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163305 tn?1333672171
proograf question
Can anyone explain what happens to our blood daily when we take prograf ? I ask this because once when I did my labs not long after taking prograf ( not the norm) my ALT and AST soared. It got me wondering, and I'd like to know.
Explanations of how it affects us physiologically would be appreciated.
Thanks !
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Avatar universal
Hepatotoxicity
Tacrolimus therapy is associated with mild to moderate elevations in serum aminotransferase levels in 5% to 10% of patients.  These elevations are usually mild, asymptomatic and self-limited, but are occasionally persistent and require dose modification.  Tacrolimus has also been implicated in instances of cholestatic hepatitis, but clinically apparent liver injury is rare.  Because tacrolimus is used in the context of organ transplantation and often in liver transplantation, the causes of liver test abnormalities arising during therapy are many, and drug induced liver injury due to tacrolimus is sufficiently rare that its clinical features and typical course have not been defined.


Mechanism of Injury
Tacrolimus undergoes extensive hepatic metabolism largely via the cytochrome P450 system (CYP 3A4) and is susceptible to many drug-drug interactions.  Liver test abnormalities during therapy may be due to direct hepatotoxicity, its effects on levels of other medications, or its effects on the immune system.


Outcome and Management
The liver injury due to tacrolimus is usually mild and self-limiting and responses rapidly to dose adjustment or drug discontinuation.  Other calcineurin inhibitors and immunosuppressants are generally tolerated, but rare instances of cross sensitivity to hepatic injury by cyclosporine and tacrolimus have been reported.

Agents used specifically for the prophylaxis against allograft rejection include cyclosporine, mycophenolate mofetil, sirolimus and tacrolimus, as well as azathioprine and corticosteroids.

References regarding the safety and potential hepatotoxicity of the cyclosporine, mycophenolate mofetil, sirolimus and tacrolimus are provided together at the end of the Overview section on drugs used to prevent transplant rejection.

http://livertox.nih.gov/Tacrolimus.htm
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29837 tn?1414538248
Hi Mike

Remember me? Magnum? How are things. What's been happening with you?. What's been happening to me you can read at Cirrhosis forum...

Magnum
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163305 tn?1333672171
Thanks Mike, that does help.
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