I after almost 8months of itching finally a blockage in the anterior duct is detected along with the posterior one. 3months back ERCP was done and liver engymes are perfectly normal.
But due to high dose of tacrolimus the creatinine is gratually on rise(it is now around 1.9). My doc is trying to reduce the dose. Since I was on tacrolimus only(as Mycophenolate causes TLC to go down in two occasion), sirolimus 1mg is started along with reduced tacrolimus(2mg BD, Tac level ~4.5). But the creatinine is still high(1.8). It seems some side effect of Sirolimus is also coming as the TLC is 3400 and platelet is 80,000.
What do you suggest to bring creatinine under control?
What is the way to determine the exact required dose of tacrolimus?