[Lisa V]

Ryan, how high did your creatinine get? That does seem like a fairly major reduction, particularly given your weight. The only reason I can think of for such a sudden cut is if either your creatinine or blood pressure had gotten dangerously high and they wanted to bring it down quickly, or if you were having some other sort of adverse reaction. The blood CSA level in and of itself doesn't necessarily warrant that, as the guidelines for therapeutic level are so unclear.

Still, at 200 mg you may be okay. It may just be a temporary reduction until things settle down. I'd ask the doctor about it.

Ken was started at 900 mg/day (!!!) when he got his first ATG. I don't know why so high, he weighs about 180. They cut it to 500 after about a month, and then to 200 a month later. His CSA level was 885 and his creatinine had shot up to 2.2 so they needed to bring it down quickly. That was fine for a while, but even then it started to creep up again. At that point a simple 25mg reduction was enough to even things out, and he's been maintaining at 175mg/day for the last few years. You just have to find that right balance point for you.