lower anti rejectiion meds

[stan50]

I am four and a halve years post liver transplant on cyclosporine mono-therapy with a through rate of approximately 90. Have kidney issues, headaches, worsening vision problems and hypertension. When my headaches get bad i seem to get increased fluid in my ears as if i am getting fluid from cranial swelling or hypertension. Have never had any episodes of rejection. labs are normal outside of increasing sugar levels. I am taking 100 mg twice daily cyclosporine.Would it be acceptable to try 75 mg twice a day and check my labs once a week for a couple of months to see if that might help my symptoms? I am worried about getting a stroke. Also have heart palpitations with uncomfortable feelings in that area for periods of time and then they usually abate. Thank you very much!

[Thomas D Schiano, MD]

.I absolutely agree with decreasing the cyclosprine dose to 75mg BID

There was some glitch in the system so I am just now receiving your question--sorry for any delay.

[Thomas D Schiano, MD]

definitely the lower levels of the cyclosporine may have contributed to your improved symptoms.  i dont think ther acftigall is playing a role here.  i think levels of 75-100 this far out from transplant is acceptable.

[stan50]

I am still on 100 mg 2x daily cyclosporine. My cyclosporine through levels have been lower, the last time they were at 79. I Have been on 300 mg ursodiol 3x daily for biliary stricture since tx. I lowered the dose to 300mg once daily but just recently raised it back to 300x 3 daily because right side discomfort an increase in bilirubin. My headaches and fluid in ears have gotten better, still have the vision issues but heart palpitations have also lessened. Is there a correlation between taking less ursodiol and my through cyclosporine levels slightly decreasing? Could my lower cyclosporine levels have contributed to the lessening of my symptoms? Could taking less ursodiol have contributed to my diminishing symptoms. What would be the lest acceptable through cyclosporine level for a patient on mono -therapy four and one half years post transplant with no episodes of rejection?  Thank you so very much Dr.Schiano

[stan50]

Test last one did not go through