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Treatments & Procedures

Transplant Medications

You have the right and responsibility to know what medicines are being prescribed for you. The more you know about your medicines and how they work, the easier it will be for you to control your symptoms. The most important step in maintaining your health after your transplant is to take your medicines exactly as prescribed. These drugs help prevent rejection and infection, and must be taken for the rest of your life.

What types of anti-rejection medicines might I be taking?

The types of anti-rejection medicines (immunosuppressives) you might be taking are prednisone, CellCept, cyclosporine, sirolimus, or prograf. You might be prescribed any combination of these drugs.

What will I need to know about taking my medicines?

Before your doctor prescribes any medicine, he or she will ask you:

  • If you are allergic to any medicines
  • If you are currently taking any other medicines (including over-the-counter medicines)
  • If you have problems taking any medicines

The type of medicines, the dosage, and side effects might be different for each patient. While you are in the hospital, the Kidney Transplant Team will teach you about your medicines and give you information sheets describing each drug and how to take it. Before you go home, the Transplant Team will make sure you know:

  • The name of the drugs prescribed and their action

Please note: all medicines have two names — the generic or chemical name (such as sirolimus) and the brand name (such as Rapamune). The Transplant Team will tell you both names of the medicines.

  • The dosages, the time of day, and how to take them
  • The side effects and how you can treat or prevent them

Your family members are also encouraged to learn about your medicines.

Will the drugs I’m taking cause any side effects?

Some of the drugs prescribed for you might cause unwanted side effects such as weight gain, acne, or excess hair growth or hair loss. Despite these side effects, never change the dose or stop taking your medicines without first checking with your doctor.

Many of the side effects can be controlled. Your doctor might adjust your dosage or offer other suggestions for managing the side effects. Keep all appointments with your doctor and the laboratory so your response to the drugs can be monitored.

The individual drug information sheets contained in this notebook describe the common side effects of each drug and how to manage them.

Does it really matter if I miss a dose?

Yes. It is very important to always follow the instructions for your medicines every day to prevent rejection. The third major cause of transplant failure results from not taking anti-rejection medicines as prescribed.

What if I forget to take my medicine at the scheduled time?

If you miss a dose of your medicine at the scheduled time, don’t panic. Take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and return to your regular medicine schedule. As you begin to feel well, it might be easy to forget to take your medicine, but always remember that your body never stops requiring the transplant medicines. By taking your medicines consistently and following-up with your doctor routinely, you are assuming the most important job after your transplant.

Dose changes

Your doctor will periodically change the dose of your medicines. The dose might be changed because you are having uncomfortable side effects or because blood test results indicate that a different dose is needed.

You will receive a medicine dosage record to write down your medicines and dosages. Every time your doctor tells you to change the dose of your medicine, cross out the previous dose and write in the new dose. (Use ink ,not pencil, and do not erase previous information so you have a record of your earlier doses). Remember, never change the dose of your medicines unless you are told to do so by your doctor.

Taking other medicines

Never take other medicines without first talking to your doctor. This includes over-the-counter drugs (those you can buy without a prescription). Some over-the-counter drugs include aspirin, ibuprofen (Advil, Nuprin), vitamins, cold medicine, antihistamines, antacids, laxatives, and sleeping pills. Some over-the-counter medicines might decrease the effectiveness of your transplant medicines and can cause unwanted side effects.

Can I get financial assistance to help pay my medicine expenses?

Yes. Your health care providers realize your medicines are expensive, especially since you must take them for the rest of your life. There are several government and state programs that offer financial assistance for medicine expenses.

Please ask your social worker what programs are available for you. You can also ask to see a financial counselor who can answer questions about insurance coverage and Medicare benefits related to your medicine expenses.

Will any new medicines be available?

Exciting developments in drug research are creating new immunosuppressive medicines. Cleveland Clinic’s Kidney Transplant Program participates in new drug studies on a continuous basis. You might be asked to take part in one of these programs after your transplant. All programs are strictly voluntary and have no influence on your transplant status.

General Medicine Guidelines

  • Know the names of your medicines and what they do. Know the generic and brand names, dosages, and side effects of your medicines.
  • Always keep a list of your medicines with you.
  • Know what side effects to expect from your medicines.
  • Take your medicines exactly as prescribed, at the same time(s) every day. Do not stop taking or change your medicines unless you first talk with your doctor. Even if you feel good, continue to take your medicines. Stopping some medicines suddenly might make your condition worse.
  • Have a routine for taking your medicines. Consider getting a pill box that is marked with the days of the week. Fill the pill box at the beginning of each week to make it easier for you to remember.
  • Keep a medicine calendar and note every time you take a dose. Your prescription label tells you how much to take at each dose, but your doctor might change your dosage periodically, depending on your response to the medicine. On your medicine calendar, you can list any changes in your medicine dosages as prescribed by your doctor.
  • Wash your hands before preparing or taking medicines.
  • Take your time. Double check the name and dosage of all your medicines before using them.
  • Regularly fill your prescriptions and ask your pharmacist any questions you have about refilling your prescription. Know your pharmacy phone number, prescription number, medicine name, and dose so you can easily call for refills. Try to fill all your prescriptions at the same pharmacy, so the pharmacist can monitor for interactions and provide proper dosing and refills. If your refill medicine does not look right, ask your pharmacist to verify that you have received the correct prescription.
  • Do not wait until you are completely out of medicine before filling your prescriptions. Call the pharmacy or doctor’s office at least two business days before running out. If you have trouble getting to the pharmacy, have financial concerns, or have other problems that make it difficult for you to get your medicines, let your doctor know. A social worker might be available to help you.
  • Do not decrease your medicine dosage to save money. You must take the full amount to get the full benefits. Talk with your doctor about ways you can reduce the costs of your medicines.
  • If you have prescription coverage, make sure you know the terms of your policy. Remind your doctor about the type of insurance coverage you have.
  • Do not stop taking your medicines. Talk to your doctor if you have concerns about how your medicines are working.
  • Keep medicines stored in their original containers. Store according to the instructions given with the prescription.
  • Do not keep outdated medicine or medicine that is no longer needed. Throw old medicines away.
  • Check liquid medicines often. If they have changed color or formed crystals, throw them away and get new ones.
  • Do not take any over-the-counter drugs or herbal therapies unless you ask your doctor first.
  • When traveling, keep your medicines with you so you can take them as scheduled. On longer trips, take an extra week’s supply of medicine and copies of your prescriptions, in case you need to get a refill.
References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/13/2012…#4683