Managing your Tacrolimus(Prograf) levels
One of the most important lessons for a transplant recipient is to manage the immunosuppressive medications as accurate as possible. This is one of the essential components in the care process that will allow your graft to survive for the longest possible time.
At the time of your discharge, you will know the dose in which you should take. This dose is going to increase or decrease over time, based on the levels of medication in your blood.
I teach these simple rules for kidney transplantation. In the first 3 months, the target level is just less than 10 ng/ml. From 3 months to 1 year, the target is just less than 6 -8 ng/ml and beyond the first year, it is just around 4 ng/ml. But like every rule, it must be taken with other organ function as well. Your transplant team may be able to adjust these goals for you.
Please understand that these levels were done based on research for preventing acute rejections in the first year and we can never be certain how these medications work at the molecular level.
In the first week post transplant, you will monitor the levels every day. In the second to the fourth week, you will need to do it every other day. After the first month to three months, monitor levels every week and after that time frame, do it every month.
Always take your Prograf at the same time of the day. The gap between the doses should be always 12 hours. Do not alter the brand without close monitoring and if you have to change doses, please do only under medical supervision.
Avoid grape fruit and pomegranates while you are on Prograf.
This is the most important medication in your immunosuppressive regimen. Our schedule is always a maintenance dual immunosuppression regimen. But it is tacrolimus which made the most important change in the transplant landscape.
At the time of your discharge, you will know the dose in which you should take. This dose is going to increase or decrease over time, based on the levels of medication in your blood.
I teach these simple rules for kidney transplantation. In the first 3 months, the target level is just less than 10 ng/ml. From 3 months to 1 year, the target is just less than 6 -8 ng/ml and beyond the first year, it is just around 4 ng/ml. But like every rule, it must be taken with other organ function as well. Your transplant team may be able to adjust these goals for you.
Please understand that these levels were done based on research for preventing acute rejections in the first year and we can never be certain how these medications work at the molecular level.
In the first week post transplant, you will monitor the levels every day. In the second to the fourth week, you will need to do it every other day. After the first month to three months, monitor levels every week and after that time frame, do it every month.
Always take your Prograf at the same time of the day. The gap between the doses should be always 12 hours. Do not alter the brand without close monitoring and if you have to change doses, please do only under medical supervision.
Avoid grape fruit and pomegranates while you are on Prograf.
This is the most important medication in your immunosuppressive regimen. Our schedule is always a maintenance dual immunosuppression regimen. But it is tacrolimus which made the most important change in the transplant landscape.
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