Cellcept and Tacrolimus Co-administration

Posted by webiondev @webiondev, Apr 7, 2019

Hey everyone. Is it better to take cellcept and tacrolimus together or hour/s apart?

Hi @webiondev welcome to Connect!

I'd like to introduce you to fellow Connect members @rosemarya @contentandwell and @cmael are all transplant recipients and may be able to share their experiences and may have opinions on this topic.

Back to you @webiondev how long ago was your transplant? How have you been feeling since then?

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@webiondev Hi, and I also welcome you to Connect. I had a liver transplant in September 2016. I only took CellCept for a certain amount of time, I think it was six months but I can't be certain, it could have been longer. Then I just took tacrolimus for a while but that was affecting my kidneys so I was switched to sirolimus.
If I recall correctly I was taking CellCept and tacrolimus at the same time, but your timing is something you really need to check with your doctor. Different doctors prefer different protocols, and have reasons for the way they want their patients to take their medications.
I saw on your profile that you are having some bile duct problems now. Is that from the immunosuppressants? I have been very fortunate and not had any serious problems from the immunosuppressants, just some digestive problems which I am trying to work out now. I hope your bile duct problems resolve quickly. Let us know how you are doing, and what will be done to treat this.
JK

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@ethanmcconkey

Hi @webiondev welcome to Connect!

I'd like to introduce you to fellow Connect members @rosemarya @contentandwell and @cmael are all transplant recipients and may be able to share their experiences and may have opinions on this topic.

Back to you @webiondev how long ago was your transplant? How have you been feeling since then?

Jump to this post

It’s been one year since my kidney transplant. I was told to take my immunosuppressants together at the same time every day. I take Cellcept, tacrolimus and prednisone every day at 8am and 8pm. At my one year checkup last week I was told my kidney was doing good and no changes were necessary. Yay!

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Hi, i always take them together and have not had any issues

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@webiondev, I take both cellcept and tacrolimus for liver and kidney transplant in 2009. I have always taken them at them together at 8am and 8pm. I have routine labs drawn and my team has on occasion adjusted the dosage. I have been on my current dosage for 4 years.

I noticed that you have mentioned having some bile duct issues. Is this a recent development, or has it been ongoing since your liver transplant? Have you talked to your doctor? Does he think it might be related to the cellcept and tacrolimus?

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@rosemarya

@webiondev, I take both cellcept and tacrolimus for liver and kidney transplant in 2009. I have always taken them at them together at 8am and 8pm. I have routine labs drawn and my team has on occasion adjusted the dosage. I have been on my current dosage for 4 years.

I noticed that you have mentioned having some bile duct issues. Is this a recent development, or has it been ongoing since your liver transplant? Have you talked to your doctor? Does he think it might be related to the cellcept and tacrolimus?

Jump to this post

Hi @rosemarya. I had already two rejection one in 2017 feb right after transplant and one in 2018 Oct. I also developed biliary stricture both after rejections. I treated first stricture with twice ercp stents and now second stricture i did my first stents. I also have duct to duct mismatch. My alp never came down to normal. So that is me..

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@contentandwell

@webiondev Hi, and I also welcome you to Connect. I had a liver transplant in September 2016. I only took CellCept for a certain amount of time, I think it was six months but I can't be certain, it could have been longer. Then I just took tacrolimus for a while but that was affecting my kidneys so I was switched to sirolimus.
If I recall correctly I was taking CellCept and tacrolimus at the same time, but your timing is something you really need to check with your doctor. Different doctors prefer different protocols, and have reasons for the way they want their patients to take their medications.
I saw on your profile that you are having some bile duct problems now. Is that from the immunosuppressants? I have been very fortunate and not had any serious problems from the immunosuppressants, just some digestive problems which I am trying to work out now. I hope your bile duct problems resolve quickly. Let us know how you are doing, and what will be done to treat this.
JK

Jump to this post

Hello @contentandwell. Thanks for your clarification. . I had already two rejection one in 2017 feb right after transplant and one in 2018 Oct. I also developed biliary stricture both after rejections. I treated first stricture with twice ercp stents and now second stricture i did my first stents. I also have duct to duct mismatch. My alp never came down to normal.

