managing Side Effects Jul 1 10:34am | By Kristin Eggebraaten (@keggebraaten)Comment receiving replies
@stan1357 I'm glad to hear that they are clarifying that. The immunosuppressants that I have been on, first tacrolimus and now sirolimus, have just said "take with or without food" but have not made it clear that you need to be consistent. If you are not consistent it affects the amount of the drug in your system. When I realized this I mentioned to my transplant department that I would prefer to take it without food so I could drop the dosage. They followed me with extra lab work and I was able to drop from 4mg to 2.5mg by taking I without food.
I always figure the least amount of anything that you have to take, the better, but I suppose if less is being absorbed it's a moot point. It could make a big difference though for anyone who has to pay for their immunosuppressants. Mine are all covered by Medicare B.
JK
Replies to "@stan1357 I'm glad to hear that they are clarifying that. The immunosuppressants that I have been..."
Tac is absorbed in the red cell membrane and released passively. If you are a slow metabolizer you will need less dose. C/D ratio < 1.55. If fast metabolizer less dose, > 1.05. In other words you need less or more tac to get the target level hence toxicity.
Regarding tac and siro whilst the same type of drug CNI they have different pharmacokinetics. He the hospital prescribe adiport tac and don't like or allow general practice to do it although mine has.
I agree less is more due to toxicity.
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If your stomach can handle it, it’s definitely better for to take the meds on an empty stomach, for exactly that reason. My Tacrolimus and Mycophenolate have been reduced by 50% in less than a year. My Tac trough is consistently at 5.5-6 which is good.
Morning is easy, I take them at 8:15 and wait at least an hour to eat breakfast. Dinner is harder, especially if you’re going out. I try to eat at 5-5:30, so I’m done by 6 and can leave two hours to metabolize my food.