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Missed doses

I'm 1 year 3 months post transplant. I currently 1mg envrolimus and 720mg myfortic every 12 hours. I've only missed 3 doses in this timeframe but 2 of them have been in the last 5 days. My transplant team doesn't seem to be concerned but I wanted everyone's input on how serious this is? Creatinine has remained stable at 1.4 for a long time now with some fluctuation.

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  • Just so you know, the most recommended course of action is.. if the missed dose is discovered up to 6 hours after schedule, take the dose. After 6 hours...wait and resume your next scheduled dose. No Worries!

  • Husband is 17 months out from transplant and missed first dose last night. Waiting to hear from doc now. Kind of freaked out, tho he feels fine.

    • Wow...That's some kind of record! It only took a month for me to sleep through a scheduled dose. I called everyone when that happened. I see now how that stress was unneeded, but I'm told it shows your level of compliance to the Tx team (not sure about that.) I'm sure he will be fine, as long as this doesn't become a habit

  • Brian, I am a lung transplant recipient, I would of kicked the hospital in the rear, but it comes down to you knowing what meds you need and to question the nurses why they are not,  Do not beat yourself up, it happens, Just keep on top of them.

  • Hi Brian - I set the alarm on my cell phone to repeat every day once at 9:30 am, once at 9:30 pm. The trick is to set it to repeat always, not have to set it everyday. Also I keep my meds in a 7 day pillbox which is labeled by day and by time. One look and I know if I missed one and can then take it immediately. I hope that helps.
  • Bryan,

    I had one problem after another post-transplant: delayed graft function for a month, a second surgery to remove fluid collection at transplant site, and c dif. During one of these additional hospital stays, I missed three consecutive doses of Prograf and Myfortic. Two weeks later, during routine labs, my creatinine registered in the 7.5 range, signaling acute rejection. I was given 3 doses of prednisone-type medication intravenously, over three days. That put a stop to the rejection but it certainly could have been avoided, especially since I was hospitalized when I missed the critical doses (long story).

    I guess my point is....I have missed an occasional dose over the past 3 1/2 years but there have been no ill effects. I kick myself for it and strive to do better. More than one missed dose can certainly lead to problems. One of the most important things you can do is to keep up with your regular labwork because that's usually the fastest way to detect an episode of rejection. Enjoy that new kidney!
    • Hey! I was wondering about those meds after transplant  ... thank you for sharing your story.

    • Tina, what's your creatinine at now?
      • I run about 2.5 but have never gotten below 2.2. My team is not overly alarmed with this because, even though it isn't great, it is stable. My kidney was from a young deceased donor and was on ice for 35 hours, leading to the delayed function. I still dialyzed for a month after the transplant until it started working.
        • Glad you are stable Tina. What's your urine output like? Is it over a liter a day? 1. 5 liters?
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