Hi Doctor, what is your opinion of when Incivek will be approved for transplant patients? Are they running or planning trials for post transplant patients or how does it normally work to get the process approved in this case?
there are prograf assistance programs that the company offers. If this is not feasible than using other cheaper medications such as verapamil for example for HTN for example will alllow much lower doses of prograf to be used (it delays metabolism of the medication) and thus it comes out cheaper.
For this reason, it works as an anti-rejection medicine. Prograf helps patients who have had a liver/kidney transplant protect their new organ and prevent it from being rejected by the body. This medicine can cause the amount of potassium in your blood-stream to increase. For this reason you should avoid large amounts of foods that have a high potassium content, for example dried fruit, bananas, tomatoes and low sodium salt, while you are taking this medicine, also avoid potassium supplements.
I'm geno type 3. I've heard Prograf is harder on the kidneys than sirolimus which is why they switched me from cyclosporine to sirolimus. That's probably why they haven't suggested switching me to Prograf in fact this is the first time I'm hearing about Prograf or Tacrolimus (it's other name as I found on the web). Thanks for your response and congrats on your great report since week 4 !
My doctors want to start treatment to clear the virus. I take Prograf for the liver transplant and I know Naragenin affects the Prograf levels. My question is if during treatment I also took Naragenin and my prograf levels were closely watched and adjusted for the Naragenin effects, wouldn't I have a better chance of clearing the virus.
One thing you should beware when it comes to the anti-rejection medicine (Prograf) that your husband is talking. The caution is that you have to ask his doctor frequently when the dosage can be lowered. Prograf is toxic and in the long run it can cause kidney failure. Right after my transplant, I was put on 10 mg. Prograf daily. Gradually, the doctor lowered it to 5, then 4, and so on. Last month, the doctor lowered it to 1.5 mg. daily.
While the course of hepatitis C in liver transplant recipients was believed to be rather benign in the late 80s and early 90s (Boker 1997), HCV has led to a more rapid progression post-transplant in recent years (Berenguer 2005, Neumann 2004) with cirrhosis within the first 5-10 years in 20-30% of patients. HCV definitely takes a more rapid course post-transplant than in immunocompetent individuals and treatment needs are obvious.
Yes, post transplant patients are being treated with the new drugs at least at my transplant center. (U.C. at San Francisco) The patients have just started treatment so there is no data regarding results. Figure at least a year or so for the data to be available. I haven't heard of other centers doing the same but I'm sure some of the other top liver transplant programs are also trying the new treatments at least on a few well selected patients.
t be used in stable liver transplants without being in conjunction with a second imunosuppressant. While Rapamune extends life of transplant patients by 14% (citation not in front of me), the authors did not differentiate liver and kidney patients, but instead collapsed their sample. Unfortunately, I can find little else that helps me make a decision. I haven't been able to find recent data to help me with this decision.
Are there other side effects I am missing from either suppressant?
More frequent aFib episodes, yet found to be hypertensive on 18-hour continuous BP study in neighborhood of 160/85 average when in sinus, lower BP when in Fib. Symptomatic in that exercise tolerance is significantly less when in Fib, also with constant chest "heaviness" and mild breathlessness.
Wish to control the arrhythmia which started ~ 6 mos ago and is now recurring once/week usually while asleep, and suspect that it is of parasympathetic character.
Two doctors, two conclusions. My transplant was Dec, 2, 2013. Just after the transplant I was on 10 mg. of Prograf a day for a couple of months or more. Slowly, after time, the doctor lowered it to 4 mg. daily. After two years I'm now at 3 mg. daily.
The interesting point here is this: The hepatologist that treated me for 13 years before my transplant saw my latest blood work of six weeks ago and he would have me on 1 mg. a day.
How have liver transplant patients fared after switching to Rapamune (an appropriate amount of time after the LT)? When patients are switched to Rapamune is there an overlap period with, say, Prograf?
Does Rapamune interact with Teleprevir the same way Prograf does?
i wouldnt lower the tacrolimus dose further
t understand the relationship between treatment and Prograf dose. It sounds logical to think that the higher the Prograf dose the less likely TX will be successful and, at the extreme, I think that's probably true. But, whether 3 mg per day or 6 mg Prograf per day makes any difference is a question I cannot answer.
When I treated there was a reluctance to dose the way a non-transplant patient would have been dosed and that can be and, in my case, was problematic.
I'm 61 years young and had a full liver transplant 2 1/2 months ago. Prograf levels go from 7 to 13.6 back to 6.5 Could it be the new lab that is screwing up. I take all 52 pills on time dailywith a wonderful hubby making sure.
I went into rejection twice in the hospital and because of this my transplant team saw it best to put me on 5mg of prograf twice a day as well as 4 mg of rapimune, which by the way was off label and i had to sign a release form for. Just within the past 2 months they lowerd my dosage of rapimune to 2mg but kept the prograf the same. My question to you is exactly how suppressed is my immune system?
If you are geno type 1 there are new more effective meds to combat the virus but there have no clinical trials that included post transplant patients and the only study I know of that is going on is at my transplant center here in Northern Cali and that is only just beginning.
Your immunosuppressive agents
There are also drug interactions between Cyclosporine A (CsA) and INCIVEK when administered. So Cyclosporine must be reduced to 1/10 of its current dosage.
Also many post-transplant drugs have generic versions. Liver transplant centers usually have their own preferences for drugs and generic or not.
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Almost 4 months post transplant and have been experiencing a dull headache for the last few weeks, everyday. It is a dull headache and the discomfort is random...sometimes its on the left side of the head, sometimes on the right, sometimes between the eyes, etc. It's not a migraine, but a dull pain, nagging pain. Can this be a side effect from any of the medications? Pentamidine (aerosol) 1x monthly, Prograf 2mg 2x daily, metroprolol tartarate 12.
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