I was OK with my test results until I read that Elidel was chemically similiar to tacrolimus a calcineurin inhibitor that is used in transplant patients. I test orally via the OraQuick test 3,4,5, and 8 months out. All negative. I also had a 6 month blood EIA test done through Quest labs with a non-reactive result. My questions are as follows:
1. Given the length of time I have been using Elidel do you think it could have prevented my body from developing antibodies to HIV.
I don't believe that OH is treating with a PI.
The PIs can increase plasma levels of tacrolimus and cyclosporine very significantly - to toxic levels. There's a lot of research regarding dosing that needs to be done before these drugs will be used in the transplant population.
Blood levels of tacrolimus (Prograf) can also be equally affected for the same reason as with cyclosporine. [both drugs are calcineurin inhibitors]
* omeprazole (Losec, Prilosec)
* oxycodone (Oxycodone is metabolized by the cytochrome P450 system, specifically CYP3A4, of which the bergamottin flavonoid is a strong inhibitor)
* hydrocodone (The hepatic cytochrome P450 enzyme CYP2D6 converts it into hydromorphone, a more potent opioid.
Hormonal contraceptives such as the pill and the patch may increase the blood level of tacrolimus. Tacrolimus may also reduce the effectiveness of these hormonal contraceptives. For this reason women who could get pregnant should ideally use a non-hormonal method of contraception, eg condoms, to prevent pregnancy while taking this medicine. Seek advice from your doctor or pharmacist.
The use of steroids and calcineurin inhibitors has been analyzed and contested as promoting HCV recurrence in the post-transplant period. Steroids have been either encouraged or disapproved of based on the retrospective analysis of different phases after transplantation. A tendency toward increase in serum HCV RNA levels seems to be associated with the early phase after transplantation when the use of immunosuppression is greatest and the use of a steroid bolus more frequent.
Although there are few data currently evaluating this regimen after transplantation, neither sofosbuvir nor simeprevir have meaningful drug–drug interactions with the calcineurin inhibitors tacrolimus and cyclosporine, and therefore, our center and others are now combining these 2 direct-acting antivirals after transplantation.
The protocol at my institution is to stop tacrolimus on Day 1 of protease inhibitor therapy and measure tacrolimus levels 3 and 7 days later, and then adjust the dose of tacrolimus according to the level. At least in the small number of patients we have seen, a tacrolimus dose of 0.5 mg once per week is sufficient to maintain a drug level of 3–5 ng/mL.
i wouldnt lower the tacrolimus dose further
Besides adverse events (anemia, neutropenia), drug interactions with immunosuppressive drugs need to be considered. For example, TLV increases levels of tacrolimus by approximately 70-fold (Garg 2011). In conclusion, patients with established graft hepatitis should be treated with PEG-IFN/RBV, but at this stage, BOC and TLV should not be used in transplant patients outside clinical trials.
The specialist reviewed all of the options with us - cyclosporine, pilocarpine or tacrolimus with sirolimus. She said that very rarely has she seen any dog respond to cyclosporine after not responding to tacrolimus. She also said that because our dog doesn't have a dry, goopy nose, that pilocarpine wouldn't be a first choice. She recommended a mix of tacrolimus with sirolimus. She said sirolimus is new. I have not been able to find anything about this drug on the internet.
His cretanine is almost 1.4 or around. My question is that should he continue his TACROLIMUS tablets or should switch to some other tablets which are safe for kidneys?
Secondly , in my sorrounding there is an opinion that lowering the TACROLIMUS dose also let the liver enzymes to increase? Do you favour such opinions as my father has lowered his tacrolimus dose to keep his kidneys safe?
Sir ,will wait for your kind reply.
Thanks.
s hard to perform my job or other daily tasks when my eyelids are so inflamed. I guess steroids are the only option until they develop something better. Is Tacrolimus a promising nonsteroidal option?
The treatments of this condition are application of topical corticosteroids (betamethasone, clobatesol, flucinolone) which will reduce the inflammatory process. Topical immunomodulators like pimecrolimus and tacrolimus can be used in severe conditions.
I hope it helps. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor.
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.
Upon doing more research about Elidel I found that this was a calcineurin inhibitor clhemically similiar to tachrolimus a drug used for organ transplants rejection therapy. I have been using Elidel topically on a small area of my face for years. My questions are:
1. Given my low risk exposure could prolonged topical Elidel usage lower my immune system enough so that antibodies were't present at testing times. My lymphocyte count at blood test time was 1792 - normal.
2.
Okay.. however I specifically asked about "Elidel" which is not a steroid, it is a TCI or (topical calcineurin inhibitor)! so what is considered short term for this?
AS I HAVE SUFFERED BREATHLESSNESS AND WALKING PROBLEMS,I HAVE BEEN TAKEN OFF TACROLIMUS AND PUT ON NEORAL-YET THERE IS NO IMPROVEMENT IN MY CONDITION.IS THERE ANY OTHER ANTI REJECTION DRUG THAT YOU WOULD RECOMMEND (I HAVE HAD A LIVER TRANSPLANT RECENTLY)? IN YOUR EXPERIENCE,CAN MY SITUATION BE IMPROVED?THANKS.
i would be extremely cautious about using it until more data is available especially since its purported effects on tacrolimus and cyclosporine metabolism are extreme. i am quite confident that there will be clinical trials coming down the road extremely soon.
My tacrolimus level is 4.2 after 4 months of liver transplant, Is it dangerous? what should i do?
Although there are few data currently evaluating this regimen after transplantation, neither sofosbuvir nor simeprevir have meaningful drug–drug interactions with the calcineurin inhibitors tacrolimus and cyclosporine, and therefore, our center and others are now combining these 2 direct-acting antivirals after transplantation.
Treatment is by topical steroids or oral therapy of corticosteroids in severe cases. Topical creams like tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel) are also useful.
If still the symptoms do not improve then please get a clinical examination done by a dermatologist.
I hope it helps. Take care and please do keep me posted in case you have any additional doubts. Kind regards.
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