Transplant: Tacrolimus, What’s Your Target Range?

Hello1234,
I was given his age from TP team. Yes my donor family contacted me and shared information about their son with me. I have been a very fortunate donor the family contacted me. We still keep in touch after 2years.
Thanks for the information to, I go for my 6mth ck up I am going to ask some questions.😊💚

Hi @myfablife 😊
That's wonderful that you are having contact with your donor family! Please post again on this discussion after your 6 month appointment.
I am looking forward to hearing about your visit!

👍 I will.

Hi folks,

I had a liver and kidney February 2021, and another kidney November 2021 and my Tac range is now 5-7!

I had a liver and kidney transplant in February 2021, and another kidney in November 2021 and my current Tac range is 5-7!

Hi @firecat 😊
It's great to meet you! Congrats on your new kidney and liver!
It sounds like you had a little extra excitement and received another kidney 9 months later. Did you experience rejection or something else? Is everything going well now with your new kidney? Your Tac target of 5 to 7 tells me you are probably good to go now! 👍

My transplant Drs are going to switch me from 360mg-2x daily of Myfortic to .50 of tacrolimus 1x daily due to GI issues and I want to see how it effects other people before I make the switch as I had a bad experience with CNIs (Cyclosporine harmed my kidneys and gave me arterialsclerosis from high LDL leading to heart attack and triple by-pass, High BP ,High potassium). This is why Im asking about Tacro as it is a CNI. Let me ask this , Is 360mg-2x daily of Myfortic more Immunosppresive than .50 Tacrolimus 1x daily? Which dose lowers my immune system more?
Greatly appreciated

Good morning @bosco17 😊
Wow, great questions! I would love to know that answer too. Are you able to portal a message to your transplant doctor with that question? Many times the actual doctor will message back or your transplant nurse will message back after speaking with one of the doctors. That's the kind of question I would run by your team. Do you normally call with questions or send a message? I prefer to send a message through the portal and I normally receive a response within a couple of hours (sometimes sooner). Please come back and post the answer here. Now you have me curious for the answer too!!

Hi @bosco17 My only experience is with Tacrolimus for a bone marrow transplant so I’m not familiar with Myfortic. You might want to speak with your pharmacist about Myfortic vs Tacro to get a good comparison rate of immunosuppressant level.

What I can tell you is that .5 mg of Tacro is a low dosage. Especially when some transplant patients are in the 3mg and sometimes up to 8mg daily. I was at a very high rate initially with some nasty side effects such as kidney damage, trembling, etc. But was soon able to drop down to 2mg daily and eventually to .5mg which was maintained for a couple of years. That kept my graft vs host disease symptoms to a minimum. My kidneys were very slightly impaired (the GFR was lower than norm for my ‘senior’ age) on the .5mg dosage.
When you were on Cyclosporine, what was that dosage? You might also want to talk with your pharmacist to compare the dosage of Cyclosporine with the .5mg of tacro. At a lower dosage maybe the risk will drop appreciably.

I found a couple of articles that compare tacro to cyclo and there is really not much difference. Apparently tacro was developed to be kinder to the system but with these studies posted below, it looks as though they are very similar.
https://pubmed.ncbi.nlm.nih.gov/9696431/

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https://www.uptodate.com/contents/pharmacology-of-cyclosporine-and-tacrolimus

I know you’re really reticent to try the tacro. But you are being monitored closely with your transplant team so sometimes we have no option but to ‘go for it’ with a medication that’s prescribed. You don’t want to lose your transplanted organ either. If you took the cyclosporine much earlier after your transplant, it may have been a larger dosage. Dropping down to .5mg of tacro might not cause much of an issue and I’m sure not a decision your transplant doctor is taking lightly.

How often do you have bloodwork done?

Hi bosco, yes that is a low dose how long have had a LT, I am 2yrs. LT and taking 1mg twice a day and myfortic also. I have some GI issues, joint pain. But so far nothing I can’t deal with.
Ru having any issues?