What does a low Tacro level mean

[SweetyPie]

Hi all,

So when I first got the transplant I was on both tacro and cellcept but after the rejection episode they took me off cellcept. The only meds I am on is prednisone and tacro (1mg in the morning and 1mh at night) I have been looking at my labs and see my tacro level never comes up above 3 which is low.
Does a low tacro level for a long period of time something I should be worried about? Just a reminder I am doing plasmapheresis once a week at the moment.

[iolaire]

I assume Tarco = Tacrolimus, my tacrolimus levels are now held at just above 5.  My most recent is Tacrolimus (FK506), Blood at 5.9 normal.  For quite some time they were holding closer to 8 or 9.  I don't know if your measure of 3 is a similar measure as mine or on a different scale.  Right now I'm taking Envarsus (Tacrolimus) extended release pills 2.75 mg once per day.

I think they should be keeping fairly close control of your Tacrolimus levels via the bloodwork so I don't know if you need to worry.  Hopefully the transplant coordinator can explain the levels they want for you.

[SweetyPie]

Yes tacrolimus is correct. The range is between 5 -19. Right now my level is 2. They take labs once week right now.

[Simon Dog]

Tacro is a delicate balancing act which is why the instructions cautions that MDs not expert in immune suppression should not prescribe it.

Too little and you get rejection.  The labs should spot this in which case you'll probably get a biopsy to determine what kind of rejection.

Too much and Tacro will damage the kidney.   It is a leading cause of the limited lifespan of transplants.

I think the only downside of too low a level is risk of acute rejection, but it is worth asking your MD.

Taking food with Tacro can decrease absorbtion by up to 50%.

I consider it good news when my Tacro is decreased.   Now @ 250 cellcept once/day and 1.0AM / 1.5PM tacro with a goal of 7-8.  I was above that on 1.5/1.5.   The goal decreases a bit when you get further out from the transplant..

[SweetyPie]

Well then my levels are definitely not good and never have been good they stay on the low side. I didnt worry much about this because I was getting plasmapheresis treatments. I was happy to be off cellcept because it made me feel sick all the time. But i will have to go back on them the doctor said