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Transplant: Tacrolimus, What’s Your Target Range?

Transplants | Last Active: Nov 21, 2022 | Replies (87)

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@loribmt

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?

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Replies to "Hi @bosco17 My only experience is with Tacrolimus for a bone marrow transplant so I’m not..."

The cyclosporine dose started at 100mg -2xdaily after liver tx then dropped to 25mg-2x daily over 6 years but by then the damage was done -kidneys,heart by pass , high potassium, . What is your GFR on .50 Tac ?