Rosemary and others can certainly offer insights…I think it best to do what meets your body parameters, within the every 12 hour timeframe. I’ve read that for optimum absorption of Tacrolimus it is best to take on an empty stomach, if it doesn’t bother you.

After experimenting with a couple of times, I’ve found that taking my morning dose at 8:30 and pm at 8:30 works well for me. I’m typically up 5-6 am. I have a half cup coffee and half cup protein shake. Take my meds, then eat breakfast/brunch between 9:30-11, which I do at work.

I try to eat between 5-6, so that I have two hours to digest supper before taking my pills. Since we’re supposed to drink a lot of water with our pills, I’ve found this time works so I’m not having to get up in the night to use the bathroom. So far, no stomach issues.

It’s not an easy thing to juggle with work, family needs, one’s body needs, etc. so, perhaps experiment by starting with taking yours at 10. Then 9:30, etc..

@nimalw, Good morning. I will share my experience of what is the best time for me. When I say best time, it is the time that has worked well for my since my transplant in 2009. 8:00 AM and 8:00 PM with minimal adjustments as needed.
My transplant team said to select a time that I knew I could adhere to. I am not confined to eat with/without food because this has allowed me to consistently take my meds, and my levels are stable with a happy liver/kidney. I do, however, still take my bedtime meds like allergy, BP, at bedtime.

Do you take your meds with food? If decide to try an earlier dose, I suggest you make a gradual adjustment. Do you think an earlier dose might be possible for you?

@nimalw I realized you addressed @rosemarya but I hope you don't mind if I also respond with my experiences with my immunosuppressant.

I have to go for tests every other month and that needs to be basically during the 23rd hour since I took my immunosuppressant - I only take it in the morning. So I generally take it shortly before 8:00 in the morning which allows me to get to the lab between 7:00 and 8:00 when I need to go for my labwork.

Initially I didn't bother to consider food vs empty stomach but then I realized that when they said to take it either with or without food they probably actually meant to be consistent with which way you did it. I spoke to my transplant team and chose to try taking it without food figuring that way I would be able to take less. At that time I was taking 4mg. When I started taking it without food (I wait an hour before eating) I was able to drop to 2.5mg a day and maintain the same level of protection. The transplant team followed me more closely than usual with more frequent testing to check the results of that change.

Do you have to coordinate your medications with getting lab work done? That can certainly make a difference. Also, if you choose to take it without regard to food and plan to eat either prior to taking it or soon after that too can make a difference, it certainly did with me.
JK