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@ethanmcconkey

Hi @webiondev welcome to Connect!

I'd like to introduce you to fellow Connect members @rosemarya @contentandwell and @cmael are all transplant recipients and may be able to share their experiences and may have opinions on this topic.

Back to you @webiondev how long ago was your transplant? How have you been feeling since then?

Jump to this post

Much appreciated @ethanmcconkey . I had already two rejection one in 2017 feb right after transplant and one in 2018 Oct. I also developed biliary stricture both after rejections. I treated first stricture with twice ercp stents and now second stricture i did my first stents. I also have duct to duct mismatch. My alp never came down to normal. My current meds 3 mg advagraf 1500 mg cellcept 4 mg prednisolone 1 g ursofalk and vitamin d and magnesium. Tacrolimus around 7

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@webiondev

Hello @contentandwell. Thanks for your clarification. . I had already two rejection one in 2017 feb right after transplant and one in 2018 Oct. I also developed biliary stricture both after rejections. I treated first stricture with twice ercp stents and now second stricture i did my first stents. I also have duct to duct mismatch. My alp never came down to normal.

Jump to this post

@webiondev it sounds like your doctors are staying on top of it. I hope you have no further problems.
JK

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@webiondev

Hi @rosemarya. I had already two rejection one in 2017 feb right after transplant and one in 2018 Oct. I also developed biliary stricture both after rejections. I treated first stricture with twice ercp stents and now second stricture i did my first stents. I also have duct to duct mismatch. My alp never came down to normal. So that is me..

Jump to this post

@webiondev, That must have been frightening for you. Thank you for telling me a little about your experience because I have been able to locate some members who have also discussed bile duct issues. @webiondev, What are the doctors saying about this? Do they offer any possible solutions?

@gaylea1, @jeanne5009 I want to bring you into this conversation because you both have some experience with bile duct strictures.

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@rosemarya

@webiondev, That must have been frightening for you. Thank you for telling me a little about your experience because I have been able to locate some members who have also discussed bile duct issues. @webiondev, What are the doctors saying about this? Do they offer any possible solutions?

@gaylea1, @jeanne5009 I want to bring you into this conversation because you both have some experience with bile duct strictures.

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Thanks @rosemarya Dr suggested ercp stenting. Dr suggested ercp stenting. I pray this works.

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@webiondev

Thanks @rosemarya Dr suggested ercp stenting. Dr suggested ercp stenting. I pray this works.

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@webiondev I take tacrolimus and cellcept at the dame time.

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@rosemarya

@webiondev, That must have been frightening for you. Thank you for telling me a little about your experience because I have been able to locate some members who have also discussed bile duct issues. @webiondev, What are the doctors saying about this? Do they offer any possible solutions?

@gaylea1, @jeanne5009 I want to bring you into this conversation because you both have some experience with bile duct strictures.

Jump to this post

@rosemarya @webiondev
I had an issue with a blocked bile duct. I underwent 3 ERCP stenting procedures. The first 2 were unsuccessful and I contracted pancreatitus twice. They ended up inserting an external drain linked to the bile duct. The third attempt was successful and I have a temporary plastic stent. This will be replaced with a metal stent early June.

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@webiondev

Thanks @rosemarya Dr suggested ercp stenting. Dr suggested ercp stenting. I pray this works.

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I'm with you in hope and prayer that this works for you. Keep in touch.

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I too have had bile duct issues due to a blocked hepatic artery. I had my transplant in June of 2016. All numbers are good and feel good until blockage. I can tell when it happens as my bilirubin spikes and I start the itching. Over the three years I have had a total of about 10 ERCP's. My last was February of this year. I am currently scheduled for my next one in middle of May. I went a period of about 10 months with no stint. I was told in February that if it is not successful this time, my doctor would talk to rest of team and consider opening me back up to do what he called creative plumbing. From what I have gathered, he said it would involve attaching my bile duct to my intestines. I have had as many as seven stents at one time. I have even had the metal stint once or twice. I currently have 2 stints right now. I keep my fingers crossed and have trust in my team. More so have trust in God that he has a bigger plan for me or I wouldn't have received a liver so quick.i hope all goes well with yours and for now I look at the ERCP as a little routine maintenance.

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