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Extended release Prograf [and Envarsus/Adoport]

PostPosted: Mon Sep 19, 2016 6:53 pm
by sporti
Hi

Any Transplant patients on the extended release Prograf please? Thank you


[Mod: subject changed: added [and Envarsus/Adoport] to reflect later conversation in this thread]

Re: Extended release Prograf

PostPosted: Tue Sep 20, 2016 8:18 am
by Rik
Hi Sporti ...
I have been taking Advagraph for most of my Tx years ...
are you thinking of changing to it??

I'm a bloke ... and would forget to take my evening dose more often than not ...
so when I heard there was a slow release prograf I suggested this to my Dr ... and changed there and then ...
no issues for me ... and far easier to take all my tablets in one go ...
I still forget to take them sometimes in the morning ... so take the lot in the evening ...
yes ... that sounds a bit off hand ... but it works for me ...

Re: Extended release Prograf

PostPosted: Tue Sep 20, 2016 12:05 pm
by sporti
Hi Rik

Thanks for getting back to me. I've never heard of it before and they want me to change to it as the Prograf I'm taking now is still after a year and half giving me the shakes and affecting me. Trouble is its doing such a good job with the new kidney I'm reluctant to change but they want me to try. It's alright for them to say 'try it' but it seems a risk to me. I'm on regular Prograf 3 tabs twice a day with a level of 4.7. Just not sure what to do.

Re: Extended release Prograf

PostPosted: Wed Sep 21, 2016 12:40 pm
by Rik
Hi Sporti ...
I can understand the reluctance to change ...
why rock the boat ...

for me ... all is going OK ...
and after 13 years of my Tx it takes a lot for my Doc to get me to agree to changing anything ...

but ...
if things can be better ... and you lose the shakes and any other issues you may be affected by ...
then it's worth considering ...

I guess my questions would be ...
firstly ... why can't my Tac level be reduced ... what is this level doing for me??
if I moved to slow release Tac ... would the level be different ... and can I change back to the twice a day type ...

check that by changing the Tac regime that it doesn't affect the regime of other drugs you may be taking ...

it would be wrong of me to suggest you should or shouldn't change ...
I can only tell you that for me it was a good thing ...

hope the Docs can help you and you feel better for it :0)

Re: Extended release Prograf

PostPosted: Tue Sep 27, 2016 1:34 pm
by bigbuzzard
Everything Rik said.

I'm now on Advagraf (one pill every 24 hours) which replaced Prograf (one every 12 hours) and the change was very smooth – completely unnoticeable in fact. It seems to be working just fine.

I was irritated when Advagraf was introduced, in particular by the way it was introduced – basically as a big pharma company finding a way around the fact that its patent was about to expire on Prograf, the regular version of Tacrolimus. In doing so it introduced a confusion among patients and pharmacists, which led to some patients, including my mother, to be given the wrong version of the drug. In her case it took her a month to realise (the packaging and capsules are almost identical). So for all that time she was taking double the amount of Tacro she was supposed to.

This potential confusion caused advice to be issued to doctors that they prescribe by brand name rather than generic name - a first, I believe! So big pharma won that one I suppose.

I'm sure it's true that the once a day dosage does reduce the number of forgotten doses, so that's a good thing.

Re: Extended release Advagraf and Envarsus ...

PostPosted: Wed Sep 28, 2016 9:44 am
by Rik
I was at my Tx clinic yesterday and have been asked to consider changing to Envarsus this is a money saving exercise by the NHS ...

personally I asked to change to the slow release advagraf as soon as I heard of it via the KPG forum ... because it better suited my lifestyle ...
(the fact I would forget to take the evening tablets more often than not!!)

I have been using advagraf for over 10 years ... and am obviously againt rocking the boat ...

so I would like to expand this thread (and the heading!!) and ask others on their views ...
advagraf Vs Evarsus ...

Re: Extended release Advagraf [and Envarsus/Adoport]

PostPosted: Wed Sep 28, 2016 10:28 am
by bigbuzzard
Envarsus is clearly a generic version of Tacrolimus. I haven't come across it yet. There's another that's commonly used now in the UK, which is Adoport. This (has been discussed here a bit before).

I was changed to Adoport on the day of my second transplant in 2012. For the next few days, my torso was covered in a really uncomfortable rash. I did some research, and discovered that a rash was a known, though very rare, possible side effect of Adoport. Obviously I'd just had an op, with all sorts of unusual things happening to my body (eg anaesthetic), so I think it was impossible to say that Adoport caused my rash, but in any case, the consultants decided to change me back to Prograf. The rash also improved around that time. Was there a connection? Who can say…

Re: Extended release Prograf [and Envarsus/Adoport]

PostPosted: Thu Nov 03, 2016 2:13 am
by sporti
Hi - thanks for replies and help. I decided not to change. Kidney doing well so I just felt as Rik said 'why rock the boat'. They have reduced my cellcept from 2000 a day to 1500 so I'm happy with that.