Tacrolimus/Adoport absorption

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Thumps
Posts: 1302
Joined: Thu Sep 14, 2006 3:50 pm
Location: London, England

Tacrolimus/Adoport absorption

Post by Thumps »

Hi everyone,

Does anyone have an experience of a sudden change in trough numbers for Tacro/Adoport? I've been hovering between 6 and 8 for a couple of years, no dosage changes in 4 years, then all of a sudden last month my Tac has skyrocketed to 15. :( I've reduced my meds but am back on weekly obs until we know what's happening.

Why would this be? My weight, diet, general health etc are all just the same. Is my transplant kidney packing up?? I've had both the others taken out by nephrectomy because of PKD (last one gone in January), so I don't understand this sudden instability. All other measures (Cret., eGFR, potassium, urea etc) are also unchanged and fine.

Any thoughts much appreciated.
PKD/PLD diagnosed 1994, CKD stage 5 Oct 2007, Living Donor Kidney Transplant Dec 2008, still going strong!
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bigbuzzard
Posts: 1481
Joined: Sun Mar 12, 2006 11:21 am
Location: Devon, UK
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Re: Tacrolimus/Adoport absorption

Post by bigbuzzard »

Something I discovered - which I wish I'd been told earlier - is that if you have diarrhoea, tacro absorption, and therefore levels can rise, and needs to be monitored. Though it doesn't sound like that's the case for you right now.
renalhope
Posts: 4
Joined: Sun Nov 30, 2014 9:55 am

Re: Tacrolimus/Adoport absorption

Post by renalhope »

Maybe your absorption and/or metabolism of tacrolimus has changed for some reason?

Maybe ask your doctors if any of the following might help :

- Stop drinking alcohol completely
- Stop drinking coffee completely
- Get your weight down to mid normal (bmi) with body fat around 20%
- Exercise a lot
- Go gluten free

These are positive actions you can take if you want.Just check first that for you they wont do harm.

Also,

Maybe ask about changing from adoport to prograf to see if it helps?
Maybe ask about changing from tacrolimus to ciclosporin to see if it helps?
Maybe ask whether controlled use of certain vitamins and supplements might help?
Maybe ask about gut management?
Maybe ask about how your citrate metabolism affects tacrolimus levels?


It seems to me to be worth making the effort to keep a transplant longer, though they do have a limited life.
Maybe the real question is how long should you keep a transplant before the medication causes more damage than its worth.
Time and technology are your friends here, so maybe try to give yourself more time?

There is always hope.
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