Worried about prograf level. Pls. Comment

[shahariar]

Today after 3 months of post kidney tx my prograf level is 4. Bit worrird but other reports r normal. Taking prograf 5.5 mg/ day. Went to my nephrologist he just increase 0.5 mg. Is this enough to raise my prograf level. Need all my friend openion regurding their experience and ideas. After all i'll decide to change my nephrologist or not. Pls. comment.

[maverick]

Everyone is different. The FK5076 levels are probably very different for each of us. ( I am 14 years out) I do not know how they ever defined the 'therapeutic' range but I have been between 1.9-2.9 for years and years. If I went up to the minimum of 6 I get too over suppressed.

[IOPCarol]

I agree that being in the normal range is much more comfortable for all of us...I have definitely been keeping on top of this and pressed the panic button with my liver doc six months ago when I saw my tacrolimus level at 2.9.  Still have some trepidation over it, but am feeling fine and guess I have to trust their edicts that all if well for me at that level!  Best wishes...

[shahariar]

Thanx IOPcarol. Yes, different prograf level for different person but there r a normal range of prograf level. I was worried because my level was below normal. By d way i m going to do my level tomorrow again.

[IOPCarol]

I am 7-1/2 yrs. out from a liver/kidney transplant.   My tacrolimus levels always ran around the 6 range until earlier this year (I was on 2 mg. a day of Prograf).  My primary care physician upped my blood pressure meds and it caused my Prograf levels to spike up to 13.  It caused me to go into acidosis and kidney transplant dr. took me off of all blood pressure meds for a month and decreased my Prograf to two .5 miligrams each day..  They have slowly increased the blood pressure meds to my original levels and have left me with taking just one miligram of Prograf a day.  My last two blood workups have my tacrolimus count at just 2.9 but the transplant team considers that fine for me.  Just shows that different levels will be acceptable for each of us, depending on all of the other variables. 

[shahariar]

Thanx Jesse. Yes my prograf level was bit low.It was 4.After that my doctor increase 0.5 mg. Now i m taking 3 mg twice daily. Will do my level after 1 week.

[Jesse]

What does your transplant coordinator or surgeon say? Are you having issues that cause you to be concerned or are you looking at the lab results and seeing a low number?

It is very important that you take your immunosuppression drugs at the same time each day and that you have your blood drawn just before you dose or the Prograf trough levels will not be accurate. 

My Prograf levels have been between 4 - 4.5 and I'm currently taking half of what i used to. I'm currently taking 2mg Prograf and 250mg CellCept each twice daily.

Prograf is known to cause kidney damage over time so you don't want to take more than necessary. If the only issue you are having is a lower than target Prograf level then you are doing great!

[frank]

i had a heart xplant,i take 7mg a day seems to working

[Bobbiejo]

For as long as I can remember, my Prograf level has been kept about 4-6, and I have had the transplant for eight years. However, I was in the hospital for about 6 months after the transplant surgery, and I do not remember if a higher Prograf level was desired then or not. I do know I had the most adjustments made to my immunosuppressant dosage that first year, but I am afraid I do not remember what the desired level was for that first year perhaps because it was difficult first year.

[shahariar]

Bigger thanx. Happy to know that your organ is doing well.

[Bigger]

Try to stay patient about this. Everyone's system responds differently. Generally Prograf scale levels are between 5.0-15.0ng/mL. A 4 is not overly out of line and my experience with a 0.5mg-1.0mg dose change would effect the level in a week to 10 days. I typically run between 5.3-7.0, am 3 yrs. post-tx taking 2mg twice/day for past 17 months.