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Transplant Recipient Information

Medicines after your transplant

You’ll notice that some of the medicines you are asked to take after your transplant are quite different than those before your surgery. It’s very important that you take all your medicines as prescribed – right dose, right time.

Some of the new medicines you’ll be taking are called immunosuppressants. These medicines work by making your immune system weaker, so your body doesn’t attack or fight against your new kidney and reject it.

immuno = your immune system
suppressant = weakens, controls, or prevents

You may also need to take medicines to help prevent infection.

These medicines may include:

Tacrolimus

Tacrolimus is an immunosuppressant that helps prevent rejection. Tacrolimus comes in 3 types:

tacrolimus regular release (Prograf)
tacrolimus extended release (Advagraf)
tacrolimus prolonged release (Envarsus PA)

Check with your transplant team if you have questions about which tacrolimus you are taking.

How to take tacrolimus

Tacrolimus comes in different strengths. Check with your transplant team to learn how much of this medicine you should take and carefully check the label of your medicine.

Take tacrolimus regular release (Prograf) every 12 hours (for example, at 8 a.m. and 8 p.m.) to keep the right amount of this medicine in your body.

Take extended-release tacrolimus (Advagraf) or tacrolimus prolonged release (Envarsus PA) once a day in the morning and at the same time every day.

Tacrolimus should be taken with food. However, it can be taken on an empty stomach if this works better for you. It’s important to take it the same way, with or without food, each day.

Stopping this medicine suddenly can cause serious health problems. Keep taking tacrolimus exactly as prescribed – right dose, right time.

Side effects

Some possible side effects of tacrolimus include:

higher blood pressure and cholesterol levels
change in magnesium and potassium levels
headaches
tremors (shaking movements that you can’t control)
nausea, stomach aches, or diarrhea
higher blood glucose (sugar) levels
risk of developing an infection and cancer
hair loss

Getting the right dose

Taking too much tacrolimus can harm your kidney transplant. If you don’t take enough, it may cause your body to reject your new kidney. Your healthcare team will check your blood often to make sure you have the right levels of tacrolimus and are getting the right dose.

If you’re having a blood test that day, it’s usually best to take tacrolimus right after you have your morning blood test.

Food and medicine to avoid

Some medicines and food can change the level of tacrolimus that is absorbed into your blood. This can lead to side effects or your body not getting enough or too much medicine to stop it from rejecting your new kidney. Grapefruit can raise the level of tacrolimus in your blood and harm your new kidney. Don’t eat grapefruit, drink grapefruit juice, or have anything with grapefruit flavouring while you’re taking tacrolimus. Your transplant team will talk to you about any foods or medicines you should avoid while on this medicine.

Don’t take any medicine without talking to the transplant team first.

Where to get my medicine

To get tacrolimus you’ll need to go to one of the hospital-based outpatient pharmacies because this medicine is funded through the government of Alberta. Your transplant team will let you know which pharmacy you can get your medicine from.

Mycophenolate

Mycophenolate is an immunosuppressant that helps prevent your body from rejecting your new kidney. Examples include:

Patients take only one of CellCept, Myfortic, or a generic brand. Check with your transplant team if you have questions about the mycophenolate you’re taking.

How to take mycophenolate

Take mycophenolate every 12 hours (for example, at 8 a.m. and 8 p.m.) to keep the right amount of this medicine in your body. You can take mycophenolate with or without food. Take it with food if you get an upset stomach or loose stool (diarrhea).

Side effects

Some possible side effects of mycophenolate include:

an upset stomach or diarrhea
low white and red blood cell counts
higher risk of infection or cancer

Keep taking mycophenolate. Don’t make any changes without talking to your transplant team first. Stopping this medicine suddenly can cause serious health problems. Keep taking mycophenolate exactly as prescribed – right dose, right time.

If you’re pregnant or planning to become pregnant don’t take mycophenolate. This medicine can harm your unborn baby. Please talk to your transplant team if you’re planning to get pregnant.

Your transplant team will talk to you about any foods or medicines you should avoid while on this medicine. Don’t take any medicine without talking to the transplant team first.

Where to get my medicine

To get mycophenolate you’ll need to go to one of the hospital-based outpatient pharmacies because this medicine is funded through the government of Alberta. Your transplant team will let you know which pharmacy you can get your medicine from.

Prednisone

Valganciclovir

Use caution with any other medicines

There are many medicines and foods that change the way other medicines work in your body. This is true for your immunosuppressant medicines as well. For example, antibiotics and anti-seizure medicines may not work the same or it may be a different dose if you’re on an immunosuppressant. This is why it’s always important to talk to your transplant team first to be sure changes to your medicines are done safely.

Don’t take any medicine without talking to the transplant team first. This includes over the counter, herbals, supplements, and prescription medicines prescribed by someone outside of your transplant team.

If you need, or are interested in starting, a new medicine, talk to your transplant team first to be sure it is done safely. Make sure any prescriber knows you have a kidney transplant.

Always talk to your healthcare team before you get a vaccine.

Current as of: September 26, 2022

Author: Kidney Health Section, Medicine Strategic Clinical Network, Alberta Health Services

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This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.