Transplant anti-rejection medications. What's your advice?

Posted by jolinda @jolinda, Apr 23, 2020

Weight gain? Hair loss? Headaches? Never missed a beat? What has your experience with transplant medications been? Have you developed a methods to deal with a side-effect? Have your meds changed at all over time? What advice do you have for others in our community that may make their experience better?

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@jerrynord

What is your Tacrolimus level from your blood tests? Is it within range?

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Currently, 6 mg/day. I was reduced to that level in early April. I’m hoping to get it reduced again at my next transplant visit in midJuly. I’m very strict on taking my meds at the same time and on an empty stomach for best metabolism. Fortunately, my stomach seems to handle this okay. My one year anniversary is August 20…very exciting!

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@benlam11

I'm a Liver and Kidney transplant patient (June 2019) I also had Carotid artery surgery (Aug 2019) and a double by-pass (Oct 2020). I'm a diabetic and I Have Neuropathy Before Transplant and ot's still the same. I use Gabapentin. I also had the tremors, even fell - after I Tapered off Prednisone and my Tac and Cellcept were reduced (after 6 months) - I improved significantly. I started Pool Walking as soon as possible. Now I'm on 1000mg Cellcept and 5 mg Tac daily. Keep going - things will improve and find some good neuropathy management. Also keep asking questions of your transplant team, they are Great and will be a source for you.

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Thank you for your encouraging words. And, congratulations on your two year transplant anniversary! I hope you can continue to be well…with no more surgeries! I have been able to reduce Tac from 8 mg to 6 mg, but increased Mycophenolate to 2000 mg/day.

My transplant doctor doesn’t believe my increasing tremors and neuropathy are due to meds, however. So, I’m now seeing a neurologist and rheumatologist who believe my symptoms are due to Sjogren’s and possibly some other autoimmune response. Like you I’m dedicated to exercising, and I’m eating well and doing everything to keep my new liver healthy. I’ve also got pretty severe osteoporosis, so am now on meds for that.

I have my next appointment with my transplant team in July. I’m hoping I have more insights on my autoimmune issues by them so I can discuss potential impacts on my liver and treatments that don’t interfere with our anti rejection meds. I’m managing pain currently with Gabapentin. It seems like a lot of other meds recommended for neuropathy interact with Tacrolimus.

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@athenalee

Hello everyone. I had a liver transplant nearly six months ago. My new liver seems to be doing well. But I increasingly suffer from nearly debilitating tremors, muscle pain, numbness in my right leg, occasional nerve pain in my foot and leg, joint pain in knees and hands. Most likely due to Tacrolimus. My liver doctor wants me to see a neurologist for neuropathy. So, I’ve been doing lots of research on it. I do not drink, do not eat refined sugar, no diabetes (yet anyway), and walk and exercise regularly. On Wednesday, my Dr. reduced my Tacrolimus to 7 mg/day and raised my Cellcept from 1,000 mg/day to 2,000. I’m curious to hear about the experiences of other transplant patients with these symptoms and if they go away or continue? I’m also wondering of what to expect at the neurologist visit and perhaps questions to ask a neurologist. This is so new to me and increasingly worrisome! Any insights would be greatly appreciated!

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What is your Tacrolimus level from your blood tests? Is it within range?

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@athenalee

Hello everyone. I had a liver transplant nearly six months ago. My new liver seems to be doing well. But I increasingly suffer from nearly debilitating tremors, muscle pain, numbness in my right leg, occasional nerve pain in my foot and leg, joint pain in knees and hands. Most likely due to Tacrolimus. My liver doctor wants me to see a neurologist for neuropathy. So, I’ve been doing lots of research on it. I do not drink, do not eat refined sugar, no diabetes (yet anyway), and walk and exercise regularly. On Wednesday, my Dr. reduced my Tacrolimus to 7 mg/day and raised my Cellcept from 1,000 mg/day to 2,000. I’m curious to hear about the experiences of other transplant patients with these symptoms and if they go away or continue? I’m also wondering of what to expect at the neurologist visit and perhaps questions to ask a neurologist. This is so new to me and increasingly worrisome! Any insights would be greatly appreciated!

Jump to this post

I'm a Liver and Kidney transplant patient (June 2019) I also had Carotid artery surgery (Aug 2019) and a double by-pass (Oct 2020). I'm a diabetic and I Have Neuropathy Before Transplant and ot's still the same. I use Gabapentin. I also had the tremors, even fell - after I Tapered off Prednisone and my Tac and Cellcept were reduced (after 6 months) - I improved significantly. I started Pool Walking as soon as possible. Now I'm on 1000mg Cellcept and 5 mg Tac daily. Keep going - things will improve and find some good neuropathy management. Also keep asking questions of your transplant team, they are Great and will be a source for you.

