Prograf question

[vandie]

I am 11 weeks post transplant and my Prograf levels are low.  They have been at 4.4 for a week.  They should bem according to surgeon, between 10 and 12.  My creatinine is at 1.0 and I feel great.  I have done nothing different.  I take it on an empty stomach and at the same times every day.  No other med changes have occured.  However I am anemic again.  Does the anemia affect the Prograf levels?  I am doing blood twice a week to monitor the levels.
Any insight? 

[Rerun]

I would call somebody and point that out to them.  I think they need to adjust something.  Your new kidney should be releasing its own eurethramison (sp) so you should not be anemic.  They could give you Procrit.  Procrit is for Transplanted patients and Epogen is for dialysis patients. 

[vandie]

I would call somebody and point that out to them.  I think they need to adjust something.  Your new kidney should be releasing its own eurethramison (sp) so you should not be anemic.  They could give you Procrit.  Procrit is for Transplanted patients and Epogen is for dialysis patients. 

I did start the shot on Thursday.  I had done Procrit pre transplant and had a prescripton already approved. 
Thanks Rerun.

xoxo

[okarol]

How much prograf are you taking now?

Jenna's hemoglobin has been 10.8, 11.3, 11.1, 10.7 - over the last several months. This week it was 12.6 - her first 'over 12' reading. They said it can take a while for the kidney to produce the Erythropoietin.

We usually check Jenna's hemoglobin and hematocrit. I don't think her actual EPO level has been checked.

How is the EPO test done? The patient is usually asked to fast for 8-10 hours (overnight) and sometimes to lie quietly and relax for 20 or 30 minutes before the test. The test requires a routine sample of blood.  According to http://www.medterms.com/script/main/art.asp?articlekey=7032: Normal levels of EPO are 0 to 19 mU/ml (milliunits per milliliter).

http://www.medicinenet.com/epoetin_alfa/article.htm says: Epogen and Procrit are both epoetin alfa, but they are marketed by two different pharmaceutical companies.

[stauffenberg]

Many patients suffer nerve damage during dialysis, especially if it is continued over many years.  This occasionally causes damage to the nerves of digestion, which in turn slows gastric emptying.  One effect of this can be that the measured blood levels of various drugs you take by mouth can be lower than expected since you are absorbing them more slowly into the bloodstream from the intestine.

It is not at all unusual for renal transplant patients to have to take a slow-acting form of EPO, usually once a week, for the entire life of their graft.  This is because a transplanted kidney is never as healthy as your own normal kidneys, and suffers from damage incurred 1) when the donor died, if it is from a cadaver; 2) when it was removed from the donor and placed into you, which is an extremely traumatic process for the organ; 3) when it is affected by the nephrotoxic effects of the immunosuppressive drugs you take.  As a result, it may not make a normal amount of hemoglobin.  I have been taking Aranesp to boost hemoglobin levels now for the entire life of my graft, since August, 2005, and will have to keep taking it for as long as the graft lasts.  Without it, my hemoglobin levels would be around 90 to 100.

[Romona]

Prograf does take awhile to reach a consistant level. Also you had major surgery which your body is still recovering from, which may be why you are anemic. 

[livecam]

My Prograf levels have run consistantly on the high side.  For that reason they have been lowered regularly over the years.  At the present time I'm on 2mg per day, thats 1mg 2x a day.