Since I was on tacrolimus only(as Mycophenolate causes TLC to go down in two occasion), sirolimus 1mg is started along with reduced tacrolimus(2mg BD, Tac level ~4.5). But the creatinine is still high(1.8). It seems some side effect of Sirolimus is also coming as the TLC is 3400 and platelet is 80,000.
What do you suggest to bring creatinine under control?
What is the way to determine the exact required dose of tacrolimus?
Both eyes had a schirmer test of 0. (interestingly though, a few days before at the vet, the schirmer test was 12 in both eyes). Now 6 weeks later, the right eye has a 6 and the left eye still has 0. 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.
Unfortunately, tylenol doesn't help much for tooth issues. We often advise patients to use ibuprofen but since you can't take that try warm salt water rinse. If it's your gum tissues bothering you try Orabase B. It's usually near the Orajel at the grocery store. It's normal to have sensitivity for a day or two after having a lot of dental work but if the pain persists I would advise you to contact your dentist.
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.
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.
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.
and the Creatinine level at that was 1.5 - 1.6. The doctor reduced the tacrolimus dose to .5 mg morning and evening and since then the Creatinine level is slowly increasing. It is now between varying between 2.1 and 2.4. The TAC level is also low and reduced from 4.5 to 3.4 to 2.4 when last checked 2 months ago. Had a biopsy 2 months back and the report was OK.
Pl suggest.
currently there is no data on its use in the post-liver transplant setting. 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.
50 yo male with kidney transplant in March, 2011 from a cadaver, donated kidney.
Tacrolimus 2.5mg BID
Mycophenolate 500mg AM , 250mg PM
No after affects post transplant, no illnesses.
Maintaining a healthy weight and on a vegetarian diet.
All other lab levels are WNL.
My tacrolimus level is 4.2 after 4 months of liver transplant, Is it dangerous? what should i do?
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.
What is considered "high blood pressure" and when does it become a concern??? My typical blood pressure is in the low 120's/low 130's however, lately its been in the mid140's/low 150's. Does this happen after transplant (3 months post transplant)? Should I be concerned?
Does Prograf cause tremors? And...can these tremors be contributing to making a person feel tired and exhausted???
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 !
You can get yourself prescribed antibiotics like testracyclines which help in decreasing the inflammation a bit. Tacrolimus combined with oral antibiotics also helps a lot. You can discuss these treatment options with your dermatologist.
I hope it helps. Take care and regards.
These include topical, oral, and intralesional corticosteroids, topical agents like Menthol, phenol, pramoxine, capsaicin cream, vitamin D-3 ointment and topical anesthetics, UV light treatment using UV-B or UV-A plus psoralen and topical immunomodulators tacrolimus and pimecrolimus in steroid unresponsive cases.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided.
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