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.

MEDICATIONACTIONADDITIONAL INFORMATIONPOTENTIAL 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
image0.5 mg
image1 mg
image5 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®
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

image20mg

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®

image
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

vfend
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
noxafil

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

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®
calcium

Mineral-based replacement drug

Calcium replacement for prevention of bone loss

Twice a day

n/a

Folic Acid 1mg
Folic Acid

Mineral-based replacement drug

Promotes blood cell production

One tablet a day

n/a

Multivitamin
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
Protonix

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