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Tac trough levels elevated last 6-months

I am 3-year post liver TX.  For the last 2 1/2 years I been taking 2mg of Prograf @ twice per day, plus Myfortic, and Prednisone.   In the last 6-months I have been reducing Prednisone from 5mg/day to most recently none.Over this same time frame my Tac trough has elevated from a steady 5 to 7 Tac level to between 8 to 14.  The most recent Tac trough was 10.1.  As result, the docs are cutting my Prograf in half to only 1 mg @ twice per day.  

I'm well aware of the "toxic" kidney affects of an elevated trough level s reducing it is good.  

My only question:  For those of yoiu on the same or similar med regimen for liver TX, is a graudally increasing Tac trough level a few years post liver TX "normal" or could it be related to the Prednisone reduction?

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  • Hi, Steve. I may not be qualified to reply to this thread, however, I do know that Pred drastically affected my tacro levels. I was told this was very normal by my team. :)

  • My guess is that the reduction in prednisone may have let you absorb more prograf.  It is normal for values to change over time.  I had to increase mine after six years.  My doctor indicated that it was not unusual.

  • Hi Steve,

    Though I take Prograf (tacrolimus) for a kidney Tx, the goals are the same.  I have been taking it for the better part of the last decade and a half, with steadily reducing doses, now at 1.5 mg AM and 1 mg PM to maintain a trough of 6.5. My increased sensitivity and risk of toxicity of the med was the reason for dose adjustments.  At over 10, you may be feeling fatigued when it goes any higher.  This IS normal.

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