Hi all
Can anyone enlighten me as to when I have to take my immunosupression drugs. The hospital gave me a discharge drug sheet which said that I could take my MMF whenever I wanted, full stomach or not; however, my Tacrolimus was to be taken one hour after food. The info. sheet that came with the Tacro. said that it should be taken either two hours after food, or one hour before (the hospital didn't tell me this). I also wasn't told that I had to take the drugs 12 hours apart - is this correct also?
Any help you can give would be much appreciated as I have had my hand slapped this week for not taking my meds correctly (even though I'm following their instructions!)
Ruth
Taking immunosupression tablets
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JMan
- Posts: 3473
- Joined: Fri Apr 23, 2004 10:21 am
- Location: Lives in a slightly weird bit of Shropshire called Telford!
Generally you should try n take drugs at equidistant times.. Eg if twice a day then 12 hours apart. (for twice daily drugs like many immono suppressants.)
However mine tend to be 10 & 14.. eg about 10 am and 8ish pm.. It varies a bit..
I can't remember the exact guidelines for MMF.. (as I'm not on it any more) however the patient info that comes with the drugs is usually pretty specific, and if in doubt DO ask your renal unit.. Sometimes the information you get is conflicting.. I've found the renal pharmacist one of the better people to ask (when the docs n nurses seem to be in conflict.)
For most people it needs to be about finding a way of fitting the tablets into their personal lifestyle n routines whilst maintaining the most effective way to take them. Thats the ideal anyway.. Most units follow this on paper at least tho some have a little more trouble putting it into practice.
HTH..
However mine tend to be 10 & 14.. eg about 10 am and 8ish pm.. It varies a bit..
I can't remember the exact guidelines for MMF.. (as I'm not on it any more) however the patient info that comes with the drugs is usually pretty specific, and if in doubt DO ask your renal unit.. Sometimes the information you get is conflicting.. I've found the renal pharmacist one of the better people to ask (when the docs n nurses seem to be in conflict.)
For most people it needs to be about finding a way of fitting the tablets into their personal lifestyle n routines whilst maintaining the most effective way to take them. Thats the ideal anyway.. Most units follow this on paper at least tho some have a little more trouble putting it into practice.
HTH..
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Read my blog:)
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Taking drugs
Hi JMan
Thanks for your advice. Not sure if Southmead have a renal pharmacist, but I'm going to the pharmacy on Monday so I will ask. If no good, then I'll ask the Senior Reg. that I see.
Cheers
Ruth
Thanks for your advice. Not sure if Southmead have a renal pharmacist, but I'm going to the pharmacy on Monday so I will ask. If no good, then I'll ask the Senior Reg. that I see.
Cheers
Ruth
Meds
odd, because I know what you mean about the ones with food, and hour before, two hours after, etc. etc.
But I take all of mine at once. Tacro, Cellcept, Bactrim, Valcyte at nine am. Cellcept and Prograf at nine pm. They said not to worry if I've eaten or not and not to worry if some say with food or some say without. It's somewhat unrealistic I suppose that you can always follow such confusion. In other words, if you were taking just ONE of those drugs, sure then follow the food and hour many hours to wait instructions. But we are taking these drugs altogether. So they work with each other, and the food is a non-issue.
I have not found any large discrepency with the Prograf levels regardless of if I eat before my labs or not. Normally I would say I eat on the day of the lab at about seven-thirty am. Just something small. Everything but Prograf has then been taken when they draw the blood around say nine-thirty am. Then I take the Prograf. I know they are late when they take my blood past nine, but I can't take the Prograf before.
Hope that helps somewhat. I do believe everyone here who takes those drugs take them all at once, 12 hours apart. A few might take some in the afternoon.
Best to you! How do you feel otherwise? Better? Is the swelling down?
Natalie
But I take all of mine at once. Tacro, Cellcept, Bactrim, Valcyte at nine am. Cellcept and Prograf at nine pm. They said not to worry if I've eaten or not and not to worry if some say with food or some say without. It's somewhat unrealistic I suppose that you can always follow such confusion. In other words, if you were taking just ONE of those drugs, sure then follow the food and hour many hours to wait instructions. But we are taking these drugs altogether. So they work with each other, and the food is a non-issue.
I have not found any large discrepency with the Prograf levels regardless of if I eat before my labs or not. Normally I would say I eat on the day of the lab at about seven-thirty am. Just something small. Everything but Prograf has then been taken when they draw the blood around say nine-thirty am. Then I take the Prograf. I know they are late when they take my blood past nine, but I can't take the Prograf before.
Hope that helps somewhat. I do believe everyone here who takes those drugs take them all at once, 12 hours apart. A few might take some in the afternoon.
Best to you! How do you feel otherwise? Better? Is the swelling down?
Natalie
Drugs and things
Hi Natalie
Thanks for your posting. Swelling has gone down (thank goodness) - I am no longer waddling around home... I am now driving (insurance company said this was fine) only three weeks after the op!
Feeling pretty good at the moment. My appetite has returned to normal (bummer - I was hoping to lose a bit more weight); however, I am feeling very tired at the moment and my Registrar can find no chemical reason why this should be as everything is normal (although Hb is only 10.9 which is a little low for me). Went for bloods yesterday and requested a Ferritin check too as sometimes I have had low iron but Hb has been normal. Will see what this brings tomorrow.
