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So, I want to start this out by saying that I never miss doses.  I am 2.5 years since my transplant, and I've maybe missed only 3 or 4 doses over that time.  I am very adamant about taking my meds at 10am & 10pm. However I got caught up on the phone Monday night and accidentally turned off my alarm instead of snoozing it (I know I should always just take it right there instead of snoozing).  Anyways, I forgot to take my meds Monday night.  I realized it as soon as I woke up on Tuesday at 7am.  I took my meds right then and adjusted my Tuesday night dose to 8pm hoping to eventually work back to my 10am & 10pm schedule over the next few days.  I had my regularly scheduled blood draw today and creatinine was normal at 1.5.  That is what it consistently runs.  Well, I had a super busy day and didn't realize that I had somehow turned off my alarm and didn't take my morning dose.  I realized this at about 4:30pm today, and I immediately took the dose.  I plan to take my dose at 6am tomorrow morning now.  I know I technically should just wait until my next dose (at 10pm), but I could not stand the fact that I had forgotten twice in 2 days.  I felt it might be risky to wait an additional 5 hours.  I will eventually get back to my regular schedule one hour at a time.  I just wanted to get everyone's take on this.  Am I thinking all wrong on this?  I am quite concerned about this, but I know that there is some wiggle room.  Is there any risk of rejection in missing these two doses like this?  In my experience I tend to think I will be fine, but just wanted to get the opinion of others.  

I currently take 720mg's of Myfortic and 0.75mg of Everolimus every 12 hours.  Please let me know your thoughts.

Thanks for the support!

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Replies

  • I've screwed up my meds only twice; once, I completely forgot my evening dose (I thought I had taken them but later discovered they were still in my med box), but once I took my tac 6 hours too early!  I saw them and, without thinking, just swallowed them!  I immediately knew this might be a problem, so I called the coordinator on call (because this happed late Friday night, of course!), explained by brain fart, and she gave me specific directions on what to do next.  She also told me that if I ever missed a dose, as long as I took them within 6 hours of when I should have taken them, then go ahead and take the missed dose.  If six hours have passed, call her for instructions.

    Your action plan sounds logical, but since the consequences of missing doses is so dire, I really would encourage you to talk to your coordinator just for some general guidelines.  They know that even the most compliant patients make mistakes.  They can further explain exactly what your "wiggle room" actually is.

  • Don't you guys NOTICE something if you miss a dose?? If I go more than an hour I feel a tingling around my kidney & I can feel the collection of urine into my bladder slow or stop! So I NEVER miss because my body lets me know!

    • Hmm.....I have never felt any of these symptoms when a dose is missed.  Of course I don't ever really miss.  This week has just been the exception.  I am super paranoid about it now.  I mean I feel fine, but just nervous something could be going on without me knowing.  Please speak up someone who has done this before!  Please tell me that it takes more than this for the rejection to begin to occur.  I just want to get this off my mind and move on with living my life!!

      • If something would have happened, then you should have known by now. Stay calm. Adding more stress on yourself may be more harmful. And if you can not calm down, then call your doctor.

    • The day I missed a dose, I felt sleepy (unusual kind of sleepy) and because it was the first time I missed a dose, I didn't realize that was the reason. Now I know that my body will tell me.

  • Hey Brian ,  you really should let your tx team know when u miss meds , esp:  your rejection meds , I am closing in on 7 years post heart ,  maybe my team is a bit over cautious or maybe its part of their ask these questions  on a prepared  list ...   but after blood draws when they  phone results ,  one of the frist 2 questions  they ask me :   did u miss any dosages ..     Becareful  every thing you have gone through  to have that organ  reject  is scarey  ...

       on another note ..  I am glad your doing so well !  keep up the good Work !!

  • My husband is two years post liver transplant. One week ago he missed his morning meds and went to work. only when he took his evening meds, he saw his morning meds still in the "pill box". I text his doctor and he said that my husband should take the morning meds and then set the alarm for the evening meds. Not less than 4 hours and not more than 6 hours. Then have at least 4 to 6 hours before the next meds and then go back on schedule. Two days later was die scheduled blood tests and everything was fine.

  • I think you'll be fine.  

    I do what I think you're doing.  If you miss a dose:  take you meds as soon as you can.  Then take the next doses at 13-hour intervals until you get back on schedule.  Even 14 hours would be not such a big deal.  That's what I do.  And I've had to do it twice in 4 years.

    Best ways to avoid a miss:

    1. Have somebody you text every time you take a dose.  I you don't text they text you!

    2. Keep you pills by your bed, next to the light you last turn off.  You'll see them.  I take my meds at 8:30 a.m. and p.m.  Even if I miss at night, I see them and take them at 10 pm.  Not much of a miss.

    Whatever you do, get  system and stick to it.  Dose don't work if you don't take 'em!

  • Hey and one thing I want to state is the reason I'm doing this stair stepping method is because I have read and my doctor tells me it's all about the drug levels in your blood stream. I thought it would be best to make sure to keep that level up in my blood as opposed to waiting and letting it drain more.
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