Immunosuppressive Medications

Immunosuppressive medications reduce the risk that your body will reject your new organ after transplant. White blood cells in your immune system – which fights infections in your body – identify your new organ as a foreign substance. Immunosuppressive drugs work by preventing the production of white blood cells or inactivating them.

Immunosuppressive Medications: What You Need to Know

At Fletcher Allen, we develop personalized immunosuppressive regimens for every transplant patient. We monitor your dosage and side effects carefully to make sure the drugs are working properly. Full recovery requires you to actively monitor your health:

  • You will need to take some combination of these drugs for the rest of your life
  • If you stop taking your medication, your body is likely to reject the new organ
  • You must take your medications on time every day
  • You may experience side effects that should be reported to your transplant coordinator, physician or nurse
  • Take only the medications prescribed by your doctor
  • Your medication dosage will be monitored at every clinic visit and may change

Types of Immunosuppressive Drugs

FK-506 (Prograf, tacrolimus): This powerful anti-rejection medication has significantly improved the success of transplants. It helps control your immune system’s response to your new organ. Side effects may include:

  • Headaches
  • Tremors
  • Skin rash
  • Nausea/diarrhea
  • Changes in mood
  • Increased blood sugars
  • Increased blood pressure
  • Thinning of hair
  • Difficulty sleeping

Sirolimus (Rapamune): This anti-rejection mediation is especially helpful in kidney transplant patients. Side effects may include:

  • Increase in cholesterol and/or triglycerides
  • Headaches
  • Decrease in platelet and white blood counts

Cellcept or Myfortic (mycophenolate): These drugs decrease your white blood count so the cells do not attack the transplanted organ. Side effects may include:

  • Increased chance of infection
  • Diarrhea and/or constipation
  • Rash
  • Yellowing of skin/eyes (jaundice)
  • Fever
  • Headache
  • Decreased white blood cell count

Prednisone: This steroid and anti-inflammatory drug reduces swelling in your transplanted kidney and helps to prevent rejection. Not all patients will leave the hospital on Prednisone. Side effects may include:

  • Rounding of the cheeks
  • Weight gain
  • Acne-like rash
  • Steroid induced diabetes/increased blood sugar
  • Increased appetite
  • Diarrhea and/or constipation
  • Changes in mood
  • Increased chance of infection
  • Increased chance of high cholesterol
  • Cataracts
  • Night sweats
  • Thinning of hair
  • Easy bruising
  • Increased blood pressure
  • Joint problems
  • Increased sun sensitivity

Other Post-Transplant Medications

These medications are important to aid the other body systems that may be affected by the immunosuppressant drugs and /or the transplant surgery.

  • Antacids (Prilosec, Pepcid, Protonix): These help prevent stomach ulcers associated with steroids. They are taken frequently in the early weeks after surgery and will then be reduced in the later weeks. Possible side effects of antacids include constipation and diarrhea.
  • Antibiotics: A transplant recipient is at high risk for infection because of the anti-rejection drugs that suppress the immune system. Antibiotics help to prevent infections. Side effects of antibiotics include gastrointestinal distress and super-infection. Bactrim is an antibiotic used to prevent a special type of pneumonia called Pneumocystis.
  • Antivirals: Valgancyclovir is used to prevent viruses in the herpes family. You will take this medication if you or the donor has had Cytomegalovirus (CMV), which is indicated by blood tests. CMV is a common virus that can make individuals taking immunosuppressant medications very ill.
  • Antifungals: Fluconazole is used to prevent fungal or yeast infection. Nystatin is used to prevent a fungal infection in your mouth (oral thrush). The immunosuppressant medications can cause fungus to grow rapidly.