The twisted tale of Tacrolimus gets a new chapter today. Addison’s all-day blood test last Thursday had one of BC Children’s Hospitals super pharmacist/scientists working overtime through the weekend doing some serious number crunching.
The initial results showed some interesting findings with our little troublemaker’s Tac levels. Before her 8am dose, it was 5.5 (remember, the goal for first-year post transplant is around 10). Then here is how the rest of the day went:
9:00 – 5.8
10:00 – 6.2
11:00 – 6.9
13:00 – 9.5
15:00 – 10.1
It took Addison 7 hours to reach her peak level (which is actually the expected low level for transplant patients)! That is pretty unusual because you’d expect to see a spike within a couple of hours after ingesting a drug.
So what’s the bottom line? While the average Tac absorption rate for babies is 20%, which is already pretty low compared to other meds, turns out Addison’s only absorbing 3%!!! The other 97% seems to be going right through her and straight into the toilet. Now there is some talk of analyzing her poop, in the name of science of course.
This means we are trying something new…again. Thank goodness it doesn’t involve an extra midnight syringe. Her dose has been increased to a whopping 5ml twice a day. This is a HUGE dose. If she was a normal baby this would give her a toxic Tac level of 39. But as Addison has proven so many times before, she is anything but normal!
PS On another drug sidebar, tonight was the final dose of Keppra, the anti-seizure drug she’s been taking since the ICU. (Click HERE for the previous post.) YEAH!!!
Elaine, Aaron and Addison