Switched from Tacrolimus to Belatacept

Posted by 2gallonhabit @2gallonhabit, Nov 20, 2023

Hi all. I'm just shy of my one year kidney transplant anniversary. At my four month appointment I asked my doctor if I'd be a candidate to switch from Tacrolimus to Belatacept (I'd done the research and knew that I was). The reason I asked was because despite Tacrolimus being the "gold standard" (combined with Mycophenolate Mofetil) for anti-rejection medications, it comes with side effects. Mine included significant GI issues, hair loss and steadily increasing blood glucose levels. Also, I was concerned with the nephrotoxic effects of the drug (ever notice that as your dosage goes up, your creatinine goes up as well?).

I started the Belatacept infusions at the beginning of July and am loving the change. My hair stopped falling out and started growing back. My blood glucose levels returned to normal. My GI issues are gone. But more importantly, I saw an 0.24 decrease in my creatinine levels and an 11 point increase in my eGFR.

Everyone's experience is different but check it out with your doctor if you're interested in learning more. I'm only 56 so I want to keep this kidney has healthy as possible for as long as possible.

Take care.

Vicki

Interested in more discussions like this? Go to the Transplants Support Group.

Thanks for sharing your experiences with me. So glad to hear you are doing better.
The drugs can be pretty tough on some people and seem just fine for others.
Congratulations- you are almost 6 months!!

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@colleenyoung

@ehu, a belated welcome. Did you switch to Belatacept? How are your eGFR levels? How are you doing?

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Hi. I haven’t switched to Belatacept yet because I’ve read that you have to be ebv positive, and I’m not. My egfr is not that great. I’m hoping that there’s some way to increase my egfr.

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My doctor has advised me to switch from Tacrolimus to Belatacept, but I’m not Epstein Barr virus positive. I’ve been reading that I should not take Belatacept if I’ve never been exposed to EBV. Has anyone been taking Belatacept without having tested positive for EBV? If so, what is your experience?

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@ehu

Hi. I haven’t switched to Belatacept yet because I’ve read that you have to be ebv positive, and I’m not. My egfr is not that great. I’m hoping that there’s some way to increase my egfr.

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My donor and I were both EBV positive. My latest EGFR was 59.7.
I feel good about that. Highest it has been in over 20 years.

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@ehu

My doctor has advised me to switch from Tacrolimus to Belatacept, but I’m not Epstein Barr virus positive. I’ve been reading that I should not take Belatacept if I’ve never been exposed to EBV. Has anyone been taking Belatacept without having tested positive for EBV? If so, what is your experience?

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@ehu, good for you for researching and advocating. I think you're asking the right questions and should ask your transplant team about switching if you are not Epstein Barr positive. I'd be interested in hearing what you learn.

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I'm doing well on Tacrolimus, and the doseage have been adjusted over the years (15) since my liver /kidney transplant. One thing that I have experienced and would like to share is that anytime there is a change in my dosage, there is always a repeat(s) of my labs and Tacrolomus level to be sure that everything is okay.
I am followed locally and also by the Mayo Transplant dept, and I not sure if all doctors or transplant teams follow patients as closely as Mayo does. So I just want to suggest, that you inquire about how any new medication or dosage adjustment will be monitored. I hope this is helpful in decision about switching medications.

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Dealing with the medication and side effects is challenging. I started on Tac, but was having hallucinations. I was put on Bela about 4 years ago. I gained a lot of weight. I was subsequently taken off the Bela by another nephrologist and put on Everolimus. My doctor reduced my Mychrophenolate by 250 mgs. because I was pre diabetic. After 5 years, My kidney is doing well.

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@pjpanning

Hi all,
I am suppose to switch to Belatacept next Wednesday. I’m really excited because besides the headaches, hair loss and flushing face, it is the tremors, and shaky body that I find very hard to tolerate. I am so curious if anyone has had any side effects from Belatacept. I am 10 months out on my kidney transplant and labs seem to be great. My Tacro is always in range now, but tremors are getting worse.
How long after starting on Belatacept before you noticed an improvement in side effects?
Thanks for the help.

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Hi how are you doing on Belatacept? It’s giving me blurred vision and dizziness.

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@kidney091967

Hi how are you doing on Belatacept? It’s giving me blurred vision and dizziness.

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I feel like I am doing well. I feel so much better than I was feeling on Tacro. I have not experienced blurred vision or dizziness. I am so happy to be rid of the side effects I was having with Tacro.
I have had a problem with Thrush, but don’t know that that has anything to do with Belatacept. They lowered my Mycophenolate.
Good luck to you.

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@pjpanning

I feel like I am doing well. I feel so much better than I was feeling on Tacro. I have not experienced blurred vision or dizziness. I am so happy to be rid of the side effects I was having with Tacro.
I have had a problem with Thrush, but don’t know that that has anything to do with Belatacept. They lowered my Mycophenolate.
Good luck to you.

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May I ask how much Myfortic your taking

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