Taking Tacrolimus, Cellcept, and Steroids together or 1 hour break?

[x8nakamo]

I’m on tacrolimus (Envarsus), Cellcept (mycophenolate mofetil), and steroids. My doctor says that I should not take them all together, I need to wait between them: take tacrolimus first, then wait an hour before taking Cellcept and steroids.

His explanation: the rest of the pills can impact the tacrolimus concentration.

In the hospital, they gave all these pills in one load in the mornings. Of course, to take them all together once would be more convenient.

Do you have the same advice from your teams?

[LisaSnow]

If you only recently had a transplant and the doctors need to do a timed through test to determine your in vivo metabolism of the drugs, then I do understand why.

In reality, drugs have half life so the effectiveness of them are continuous. Unless you experience irritation from taking multiple pills at once most people do take multiple pills together to avoid forgetting them.

Not knowing the specifics of your case I would say just follow the recommendation of your doctor to be safe. Do set reminders of your pill intake with alarms so you don't forget taking one as we get busy in the day.

[x8nakamo in reply to LisaSnow]

Thank you!

ABsolutely, I am following the doctors' recommendations. I just hope that once I will be able to take pills twice per day only.))

[Sunnydaylove in reply to LisaSnow]

I take same regimen, all at once in hospital and at home. Recently my cellccpt was increased in the morning, and I noticed stomach upset with the increase, so I take the second pill approx 30 min later with a couple crackers and it helped. I am 7 months post liver to, and 3.5 months post kidney transplant. Feeling good, getting my strength back and grateful.

[PostivelyJo]

I’ve never been told that .I’m at a world leading unit in uk. Amazes me all the different advice out there. Best to go with the advice you are given.

FYI I take mine at the same time within a -15-30 minute window on a full stomach an empty stomach. I give it little thought .. life gets in the way.

[x8nakamo in reply to PostivelyJo]

And have they never given you advices on how to take it: on a full or empty stomack?

[Darlenia]

Agree with LisaSnow. Spacing between pills might be needed early on to avoid an supset stomach and/or fine tuning prescriptions. However, my husband, now almost 4 years post transplant, takes the same meds you do and does so all at once, twice daily. Boom! Done! The only exception is that he holds back on Envarsus before a blood draw for a renal panel.

[Temagamigal9]

Here’s my transplant team approved schedule

8am Tacrolimus/ Envarsus

9am Cellcept, prednisone

2pm Cellcept

10pm Cellcept

I take a slew of other meds, this is transplant meds

Good luck

[x8nakamo in reply to Temagamigal9]

Thank you!

Did they explain why there is a 1-hour break between Tacrolimus and Cellcept, pridnisone?

[Temagamigal9 in reply to x8nakamo]

I was told to take Tacro alone on an empty stomach (1 hour before or 2 hours after a meal)

Cellcept & prednisone with food

[lexamillz]

I have also been on all three since receiving my transplant in July of last year. I have not been told to take them separately and have taken mine all together daily! No issues with labs when they check them and the main thing I remember is making sure to eat/drink around the same time as some of the medications.

[MToQ]

I take the same meds and have for more than 6 years. I usually take them on an empty stomach all together. No issues. Was never told otherwise. I would probably forget if I had to take them an hour apart!

[x8nakamo]

Thank you, everybody, for your answers!

Knowledge is our power!))

[Tankjsl]

I take my tacrolimus, steroids and mycophenalate all together. I have not had any issues. Why not ask the pharmacist the you work with. The hospital that I got my transplant has a specialty pharmacy and they are real good about giving me guidance with pills. If your set up is similar I would ask a pharmacist. Best of luck....stay healthy.

[Herkidney]

Hi. I’m seven years post transplant and still take all my meds roughly the same as when I was released from the hospital. I figure if it’s worked well for me, why mess with it.