Rapamune and cholesterol

[Mary4Mike]

Have any of you, who have had a transplant, experienced elevated cholesterol due to their immunosuppressant med sirolimus or tacrolimus? This is a side effect and my husband's cholesterol has risen significantly since being on this. Prior to transplant, he had HDL, LDL, triglycerides, and total cholesterol all in the normal ranges. His internal medicine doc wants to start him on a statin drug (yikes!) and I am wondering if any of you have had success with lowering your cholesterol when it high due to a drug side effect? The doc said they don't know if it will lower it until they try it. We are worried about the side effects (liver) because he has had liver issues even though his enzyme levels are normal now.

Any comments?

[Mary4Mike]

We heard back from the transplant doc and she said that we can try getting the cholesterol/triglyceride levels down by exercise and supplements. She wasn't as alarmed about the numbers as the internal medicine doc. She said that if it comes to needing a drug to lower his cholesterol we could try Lopid. Are any of you on Lopid since being transplanted? Are any of you having cholesterol problems?

[Ruth Cuadra]

Mary, high cholesterol is a common side effect of immunosuppressants. I had very high cholesterol when I was taking cyclosporine after ATG treatment for aplastic anemia and when taking tacrolimus after my BMT. In both cases, my hematologist/transplant doctor was not at all concerned and assured me that my numbers would go down as the dosages were reduced. In fact, my cholesterol returned to normal very quickly once immunosuppressants were discontinued. I'm not surprised that your husband's internal med doctor would be alarmed, but the numbers have to be understood in the context of his treatment. You are right to be concerned about stressing his liver with statins right now. If he has to be on an immunosuppressant for a very long time (years), then some treatment for the cholesterol issue might be warranted. In the short term, watching diet and exercising is always a good idea and may help a bit, but since the numbers are inflated by medication he may not see much change.

Hope this helps.
Ruth

[Mary4Mike]

Ruth,
I really appreciate your reply. Our doctor is open to exercise and healthy diet plus a few supplements to address the cholesterol. He will be rechecked in 6 months and see where we are at. We have begun a taper with the immunosuppressant and the first one went well. We are getting ready to try another one. He is on very few maintenance meds and we have been blessed with that.

Again, thanks for commenting!
Mary