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Immunosuppression: Watching For and Managing Side Effects Jul 1 10:34am | By Kristin Eggebraaten (@keggebraaten)
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@athenalee

Hello,

I am one year out of my liver transplant, I’ve had my Tacrolimus reduced from 4 mg am/pm, to 3 mg am/pm; my Mycophenolate from 2,000 mg am/pm to 1,000; I also take 300 mg Ursodial am/midday/pm (to help my new liver due to PBC which I still have); and, a multivitamin in the am. I had a very bad reaction to prednisone following my surgery, so I’ve not been on it since.

I take all my meds on an empty stomach at 8:15-8:30 am/pm. So far this works for me and I do not have any stomach issues. My trough is consistently 5.6-7. I’ve read that between 5-10 is optimal. I can send you a research paper I have on Tac trough levels if you’re interested.

Are you a liver transplant recipient? How many years? Are you liver functions ok. My AST and ALT are well within normal. My ALP remains high due to PBC, but even it has gone down which is good.

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Replies to "Hello, I am one year out of my liver transplant, I’ve had my Tacrolimus reduced from..."
stan1357 | @stan1357 | Sep 21, 2021

Hi, interesting that you don't take pred any more. Sounds like it hasn't affected liver function / tests. I don't like drugs so take minimum due to symptoms and long term side effects. I think I could reduce or even stop my Pred as well. I used to get swollen feet which stopped when I reduced. My MMF is at minm dose 250 mg bd but I have side effects with my concentration and memory plus it can damage the liver so I would like to reduce that as well, sad to say the medics are not supportive. I was surprised and pleased that you could talk to them about reducing tac dose and they were prepared to do a trial for you. Mostly / always no comment I get ignored about side effects and the mind set is disease progression and rejection.
I am a kidney transplant post 7years. I recently read a research paper from Tokyo Japan med. Center of 554 patients on low dose tac 4 - 6 and there was no correlation between the level and patients who did or did not have rejection events. Tac trough target levels change depending on time of transplant, per / post. Personally I think the medics are more concerned with law suits for under dosing than side effects of medication, long or short term.

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