Transplant Medications

Immunosuppressants are known as anti-rejection medicines because they keep your body from rejecting donor organs and stem cells.

Commonly prescribed anti-rejection medications include:

• Azathioprine (Azasan^®, Imuran^®)
• Cyclosporine (Gengraf^®, Neoral^®, Sandimmune^®)
• Everolimus (Zortress^®)
• Mycophenolate Mofetil (CellCept^®)
• Mycophenolic Acid (Myfortic^®)
• Sirolimus (Rapamune^®)
• Tacrolimus (Astagraf XL^®, Prograf^®)

Azathioprine

Brand names: Azasan^®, Imuran^®

Dosage: Take azathioprine once a day with food or as directed by your doctor.

Side effects:

• Joint pain
• Diarrhea, vomiting, upset stomach
• Increased risk of infections, such as in the urinary or upper respiratory tracts
• Higher risk of skin cancer
• Low counts of white blood cells, hemoglobin or platelets
• Mouth ulcers (contact your doctor immediately)
• Tarry stool (contact your doctor immediately)
• Blood in urine (contact your doctor immediately)

Helpful information:

• Store azathioprine at room temperature away from heat, direct light and moisture.
• Learn more about azathioprine.

Cyclosporine

Brand names: Gengraf^®, Neoral^®, Sandimmune^®

Dosage: Take cyclosporine with food twice a day 12 hours apart (for example, at 9 a.m. and 9 p.m.), or as directed by your doctor.

Side effects:

• High blood pressure
• High cholesterol
• Increased facial hair growth
• Diarrhea, vomiting, upset stomach
• Hand tremors
• Increased risk of infections, such as in the urinary or upper respiratory tracts
• Higher risk of skin cancer
• Swollen gums
• Decreased kidney function
• Elevated potassium levels

Helpful information:

• Do not consume grapefruit, pomegranates or products made with these fruits. These fruits heighten the medicine’s effects and could cause side effects.
• Do not take your morning dose of cyclosporine before getting blood drawn. Bring the medication with you and take it after your blood has been drawn. It is possible that future dosage amounts may change based on your lab results.
• Store cyclosporine at room temperature away from heat, direct light and moisture.
• Learn more about cyclosporine.

Everolimus

Brand names: Zortress^®

Dosage: Take everolimus with food and a full glass of water twice a day 12 hours apart (for example, at 9 a.m. and 9 p.m.), or as directed by your doctor.

Side effects:

• Headache
• Joint pain
• Rash
• Diarrhea, vomiting, upset stomach
• Swollen hands, feet or lower legs
• Decreased counts of white blood cells, hemoglobin or platelets
• High cholesterol
• Increased protein in urine
• Slow wound healing
• Mouth sores or ulcers
• Weakness
• Increased risk of infections, such as in the urinary or upper respiratory tracts
• Higher risk of skin cancer
• Facial swelling (contact your doctor immediately)
• Shortness of breath or wheezing (contact your doctor immediately)

Helpful information:

• Store everolimus at room temperature away from heat, direct light and moisture.
• Do not consume grapefruit, pomegranates or products made with these fruits. These fruits heighten the medicine’s effects and could cause side effects.
• Learn more about everolimus.

Mycophenolate Mofetil

Brand name: CellCept^®

Dosage: Take mycophenolate mofetil with food twice a day 12 hours apart (for example, at 9 a.m. and 9 p.m.), or as directed by your doctor.

Side effects:

• Diarrhea and vomiting
• Stomach cramps
• Constipation
• Heartburn
• Headache
• Increased risk of infections, such as in the urinary or upper respiratory tracts
• Higher risk of skin cancer
• Decreased counts of white blood cells, hemoglobin and platelets

Helpful information:

• Take each dose of this medication with food.
• Do not take antacids without talking to your doctor. Antacids can decrease the medicine’s effects.
• Take this medication whole. Do not break, crush or chew the pill.
• Store mycophenolate mofetil at room temperature away from heat, direct light and moisture.
• Learn more about mycophenolate mofetil.

Mycophenolic Acid

Brand name: Myfortic^®

Dosage: Take mycophenolic acid twice a day with food 12 hours apart (for example, at 9 a.m. and 9 p.m.), or as directed by your doctor.