Creatinine is down to 103 from 900 the day before the op so I'm very pleased. Feel so different.
How about you - how are you doing? How are you finding it back at work, and are you finding it tiring or ok?
Great to hear from you.
Ruth
Thanks for your posting. Swelling has gone down (thank goodness) - I am no longer waddling around home... I am now driving (insurance company said this was fine) only three weeks after the op!
Feeling pretty good at the moment. My appetite has returned to normal (bummer - I was hoping to lose a bit more weight); however, I am feeling very tired at the moment and my Registrar can find no chemical reason why this should be as everything is normal (although Hb is only 10.9 which is a little low for me). Went for bloods yesterday and requested a Ferritin check too as sometimes I have had low iron but Hb has been normal. Will see what this brings tomorrow.
Creatinine is down to 103 from 900 the day before the op so I'm very pleased. Feel so different.
How about you - how are you doing? How are you finding it back at work, and are you finding it tiring or ok?
Great to hear from you.
Ruth
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Andy
- Posts: 856
- Joined: Sat Apr 24, 2004 1:02 pm
- Location: Cardiff, Wales- now Christchurch New Zealand
Hi Ruth,
just reading what you said about being tired, I was tired for a while after my op even though my bloods were all good. I think it is still the fact that your body is repairing itself after a major operation.
After all my ops (19 of them) I felt tired but that was due to the continuous infection that was in my body at the time.
But after my Tx, I had no real reason to be tired, I think it was just the body repairing itself inside.
just reading what you said about being tired, I was tired for a while after my op even though my bloods were all good. I think it is still the fact that your body is repairing itself after a major operation.
After all my ops (19 of them) I felt tired but that was due to the continuous infection that was in my body at the time.
But after my Tx, I had no real reason to be tired, I think it was just the body repairing itself inside.
When to take the immunosuppression drugs
Hi Ruth,
My neph, as well as my txp surgeon, was not so anxious about the protocol.
I take the AM meds at about 7:30 and the PM meds at about 6:30.
I have never been told not to take them with meals, and the food reduces their effect on your stomach.
It is important to set your schedule (and stick to it) soon after the transplant, when your labs are taken frequently, so if the drugs are partially absorbed your neph can tell by your labs and adjust your dose.
I started with cellcept (MMF), prograf (tacrolimus) and medrol (prednisone).
Prednisone must be taken with food or you'll have constant stomach pain.
I took my prednisone once a day (not anymore
)
I heard from others that they had been told to take it twice a day.
The prograf was taken twice a day and was later replaced by rapamune (sirolimus), which I take once daily.
My initial cellcept dose was 2x500 mg, and when it was increased to 2x750 and I got stomach upset they told me to do 3x500. Now I take them AM, noon, PM, and not every 8 hours. They even told me to skip one or two when I had severe diarrhea.
My conclusion is that the exact time is not as important as keeping the same schedule. These meds are for life so they must go with your lifestyle. Taking your meds at odd hours is a sure way to forget them.
Gil
My neph, as well as my txp surgeon, was not so anxious about the protocol.
I take the AM meds at about 7:30 and the PM meds at about 6:30.
I have never been told not to take them with meals, and the food reduces their effect on your stomach.
It is important to set your schedule (and stick to it) soon after the transplant, when your labs are taken frequently, so if the drugs are partially absorbed your neph can tell by your labs and adjust your dose.
I started with cellcept (MMF), prograf (tacrolimus) and medrol (prednisone).
Prednisone must be taken with food or you'll have constant stomach pain.
I took my prednisone once a day (not anymore
)I heard from others that they had been told to take it twice a day.
The prograf was taken twice a day and was later replaced by rapamune (sirolimus), which I take once daily.
My initial cellcept dose was 2x500 mg, and when it was increased to 2x750 and I got stomach upset they told me to do 3x500. Now I take them AM, noon, PM, and not every 8 hours. They even told me to skip one or two when I had severe diarrhea.
My conclusion is that the exact time is not as important as keeping the same schedule. These meds are for life so they must go with your lifestyle. Taking your meds at odd hours is a sure way to forget them.
Gil
Ruth:
During my first transplant in '96 I was told the same thing you were concering timing of tacrolimus. No one at the hospital said anything about any cellcept constraints at the time, yet the Rx bottle said to take on empty stomach.
After my second tx in '03 I asked again. The second time they said it did not matter concerning MMF and said it also did not matter for tacrolimus whether you had ingested food. What they did insist the second time is that I take my tacrolimus consistently either with food or without food ie... if you take it with food always take it with food and conversely if you don't take it with food, always take it without food. The second time they insisted on no grapefruit or grapefruit juice whereas the first time I could take grapefruit a few hours before or after taking tacrolimus.
During my first transplant in '96 I was told the same thing you were concering timing of tacrolimus. No one at the hospital said anything about any cellcept constraints at the time, yet the Rx bottle said to take on empty stomach.
After my second tx in '03 I asked again. The second time they said it did not matter concerning MMF and said it also did not matter for tacrolimus whether you had ingested food. What they did insist the second time is that I take my tacrolimus consistently either with food or without food ie... if you take it with food always take it with food and conversely if you don't take it with food, always take it without food. The second time they insisted on no grapefruit or grapefruit juice whereas the first time I could take grapefruit a few hours before or after taking tacrolimus.