← Return to Immunosuppression: Watching For and Managing Side Effects

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@stan1357

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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Replies to "Hi, interesting that you don't take pred any more. Sounds like it hasn't affected liver function..."

Well, I had terrible hallucinations and just slept for about two weeks after surgery until they felt they could take me off prednisone. So, not pleasant. But, I’m definitely glad I’m not on it. And, it certainly hasn’t effected my ALT or ASP. ALP is high, due to PBC, but even it has gone down. Have you found research on transplant recipients and prednisone vs. those not on it? Perhaps there’s a natural way to reduce swelling if you lower or eliminate prednisone? I’m a liver transplant recipient, so might make a difference too.

I’m with you…I’m so glad I’ve been able to cut my meds in half in a year. I hope to reduce them more. That’s great your Mycophenolate dosage is so low. I have hand tremors, which seem to relate to neuropathy I have due to an autoimmune disease. But, my liver doctor agreed to see how I’d due lowering Tac, to see if it might be causing or worsening the tremors. I’m now at 3 mg am/pm. The tremors are better, but I’ve also been taking supplements and eating well. So, who knows, but I’ll take it!

The attached article is similar to yours, putting the trough level range at 4.6–10.2 ng/mL. You only take 1 mg, am/pm of Tac? Do they make a lower dose?

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LT Tacrolimus Trough jpm-11-00090-v2 (LT-Tacrolimus-Trough-jpm-11-00090-v2.pdf)