Side effects:

• Diarrhea and vomiting
• Stomach cramps
• Constipation
• Heartburn
• Headache
• Increased risk of infections, such as in the urinary or upper respiratory tracts
• Higher risk of skin cancer
• Decreased counts of white blood cells, hemoglobin and platelets
• Wheezing (contact your doctor immediately)
• Chest pain (contact your doctor immediately)

Helpful information:

• Mycophenolic acid is given to prevent organ rejection when a patient cannot tolerate the side effects of mycophenolate mofetil (CellCept^®).
• Do not take antacids without talking to your doctor. Antacids can decrease the medicine’s effects.
• Take this medication whole. Do not break, crush or chew the pill.
• Store mycophenolic acid at room temperature away from heat, direct light and moisture.
• Learn more about mycophenolic acid.

Sirolimus

Brand name: Rapamune^®

Dosage: Take sirolimus once a day with food or as directed by your doctor.

Side effects:

• Headache
• Joint pain
• Rash
• Diarrhea, vomiting, upset stomach
• Swollen hands, feet, lower legs
• High cholesterol
• Increased protein in urine
• Weakness
• Slow wound healing
• Mouth ulcers or sores
• Decreased counts of white blood cells, hemoglobin and platelets
• Increased risk of infections, such as in the urinary or upper respiratory tracts
• Higher risk of skin cancer

Helpful information:

• Do not consume grapefruit, pomegranates or products made with these fruits. These fruits heighten the medicine’s effects and could cause side effects.
• Do not take your morning dose of sirolimus before getting blood drawn. Bring the medication with you and take it after your blood has been drawn. It is possible that future dosage amounts may change based on your lab results.
• Store sirolimus tablets at room temperature away from heat, direct light and moisture.
• Keep liquid sirolimus medication in the refrigerator. Throw away any unused medication one month after opening the bottle. Do not freeze liquid medication.
• Learn more about sirolimus.

Tacrolimus

Brand names: Astagraf XL^®, Prograf^®

Dosage: Take tacrolimus with food once or twice a day 12 hours apart (for example, at 9 a.m. and 9 p.m.), or as directed by your doctor.

Side effects:

• Diarrhea, vomiting, upset stomach
• Hand tremors
• Tingling in arms or legs
• Headaches
• Decreased magnesium and potassium levels
• Elevated blood sugar
• Decreased kidney function
• Increased risk of infections, such as in the urinary or upper respiratory tracts
• High blood pressure
• Hair loss

Helpful information:

• Do not consume grapefruit, pomegranates or products made with these fruits. These fruits heighten the medicine’s effects and could cause side effects.
• Do not take tacrolimus before getting blood drawn. Bring the medication with you and take it after your blood has been drawn. It is possible that future dosage amounts may change based on your lab results.
• Store tacrolimus at room temperature away from heat, direct light and moisture.
• Learn more about tacrolimus.

Antibiotics prevent and treat bacterial infections that can occur after a transplant.

Commonly prescribed antibiotics include:

Trimethoprim and Sulfamethoxazole

Brand name: Bactrim^®

Dosage: Take this medication as directed by your doctor with 8 ounces of water.

Side effects:

• Diarrhea, vomiting, upset stomach
• Appetite loss
• Rash
• Increased sun sensitivity
• Decreased counts of white blood cells and platelets
• Elevated potassium levels

Helpful information:

• Do not take this medicine if you are allergic to sulfonamides or sulfa, a chemical found in some antibiotics.
• Learn more about trimethoprim and sulfamethoxazole.

These medicines treat fungal infections of the skin, mouth, throat, intestinal tract and genitals. Depending on the type of infection, you may take a liquid or lozenge medication, or apply a topical skin cream.

Immunosuppressants make you more prone to viral infections. Antivirals prevent and fight off viruses like cytomegalovirus (CMV).

Commonly prescribed antivirals include:

Valganciclovir

Brand name: Valcyte^®

Dosage: Take valganciclovir with food as directed by your doctor.

Side effects:

• Diarrhea, vomiting, nausea
• Decreased counts of white blood cells and platelets

Helpful information:

• Take valganciclovir whole. Do not break, crush or chew the pill.
• Learn more about valganciclovir.

Immunosuppressants can cause your blood pressure to rise. Certain medications keep your blood pressure in the heart-healthy range.

Certain immunosuppressants can raise cholesterol levels. Medications, such as statins, counteract this effect by lowering cholesterol levels.

Fluid retention is a common problem after a transplant. Diuretics, more commonly known as water pills, help your body flush out extra fluid and reduce swelling. They also help lower blood pressure.

Certain transplant medicines can cause stomach irritation and ulcers. Proton pump inhibitors and histamine receptor blockers protect your stomach by reducing acid production.