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@cania

Post transplant 18 years. In a few months will be 19 years.
No complications from the start of my transplant up to now.
I take 3mgs of prograf in the morning w/250mgs of Cellcept at night
&
2mgs of Prograf at night w/ 250mgs of Cellcept.
My immunosuppressived are brand name. Cannot take generic

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@cania, If my math is correct, You must be near the date to celebrate your 19th transplant anniversary. Please accept my sincere congratulations.

Did you do anything special to honor this day?

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@colleenyoung

@jerrydrennan @lisamb @livertrex, what questions should @athenalee prepare for her consultation with the neurologist?

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Thank you everyone for the sharing of your experiences and insights. I’m feeling more comfortable about the knowledge I can bring to my neurologist appointment. It is very much a daily struggle, but I know that my alternative would have been death. So, the blessings of my new liver are always in the forefront of my thoughts. And, the support and guidance I have found through this group also helps me remain strong, especially during these isolating and difficult times!

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@jolinda

Hair loss! One of my first side-effects showed up just days after being released from the hospital when I noticed gobs of hair falling out in the shower. I was so grateful for the new kidney and it seemed petty to care about my hair but I worried if it would never stop. One of my doctors at Mayo Clinic theorized that my hair loss was caused from a combination of trauma to my body from surgery, being severely anemic and as a side-effect from one of my anti-rejection drugs. She prescribed Vitron C (an high-potency iron supplement with vitamin c) to treat the anemia but there was nothing else she could do. My hair continued to fall out to a lessening degree for the next two years until it finally rebounded. I will never have the same hair but it got better. I was recently told hair loss should be treated by a dermatologist which I think is interesting.

Jump to this post

Post transplant 18 years. In a few months will be 19 years.
No complications from the start of my transplant up to now.
I take 3mgs of prograf in the morning w/250mgs of Cellcept at night
&
2mgs of Prograf at night w/ 250mgs of Cellcept.
My immunosuppressived are brand name. Cannot take generic

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@athenalee , In my case the neurologist asked a lot of questions about my history before transplant. I asked about reaction to tacrolimus so they switched me to cyclosporine. this did not help with the tremors in my speech. side affects were a lot worse on cyclosporine. they moved me back to tacrolimus. ask about changing medication, The Neuropathy comes and goes. The Neurologist did not find anything wrong. It did take about a year for the body tremors and drop foot to stop. i am still struggling with the speech. Stay strong and God Bless

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@athenalee

Hello everyone. I had a liver transplant nearly six months ago. My new liver seems to be doing well. But I increasingly suffer from nearly debilitating tremors, muscle pain, numbness in my right leg, occasional nerve pain in my foot and leg, joint pain in knees and hands. Most likely due to Tacrolimus. My liver doctor wants me to see a neurologist for neuropathy. So, I’ve been doing lots of research on it. I do not drink, do not eat refined sugar, no diabetes (yet anyway), and walk and exercise regularly. On Wednesday, my Dr. reduced my Tacrolimus to 7 mg/day and raised my Cellcept from 1,000 mg/day to 2,000. I’m curious to hear about the experiences of other transplant patients with these symptoms and if they go away or continue? I’m also wondering of what to expect at the neurologist visit and perhaps questions to ask a neurologist. This is so new to me and increasingly worrisome! Any insights would be greatly appreciated!

Jump to this post

@jerrydrennan @lisamb @livertrex, what questions should @athenalee prepare for her consultation with the neurologist?

REPLY
@athenalee

Hello everyone. I had a liver transplant nearly six months ago. My new liver seems to be doing well. But I increasingly suffer from nearly debilitating tremors, muscle pain, numbness in my right leg, occasional nerve pain in my foot and leg, joint pain in knees and hands. Most likely due to Tacrolimus. My liver doctor wants me to see a neurologist for neuropathy. So, I’ve been doing lots of research on it. I do not drink, do not eat refined sugar, no diabetes (yet anyway), and walk and exercise regularly. On Wednesday, my Dr. reduced my Tacrolimus to 7 mg/day and raised my Cellcept from 1,000 mg/day to 2,000. I’m curious to hear about the experiences of other transplant patients with these symptoms and if they go away or continue? I’m also wondering of what to expect at the neurologist visit and perhaps questions to ask a neurologist. This is so new to me and increasingly worrisome! Any insights would be greatly appreciated!

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Yes, my liver transplant was a year ago. I was also dizzy, but i had all the symptoms you describe. They all seem to finish over the months. Walking helped me the most. I do take magnesium. However the neuropathy still lingers. I went to the neurologist did all the tests. In the end it just takes time.

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