Kidney Transplant Medications

While you are in the hospital recovering from your surgery, our pharmacists, coordinators and nurses will teach your family members about all your medications. We will review with you the purpose, dosage and possible side effects of each medicine. All transplant patients take immunosuppressants to help prevent rejection of their new organ.

Many patients will require additional medication for their blood pressure and to replace magnesium and phosphorus. Most patients also receive a stomach acid reducer, a cholesterol-lowering agent, and antibiotics. Other medications will be prescribed based on patients’ individual needs.

Disclaimer: Reasonable effort has been made to ensure that the information provided is accurate, up-to-date, and complete. If you have questions about the drugs you are taking, check with your doctor or pharmacist.

Common Immunosuppressant Agents

MEDICATIONACTIONADDITIONAL INFORMATIONPOTENTIAL ADVERSE EFFECTS
(*denotes most commonly seen; often dose dependent)

Tacrolimus (Prograf)

Inhibits cytokine production (including IL2)

Primarily inhibits T-cells (lymphocytes)

Dosed according to 12 hour blood levels. Target level 8-12 ng/ml depending on interval post-transplant.

*renal dysfunction, * increased blood pressure, headache, tremors, *decreased magnesium, *elevated cholesterol, glucose intolerance

Cyclosporine (Neoral, Gengraf or generic equivalent)
not interchangable

Inhibits cytokine production (including IL2)

Primarily inhibits T-cells (lymphocytes)

Dosed according to 12 hour blood levels. Target trough level 150-200 ng/ml depending on interval post-transplant.

*renal dysfunction, * increased blood pressure, headache, tremors, hair growth, *decreased magnesium, gallstone formation, *elevated cholesterol, enlarged gums

Belatacept (Nulojix)


Binds to antigen-presenting cells to prevent binding and acitivation of T-cells (lymphocytes)

IV medication given monthly in clinic as part of maintenance immunosuppression. Dose based on weight.

*Urinary tract infections

Mycophenolate Mofetil (Cellcept)

Inhibits purine synthesis to block immune cell division

Dosed at 2 grams daily in two divided doses.

*low white blood cell count, nausea, *diarrhea

Azathioprine (Imuran)

Inhibits purine synthesis to block immune cell division

Used in place of Cellcept to prevent rejection.

Taken once daily. Dose based on weight.

*Low white blood cell count

Prednisone and Methylprednisolone

Anti-inflammatory and immunosuppressive properties

Inhibitory effects on the production of prostaglandins, leukotrienes, and cytokines

5 mg taken once daily as part of maintenance immunosuppression regimen.

Given in high IV doses at the time of transplant or to treat rejection episodes.

*osteoporosis, *elevated blood sugars, fluid retention, upset stomach, increased blood pressure, cushingoid effect, increased appetite, glaucoma, *cataracts

Basiliximab (Simulect)

Inhibits binding of the cytokine IL-2 to block T-cell (lymphocyte) production

Given intravenously during transplant surgery.  A second and final dose is given 3 days after transplant.

*Flu-like symptoms (fever, chills, headaches), diarrhea, shortness of breath, rash

Anti-lymphocyte globulin (Thymoglobulin)

Binds and destroys T-cells (lymphocytes)

Intravenous medication used to treat rejection. Given daily for 5-14 days.

*Flu-like symptoms (fever, chills, headaches), diarrhea, shortness of breath, and rash



Other Common Post-Transplant Medications
(treating the side effects of immunosuppressants)

MEDICATIONACTIONDOSING RECOMMENDATIONS

Valacylovir (Valtrex)

Antiviral medication used to prevent and treat herpes virus.

Usually given once daily for 3 months after transplant in those not at risk for cytomegalovirus.

Valganciclovir (Valcyte®

Antiviral agent used to prevent and treat cytomegalovirus

Usually given once daily for 3-6 months after transplant.

Sulfamethoxazole/Trimethoprim (Bactrim

Antibacterial medication used to prevent a type of pneumonia seen in a patients with decreased immune systems called Pneumocystis Jiroveci Pneumonia.

Usually taken once daily for 6 months after transplant. Dapsone or atovaquone substituted for those with sulfa allergies.

Proton pump inhibitors – Pantoprazole (Protonix), Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid)

To protect the stomach from effects of prednisone.

Usually taken once daily.

H2 blocker – Famotidine (Pepcid), ranitidine (Zantac)

To protect the stomach from effects of prednisone.

Usually taken once daily.

Potassium phosphorus/Sodium phosphorus (K-phos neutral)

Serves as a phosphorous supplement.

Usually two tablets are taken three times a day.