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I am 11 years post-kidney transplant. I have been on the same drug regime for the last 11 years as well, 5mg predisone, 360mg of Myfortic, and 2mg tacrolimus in the morning, 1mg at night. About a year ago I switched to a different transplant hospital from the one I was transplanted in due to moving cities. This new transplant clinic has a great reputation and does many transplants as well. I had my second clinic appointment with the new clinic yesterday and say the transplant program medical director. She told me about some new drugs that have come out on the market since my transplant 11 years ago and wants me to switch, although she left it open for me to research and decide. Obviously, I am pretty nervous since I've been on the same medications for 11 years without any rejection episodes.

The first drug is the Envarsus/Astagraf, which is basically an extended release tacrolimus that you take once a day instead of twice a day. Supposedly you have a more consistent tacrolimus level and it is less toxic long-term on the transplanted kidney. That all sounds pretty great to me. Has anyone made the switch from regular tacolimus to the extended release and did everything go okay?

The second drug we discussed is Everolimus/Zortress, which I had never ever heard of before. It would take the place of the Myfortic and her exact words were "if I was a transplant patient, that's what I'd want to be on". Basically, the Myfortic is tearing up and damaging my digestive track. I've been dealing with chronic diarrhea from the Myfortic for many years. Supposedly, this medication does not have that side effect. Does anyone have any experience with this medication?

It seems like there are so many more drugs for transplant patients on the market now that when I was first transplanted. I'm sure that progress and improvements in anti-rejection medications are a good thing, but it is a bit overwhelming and scary to change. Any experience anyone has had is appreciated.

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  • This drug has gained use in the last decade, owing to the effort to reduce drug levels of Tacrolimus and it's long-term effects. There is an extensive list of side effects, however,  it is best to judge it on your own or be advised by those who are on it, for what to look for.


    Zortress (Everolimus): Side Effects, Interactions, Warning, Dosage & Uses
    Learn about Zortress (Everolimus) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medicati…
  • Hi thete! I have been on Zortress for a while now. I'm a double lung transplant and have and continue to be, on many meds. Zortress has caused kidney issues in the past, but with attention to hydration, that problem has lessened. I take it and Tacrolimus for rejection

  • Change has always been my friend.

  • Hi Lizze

    i have been on everolimus and reduced dose of tacrolimus for over 3 years. Like all transplant meds the side effects come and go.i first tried rapamune which wasn’t tolerated, then everolimus which is a cousin to rapamune There was no reason to switch to Astagraf  since the tacrolimus and zortress are taken together every 12 hours. The everolimus will reduce issues with skin.People without good insurance are reluctant to switch due to high cost of medication.


    • im in evorilimus too, certican 0.5mg 2x a day with 2mg prograf twice a day also. it replaced myfortic. but my concern is its price. it's very expensive here in the Philippines. but i feel better with certican (evorilimus) now than with myfortic, my crea level decreased. 

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