Tacrolimus Dosage

[sugabear]

My husband has been taking 3 mgs of Envarsus for about a year or so. Right at his three-year anniversary appointment, they increased it to four because his tacrolimus levels have been consistently under 5 for three months. What's odd about this is that back in December, he received a letter from the transplant clinic stating they wanted his levels between 3 and 5, so we thought he was right on track.

I'm curious about other people's experiences. Yes, we are listening to doctors. If you take tacrolimus, how much do you take daily and which brand (prograf, envarsus, etc.)?

[Winner76]

Hi ,

I take 1mg of Prograf twice daily since the beginning nearly. Go with what your doctor said because as far as I’m aware below 5 is low.

[DexterLab]

I take 2 mg of Prograf twice a day. Got to that level about 6 months after transplant. My tacro levels are generally 6-7. The note on the test results says the usual range is 3-8, well after transplant.

[littlelinda50]

I take Prograf 2 mg AM and 2 mg PM. I would mention the letter and ask why now are they changing what they said they want the level to be now. Sometimes it can depend on how your creatinine and bun levels are on what they want your tacrolimus level to be. It took me a year to get my transplant center to tell me what they wanted my level to be like it was some big secret. I definitely would ask and make sure they give you a clear explanation. Good luck

[sugabear in reply to littlelinda50]

I called the clinic and after some research, they realize that the letter they sent out was wrong. They want him between five and seven because of the Campath induction he received at the time of transplant. It’s annoying that the letter was incorrect,

[Steph1957]

Hi, I currently take 1 1/2 mg. prograff twice daily. I am only 4 1/2 months post transplant with a target of 6-9. My level has been right around 7. Good luck.

[VeroBeachTransplant]

Mine started out at 4 mg total daily and was decreased quickly (less than a year) to 2 mg, where it has remained for 12 years now. These dosages were split between AM and PM.

[Sunnydaylove]

I was on prograf for 3 months before kidney transplant and continued for 3 months after. I just recently switched to envarsus. Tac levels went to 3 on 2 mg, and then 9 on 3 mg. Now on 2.5 mg. and I am at 7. 7 is ok with the doc. Switched from prograf to envarsus to see if it would help with shortness of breath, it did not help, what did change is my tremors have disappeared. I sleep so much better too.

[dmteacher]

I take 3mg of Envarius and keep the level between 4-6. I had my transplant 18 years ago.

[Darlenia]

My husband takes 2 mgs of Envarsus once daily. His trough levels are good (normal). Prescriptions can vary depending on one's weight, other drugs you're on, etc. They're tailored to each individual. Hubby is almost 4 years post transplant. It's very good idea to keep an eye on labs and trends.

[sugabear in reply to Darlenia]

What range do they want him in?

My husband's labs have been great other than the tacrolimus levels. I just hate changing things.

[Darlenia in reply to sugabear]

In my husband's last report, his trough level was 5.3 for Envarsus, a time-release version of tacrolimus. For those taking Envarsus, levels of 4-11 are normal. If one takes standard tacrolimus, the trough level should be between 5-10. Trough level indicates the amount of medication in the blood stream. If it's too low, kidney rejection increases significantly. A review of your husband's prior labs will give you a good sense of what's happening and the reason why his immunosuppressant is being increased. Hope this helps!

[JackN]

I'm sure you're doing this but just in case, my prograf labs require to skip it the morning of the test. I assume your husband should be doing the same. Just a friendly reminder, good luck figuring it out!

[sugabear in reply to JackN]

Thanks for the reminder! He does not take any medication before his labs. We spoke with the clinic again and they notified us that the letter they mailed out was incorrect and that his trough level should be between five and seven. I’m glad we got an answer.

[Darlenia in reply to sugabear]

Ooh..I'd be sooo upset to be put through that! Glad you were proactive and caught it! Medical professionals should have done that. Smh.