Since the BK is responding nicely to the lowering of the Cellcept, allowing your immune system to get the virus under control, it’s not likely you’re going to have an increase in the Tacro dosage to compensate. That would defeat the purpose. It would again increase your immunosuppressant level and slow the immune system down. Your doctor lowered the Cellcept to ‘unleash the hounds’ of defense. ☺️ Of course, it is a balancing act between defending against the virus and protecting the transplant. So your doctor’s will be following the other blood numbers too, not just tacro.

Some foods and meds, such as grapefruit or pomegranate juice can increase the amount of tacro in the body and other meds can cause it to be processed through faster. Your numbers don’t look alarming from my experience. I had fluctuations too and most of them could be explained by timing on the tests and if I was late for a dosage. Your tacro numbers might even be affected by the decrease in your Cellcept. That’s another variable that’s changed besides the BK. As an example, I had a med swap from IV form to capsule form of a medication about 2 months after transplant. My trough level of 7 had shot up to a whopping 22.6 in a matter of days. The new med interfered with processing the tacro out of my body so toxic levels built up rapidly. So it shows how med interactions play a role with each other.

Consistency is really important especially since you’re on 2 anti-rejection meds and one has been reduced to control the BKV.
Your team is monitoring you closely. If there’s an issue they’ll let you know. Relax and enjoy the holidays! ☺️