Need help with Prograf level

Hello Friends, 

I am struggling with maintaining prograf level since 6 months now and doing weekly blood work to make sure it is in correct level.   

Can you please suggest me how much mg twice a say should I take to maintian level between 5-7 ng/ml ?  Please see below for daily dosage and prograf level after 1 week blood test. 

  •  2 mg twice a day -->  Prograf level less than 2 ng/ml 
  •  3 mg twice a day -->  Prograf level less than 2 ng/ml 
  • 5 mg twice a day --> Prograf level was 9 ng/ml 
  • 4 mg twice a day --> Prograf level was 14 ng/ml

Even doctors cannt suggest anything now.  Next week I will start to try some .5 mg dosages. 


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  • My transplant doctors said that consistency is important. They said I could choose to eat or fast the day I have my blood drawn, but always do it the same way.  I take my Prograf at 8:45 PM, eat a bowl of cereal at 8:00 AM the next morning, and try to arrange to have my blood taken as close to 8:45 AM as I can.  I eat the same kind of cereal the mornings I have my blood draws. I am to avoid eating grapefruit, pomegranate, Seville oranges, and green tea. Black tea is acceptable. I don't take any supplements that have not been approved by my transplant pharmacist. So far, I haven't had a lot of variation in my levels unless there has been a dosage change. I'm sure this has been frustrating for you. Good luck.

  • I'd suggest being careful about adding supplements or foods that you haven't told your docs about.  My prograf level was at 17 at a recent 3-month check and the only thing I could think that I might have done differently was that I had used CBD oil on my painful fingers a few times a week.  So document anything new and let your doctors know.

  • Consistent hydration.

    Avoid grapefruit and also pomegranate products.  

    Your TX team are the ones to adjust your dosage levels.

    • Thanks Antoinetta. 

  • The level is affected by many factors. 

    1. Water intakes, make sure be consistent (for examples 8 glasses of water a day, or so)

    2. The time when you take the med

    3. Tea (for some people)

    4. Definitely no grapefruits


    Goid luck. 

    • Yes I need to quit tea now and lets see how it goes.  Thanks for the suggestion. 

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