You will need to take medicines called immunosuppressants after you have a kidney transplant. These medicines work by weakening your immune system so your body doesn’t attack your new kidney and reject it.
You may also need to take an antiviral medicine or an antibiotic to help prevent infection.
Tacrolimus
Tacrolimus (Prograf) is an immunosuppressant that helps prevent rejection. Tacrolimus comes in two types: regular release (like Prograf) and extended release (like Advagraf). Patients take either Prograf, which is taken twice a day or Advagraf, which is taken once a day. Check with your transplant team to make sure you are taking the right type of tacrolimus.
You will need to get tacrolimus from one of the hospital-based outpatient pharmacies identified by your transplant team to have it paid for you through Alberta Health.
How to take tacrolimus
Tacrolimus comes in different strengths. Carefully check the label of your medicine and check with your transplant team to know how much of this medicine that you should take.
Take
tacrolimus (Prograf) every 12 hours (for example, at 8 a.m. and 8 p.m.) to keep the right amount of this medicine in your body.Tacrolimus should be taken with food but it can be taken on an empty stomach if preferred.
Take tacrolimus (Advagraf) once a day in the morning and at the same time every day.
Side effects
Possible side effects of tacrolimus include:
- higher blood pressure and cholesterol levels
- change in magnesium and potassium levels
- headaches
- tremors (a body movement that you can’t control where your muscles constantly relax and tighten)
- nausea, stomach aches, or diarrhea
- higher blood sugar levels
- risk of developing an infection and cancer
- hair loss
Getting the right dose
Taking too much tacrolimus can harm your transplanted kidney. If you don’t take enough, it may cause your body to reject your new kidney. Your healthcare team will check your blood often to make sure you have the right levels of tacrolimus and are getting the right dose. Your healthcare team may need to make changes to your dose until they find how much your body needs.
Don’t take tacrolimus right before you have a blood test.
Medicines and food to avoid
Some medicines and food can change the level of tacrolimus in the blood. This can lead to side effects or your body rejecting your new kidney. For example, grapefruit can raise the level of tacrolimus in your blood and harm your new kidney. Don’t eat grapefruit or drink grapefruit juice.
Don’t take any medicine without talking to the transplant team first. This includes over-the-counter medicines, prescription medicines (prescribed by someone outside of your transplant team), and herbal medicines. Always talk to your healthcare team before you get a vaccine.
More information about tacrolimus
Find out more general information about
tacrolimus (Prograf) and
tacrolimus (Advagraf).
Mycophenolate
Mycophenolate mofetil (CellCept) is an immunosuppressant that helps prevent your body from rejecting your new kidney. Some people may take a different type of mycophenolate . Patients take either CellCept or Myfortic. Both medicines are taken twice a day but they come in different strengths. Check with your transplant team to make sure you are taking the right type of mycophenolate.
You will need to get mycophenolate from one of the hospital-based outpatient pharmacies identified by your transplant team to have it paid for you through Alberta Health.
How to take mycophenolate
Take mycophenolate every 12 hours (for example, at 8 a.m. and 8 p.m.) to keep the right amount of this medicine in your body. You can take mycophenolate with or without food. Take it with food if you get an upset stomach or loose stool (diarrhea).
Side effects
Possible side effects of mycophenolate include:
- an upset stomach or diarrhea
- low blood cell counts
- risk of infection and cancer
Don’t take mycophenalate if you are pregnant. This medicine can harm your unborn baby. Please talk to your transplant team if you are planning to get pregnant.
More information about mycophenolate
Find out more general information about
mycophenolate mofetil and
mycophenolate sodium.
Prednisone
Prednisone is an immunosuppressant that helps prevent your body from rejecting your new kidney. It belongs to a class of drugs called corticosteroids.
How to take prednisone
Take prednisone in the morning unless your doctor gives you other instructions. To help prevent an upset stomach, take it with food or milk.
You may need to take several tablets to get the right dose of this medicine. The transplant team will likely prescribe you a high dose of prednisone at first and lower your dose over time.
Don’t stop taking prednisone suddenly.
Side effects
Possible side effects of prednisone include:
- upset stomach
- extra water in your body (called water retention)
- feeling hungry more often (increased appetite)
- weight gain
- higher blood sugar levels
- mood changes
- change in sleep patterns
- bone loss (osteoporosis)
- higher risk of infection
- extra hair growth on head and body
- acne
- cataracts
- a menstrual cycle that isn’t regular
- delayed wound healing and bruising
- swelling of the face
- increased blood pressure
More information about prednisone
Find out more general information about
prednisone.
Medicines to avoid when you’re taking immunosuppressants
You should avoid some medicines as some medicine can interact with your immunosuppressants. For example:
- aluminum or magnesium-based antacids (such as Maalox)
- some antibiotics (for example, Erythromycin)
- some medicines to prevent seizures (called anti-seizure medicines)
- cholestyramine (Questran)
- herbal medicines and remedies ( St. John’s wort, Echinacea, for example)
Don’t take any medicine without talking to the transplant team first. This includes over-the-counter medicines and prescription medicines prescribed by someone outside of your transplant team. Of particular concerns are
antibiotics and
anti-seizure medicines. If you require anti-seizure medications, talk to your transplant team.
Valganciclovir
Valganciclovir is a type of medicine called an antiviral that helps prevent an infection with some viruses. Valganciclovir is often given to people who have had a kidney transplant to prevent or treat a viral infection called cytomegalovirus (CMV).
How to take valganciclovir
Take valganciclovir with food so your body absorbs it better. Take it at the same time of the day every day. You can take valganciclovir at the same time as your other medicines.
Side effects
Some possible side effects of valganciclovir include:
- an upset stomach or diarrhea
- low blood cell counts
If you have low blood cell counts, you have a higher risk of developing an infection and bleeding. The healthcare team will send you for regular blood tests to check your blood cell counts.
More information about valganciclovir
Find out more general information about
valganciclovir.
