Medicines After Kidney Transplant

Taking your medicines will help keep your new kidney healthy. Your doctor will be adjusting the medicines based on your drug levels, lab test results and side effects. You will need a large sectioned pill box to organize the medicines (the size of a 8 ½ x 11 piece of paper).

Anti-Rejection Medicines or “Forever Drugs”

Tacrolimus (Prograf® or FK506)
  • This medicine helps lower the immune system so the new kidney can stay in the body.
  • Comes as a capsule, or can be made into a liquid by the pharmacy.
  • The liquid must be kept in the refrigerator and shaken well before use.
  • Use an oral syringe when taking the liquid form.
  • This medicine must be taken every 12 hours.
  • Do not take within 2 hours before or after taking an antacid (example: TUMS, Rolaids).
  • NO grapefruit or grapefruit juice while taking Tacrolimus because these may block your body’s ability to absorb the drug.
  • Possible side effects include: Kidney damage, increased infection risk, high blood pressure, upset stomach, lower immune system, elevated blood sugar that could lead to diabetes, tremors (shaking).
Cellcept® (mycophenolate mofetil)
  • This medicine comes in capsule, tablet or liquid suspension (medicine that is mixed with a liquid).
  • This medicine helps lower the immune system so the new kidney can stay in the body.
  • Must be taken every 12 hours.
  • Possible side effects include: diarrhea and stomach upset, lowers the number of white blood cells in the body.
Myfortic®
  • This medicine comes in a pill.
  • This medicine helps lower the immune system so the new kidney can stay in the body.
  • Do not crush or chew the tablet.
  • Possible side effects include: lowers the number of white blood cells in the body.
Steroids such as Prednisone
  • These medicines help lower the immune system so the new kidney can stay in the body.
  • They are given on the first day of transplant and for four days after transplant while you are in the hospital.
  • Some people who have had transplants may require prednisone as an ongoing medicine. This is not unusual.
  • Possible side effects include: hunger, stomach upset, higher blood pressure, mood swings, fluid retention (swelling).
Neoral®
  • This medicine has no generics. The brand name is “Neoral.”
  • It comes in gelcap or liquid suspension. You must keep the gel cap in the foil wrap until you are ready to take it.
  • This medicine helps lower the immune system so the new kidney can stay in the body.
  • Neoral must be taken every 12 hours.
  • For example, take the pills at:
    • 8am and 8pm
    • 9am and 9pm
  • No grapefruit or grapefruit juice while taking Neoral. These may block your body’s ability to absorb the drug.
  • Possible side effects include: heavy, fast hair growth; hair growth in unusual places; gum swelling; higher blood pressure; headache; kidney injury; tremor (shaking).
  • The first side effect (hair growth) may tell your doctor you have an increase in the serum Creatinine. That means the dose needs to be adjusted.
  • Your hands may shake if your Neoral level is too high.
Rapamune® (Sirolimus)
  • This medicine comes in a tablet and a liquid suspension.
  • It is taken one time each day, four hours after the morning Neoral dose.
  • Your levels will get too high if the two drugs are taken at the same time.
  • This medicine helps lower the immune system so the new kidney can stay in the body.
  • Possible side effects include: lower number of white blood cells in the body, anemia (not enough red blood cells to carry oxygen through the body), increased cholesterol, mouth sores, joint pain and slow wound healing.
ATG (Antithymocyte Globulin)
  • This medicine helps lower the immune system so the new kidney can stay in the body.
  • It blocks the effects of lymphocytes, or white blood cells, which may harm the new kidney.
  • ATG is given through an I.V. for the first few days while in the hospital.
  • You will get Tylenol® and Benadryl® before the ATG to help control this medicine’s side effects.
  • Possible side effects include: fever, chills, rash, dizziness, nausea and vomiting.
Bactrim™ (trimethoprim sulfamethoxazole - SMZ-TMP)
  • This medicine comes in a pill or liquid.
  • It prevents infections, especially urinary tract infections (UTIs) and a rare type of pneumonia (PCP).
  • DO NOT take this medicine this if you are allergic to sulfa.
  • Use sunscreen because this drug increases sensitivity to the sun.
  • Possible side effects include: nausea, vomiting, rash, feeling less hungry.
Valcyte®
  • This medicine is used to prevent or treat a virus called Cytomegalovirus (CMV).
  • You must drink a lot of liquids with this medicine.
  • Possible side effects include: fever, rash, headache, and lower white blood cell count.
  • The doctor will decide when you need this medicine and for how long.
Nystatin
  • This medicine comes in a liquid.
  • You need to swish it in your mouth and swallow four times each day after meals.
  • It is given to prevent a fungal infection in the mouth (thrush) and the entire digestive system.
  • DO NOT eat or drink anything for 30 minutes after taking this medicine.
Colace®
  • This medicine makes it easier to go to the bathroom (bowel movement).
  • Given right after surgery, it may help you pass a bowel movement without straining.
  • After your incision has healed, you will only use this medicine if you are constipated (cannot have a bowel movement).
Aspirin 81 mg
  • This medicine comes in a chewable tablet.
  • It is a mild blood thinner that helps prevent clotting of the new renal artery or vein.
  • Possible side effects include: upset stomach and dizziness.
  • Take this medicine ONLY if your doctor prescribes it. DO NOT TAKE ASPIRIN for any other reason.
Stomach Acid Blockers

Zantac®

  • This medicine helps prevent the stomach from making too much acid.
  • It is taken two times a day.
  • Possible side effects include: headache.
  • Other similar medicines are:
    • Pepcid®
    • Nexium®
    • Prilosec®
    • Prevacid®
High Blood Pressure Medicines
  • These medicines are used to control high blood pressure.
  • Possible side effects include: fatigue (tired), dizziness, headache
  • Names of these medicines include:
    • Norvasc®
    • Enalapril (Vasotec®)
    • Atenolol