Sudden rise in Tacrolimus

[ILMA54]

I received a kidney transplant in July 2021. Everything has gone swimmingly. I caught a mild case of Covid at the end of July and received a multiclonal antibody infusion.

When I went for my August bloodwork, my Tacrolimus trough, which had been running 5-7, was suddenly 9.6. When I did my bloodwork earlier this week, my Tacrolimus was again high, 9.4. I have not changed my Tacrolimus dosage at all, and the rest of my lab work was within normal range.

Have any of you experienced this phenomenon. If so, what was the root cause for the sudden change?

[Denise-80]

Hi ILMA54 - I am not on tac now but I was for about seven years. My levels would fluctuate a bit and the doc would alter my dose when it went too low. They were never concerned about a higher level unless I complained. Unless you are reporting unwanted side effects, they might not change the dose. I always knew when my level was higher than the 4-6 range they kept me at because my head would pound. Reasoning for the rise in levels…I have no idea.

Best wishes to you.

D

[ILMA54 in reply to Denise-80]

Thank you

[SouthwoodTiger]

Hi ILMA54,

Please talk to your Transplant Nephrologist if possible.

You should not take any grapefruit.

My Cyclosporin level changed from 62 to 164 in the first 5 years. Now settled around 72 to 106 (range should be >75 or 75 to 100 ng/mL).

Good luck and take care!

[meggy619]

Hi, I have had a reduction in Tacrolimus dose as it had gone too high, but its dosage is based on body mass, and I have been slowly losing weight, I am now back to the weight I was thirty years ago, in fact it's now gone up a little, it's more to do with my strict-ish diet I think. so, quite happy as long as it gets no less, apart from that all else is fine.

[BabyTee]

Also, tacrolimus levels can vary if you take it with or without food. It says you can take it with or without food, but you should do the same all of the time, because something in the intestines affect how these pills are processed.

[JackN]

Did you take paxlovid? It sounds like you didn't (and you shouldn't) because paxlovid shuts off the mechanism that controls the amount of tacrolimus in your blood. it can raise the level up to 100x normal! Glad everything else is going well!