Kidney-Pancreas Transplant Medications

While you are in the hospital recovering from your surgery, our pharmacists, coordinators and nurses 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. 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: The product images are intended as a guide only. Reasonable effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made that up-to-date images will be available for every drug.

The appearance of any medication is subject to change. If you have questions about the drugs you are taking, check with your doctor or pharmacist.

Common Immunosuppressant Agents

(*denotes most commonly seen; often dose dependent)

Tacrolimus (Prograf)

image0.5 mg
image1 mg
image5 mg

*Inhibits cytokine production (including IL2)

*Blocks cell division

*Target level 8-14ng/ml depending on interval post transplant

*renal dysfunction, *HTN, headache, tremors,
*decreased magnesium, gallstone formation,
*elevated cholesterol, glucose intolerance

Cyclosporine-Sandimmune and Neoral, Gengraf (or generic equivalent)
not interchangable

image 25mg

image 25mg

*Primarily T-lymphocyte selective

*Inhibits responsiveness of killer T-cells to Interleukin II

* Replaces Prograf when efficacy, absorption or tolerance is a problem.

* Metabolized by the liver

*Dosed according to 12 hour trough blood levels and renal function; target level 300-400 ng/ml depending on interval post transplant

*renal dysfunction, *HTN, headache, tremors, hirsutism, *decreased magnesium, gallstone formation, *elevated cholesterol, gingival hyperplasia

Mycophenolate Mofetil (Cellcept)


*Inhibits purine synthesis

*Effective on both T & B lymphocytes

* Used as triple immunosuppressive therapy or as and adjunctive immunosuppressant in rejection episodes.

* Dosed at 2 grams daily in two divided doses.

* leukopenia, nausea and abdominal distress

Imuran (Azathioprine)


* Suppresses cell-mediated immunity and causes alterations in antibody production.

* Taken once a day 75 mg to 150 mg per day.

* Used in place of cellcept to prevent rejection.

* Low white blood cell count

* Nausea/vomiting

(Rapamune, Rapamycin)


*Macrocyclic lactone, inhibits IL II signal transduction

*Effective on both T & B lymphocytes

*Dosing based upon trough level

*Target level 8-12 ng/ml

thrombocytopenia, leukopenia, anemia, *hyperlipidemia



*Anti-inflammatory and immunosuppressive properties

*Inhibitory effects on the production of prostaglandins, leukotrienes, and cytokines such as interleukin-1.

IV steroid that is given in high doses over 30 minutes for three days in mild rejection episodes

osteoporosis, hyperglycemia, *fluid retention, GI distress, *increased BP, cushingoid effect, *increased appetite


It is an antibody that is targeted against the cells that are causing the rejection

Given IV over 60 seconds for 7 to 14 days

*Side-effects similar to the flu

*High fevers, chills, headaches, diarrhea and shortness of breath.

ATGAM® and Thymoglobulin®

Potent immunosuppressant that is an antibody that is targeted against t-cells that cause rejections.

Given over 4 – 6 hours for seven to 14 days

*Side-effects similar to the flu

*High fevers, chills, headaches, diarrhea and shortness of breath.

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



Herpes Prophylaxis

Take twice a day for 6 months post-transplant.

Valcyte® (Valganciclovir)


Antiviral agent used to revent and treat cytomegalovirus

Given for 3 months to decrease the likelihood of CMV illness, given in 450 mg tablets

Bactrim DS

Bactrim SS
80 mg

Prophylaxis for pneumocystis pneumonia in patients on higher doses of immunosuppression early post-transplant

Prescribed 1 tab QMWF for 1 year post transplant; continued at 3X/wk dosing for all patients on methotrexate and rapamycin (dapsone substituted if patient allergic to sulfa)


Antibacterial prophylaxis given for biliary complications.

Prescribed 500mg pill twice a day, avoid giving with products that contain calcium.


Antifungal prophylaxis – given daily for candidates with high-risk of having biliary complications.

Prescribed 200 mg tablet daily for two to three months.

Calcium Channel Blocker – Norvasc/Procardia

New onset hypertension

Doses should be maximized before starting second line therapy.

Clonidine Tablets

Second-line therapy for hypertension

Beta Blockers – labetalol or propranolol

Third-line therapy for hypertension


Treatment of drug induced hyperlipidemia. Prescribed as a result of data showing reduction in 12-month rejection in transplant recipients. *Preferred statin choice due to reduced incidence of myositis and rhabdomyolysis when used in conjunction with cyclosporine or Prograf.

Prescribed initially at 20 mg QHS.

H2 blocker – Pepcid, Zantac, and Axid

GI protection from effects of steroids

Twice a day dosing

K Phos Neutral®

Phosphorous supplement

Two tablets thee times a day