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Lung Transplant Medications

After your lung transplant, you will have to take certain medicines for the rest of your life. These medicines are very important and must be taken exactly as prescribed and on time for the transplanted organ to work properly.

While you are in the hospital recovering from your lung transplant, our pharmacists and nurse coordinators will teach you and at least one family member about all your medications. We will review with you the purpose, dosage and possible side effects of each medicine.

To help you feel more comfortable taking these medications, we will ask you to begin administering and keeping your own medication records in the hospital a few days before your discharge.

All transplant patients take Prograf, Imuran and prednisone to help prevent rejection of their new organs. You may also be placed on medications other than these after transplant.

Download a pdf (936 KB) of this list for use at home.

MEDICATION	ACTION	ADDITIONAL INFORMATION	POTENTIAL ADVERSE EFFECTS (*denotes most commonly seen; often dose dependent)
Prograf (Tacrolimus) 0.5/1.0/5.0mg capsules Dose changes based on drug level Every 12 hours 0.5 mg 1 mg 5 mg	Immunosuppressant agent Prograf® (formerly known as FK 506) is a potent anti-rejection. It is used for patients having difficulty tolerating cyclosporine. Cyclosporine and Prograf® are never taken at the same time.	Do not drink grapefruit juice or eat grapefruit while taking this medication. Take after morning blood test on days of clinic or office visits.	• Increased risk of infection • Damage to kidneys • Increased potassium • Increased blood pressure • Increased blood sugar • Nausea, vomiting, and poor appetite • Trembling hands and voice • Headache • Difficulty sleeping • Constipation
Azathioprine (generic) 50 mg tablets Imuran®	Immunosuppressant agent Imuran® is an anti-rejection drug that reduces the number of white blood cells that attempt to reject an organ. Imuran® comes in 50 mg tablets.	May take with food to reduce nausea or stomach upset Will monitor WBC (white blood cell count)	• Increased risk of infection • May lower your white blood cell or platelet count • Mouth ulcers • Irritation of the liver • Anemia • Nightmares • Nausea, vomiting, diarrhea, upset stomach
Prednisone 20 mg 20mg	Immunosuppressant agent Prednisone is a steroid drug that helps prevent and treat rejection. The dose of this drug will be slowly decreased over time. Most of the side effects of prednisone are dose-related. As the dose is lowered, the side effects decrease. Prednisone comes in 1 mg, 5 mg, 10 mg, 20 mg and 50 mg tablets.	• Take with food • Monitor your weight and report gains of 2-3 lbs. in 24 hours or more than 4-5 lbs. in 2-3 days • Have an annual eye exam • Wait four to six months before changing your eyeglass prescription, because prednisone can change your vision	• Stomach irritation • Increased appetite, weight gain • Fat deposits • Water retention and round, puffy face • Cataracts • Weakening of the bones (osteoporosis) • Acne • Fragile skin with bruising and skin tears • Muscle weakness • Night sweats and trouble sleeping • Blurred vision • Increase in blood sugar (diabetes) • Mood swings • Increased blood pressure (hypertension) • Sun sensitivity
SMZ/TMP DSM/p> Bactrim DS® 160mg	Infection prophylaxis (antibiotic) Prescribed to prevent a life-threatening pneumonia called Pneumocystis carinii (PCP)	One tablet daily on Monday, Wednesday and Friday	• Nausea and vomiting • Rash • Lowered white blood cell count
VFEND® 200 mg tablets 200mg	Infection prophylaxis (antifungal) Voriconazole (VFEND®) is a second-line antifungal to treat Aspergillus. The usual dose of voriconazole comes in 200 mg or 50 mg tablets; the oral form is just as effective as the IV form of the drug.	• Take at least one hour before or after a meal. • Take with a full glass of water. • Take all of the voriconazole that your doctor prescribes, even if you start to feel better.	• Blurred vision, increased sensitivity to light, or other visual changes • Nausea or vomiting • Diarrhea • Swelling or water retention
Valcyte® 450 mg tablets Valgancyclovir 450mg	Infection prophylaxis (antifungal) Antiviral to prevent CMV Treatment for 6-12 months.	• Two tablets (900 mg) every 12 hours for 2 weeks then 2 tablets once a day • Take with food. Do not crush or chew.	• Nausea or vomiting
Noxafil® 400mg/ 10cc bid Posaconazole	Infection prophylaxis (antifungal) Prevents infections caused by Aspergillus.	Will use for 1 year. Effects prograf level. Do not stop med. If you run out, please notify your coordinator. Take w/ an acidic drink (coke or ginger ale)	• Nausea or vomiting
Mag Ox 400 mg tablets Magnesium	Mineral-based replacement drug Magnesium is prescribed to replace this normal body salt that is wasted in your kidneys when you take certain immunosuppressive medications.	Must use this brand only. Take with a full glass of water.	n/a
Calcium Carbonate 1250 mg tablets (or equivalent) Oscal 500®	Mineral-based replacement drug Calcium replacement for prevention of bone loss	Twice a day	n/a
Folic Acid 1mg	Mineral-based replacement drug Promotes blood cell production	One tablet a day	n/a
Multivitamin	Mineral-based replacement drug Calcium replacement for prevention of bone loss Dietary Supplement. Any brand is okay.	One tablet every day (any brand)	n/a
Metoprolol 75 mg tablet Lopressor	Anti-hypertensive Anti-hypertensives are drugs that help control blood pressure	One tablet twice daily	• Low blood pressure • Dizziness • Weakness • Fatigue • Possible sexual dysfunction • Fluid retention
Protonix 40 mg tablet	Helps protect stomach from ulcer formation	Take 1 tab once a day	n/a
Inhaled Amphotericin B 10 mg/2 cc via nebulizer every 12 hours	Anti-fungal Respiratory treatment	10 mg/2 cc via nebulizer every 12 hours. Will discontinue after 8 week bronch	n/a
Insulin	Blood sugar control		n/a
Fosamax	Prevention of osteoporosis	Do not lie down or recline for 30 min after taking pill	n/a

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