• You can take unequal dosages. Just remember that Tac has a half life of 12 hours so if you do blood draws in the AM the reading will show the trough level of the PM dose.


  • It's my 18 years of Kidnet Tx this year. I'm take 1 mg in the morning and 0.5 mg at evening.  The dosage is adjusted based on the tacro level in the blood. 

    Take care and happy New Year to all!

  • The general intent is to keep an adequate even blood level at all times, hence the "double doses." Shortly after ingestion, the level spikes, often to it's highest, then slowly drifting down throughout the dose cycle (This spike may explain the intensity of some of the side effects after ingestion, even if you have been taking the med for years.) Astellas did reformulate the med into a micro-encapsulated version, Astagraph XL, in an attempt to relieve these spikes. For this reason, blood work should be performed 12 hours from the last ingested dose, to produce accurate test results and levels.

    If you did ingest a larger dose in the AM, it would metabolize in the 12 hour cycle and result in lower PM blood levels, even with the second dose, defeating the intent. It is best to keep the lowest, most effective blood level of all our meds to be protected enough throughout the 24 hour cycle. If you cannot tolerate these formulations,  have a frank discussion of your own Tx team about your options.

  • Thanks everyone

  • All Prograf/Tacrolimus dosage amounts depend on what your lab and organ function results are.  This is how a transplant center will determine what your dose is.  Follow whatever they tell you to do.  Can each dose vary?  Yes.  There are time where you might have a dose of 2.5 mg AM and 3 mg PM or a 4mg AM and 5 mg PM (These are doses I've actually had at one point).  Again, it all depends on how the levels are reading when they get your labs.  This is why it's important to draw labs according to the schedule your center wants it at.


  • I would think it would be better to keep a more consistent level of Prograf in the blood stream, but I am not a medical professional nor do I know your situation so I would suggest inquiring what your doctor and transplant team feel is best for you. I wish you well.

    Warm regards,


  • I take 2mg AM

    and 1.5 PM

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