​​​​​​​​​​​​​​​​​​​​​​​​​​​​​What kind of medicine will I need to take after my liver transplant?

Anti-rejection medicines (also called immunosuppression medicines) prevent your immune system from attacking the transplanted liver. Anti-rejection medicines include:

• tacrolimus (common brand names: Prograf, Advagraf, or Envarsus)
• mycophenolate mofetil (common brand name: Cellcept)
• sirolimus (common brand name: Rapamune)
• prednisone (common brand name: Deltasone)
• cyclosporine (common brand name: Neoral)

You will need to take anti-rejection medicines every day (every 12 hours) for the rest of your life. 

Not taking these medicines as instructed, or missing doses, can lead to rejection, which can cause your liver to not work properly.

Take these medicines at the same time of day that you took them in hospital. Never stop taking these medicines or change your dose without first talking to your transplant team.

Always have at least a 2-week supply of medicines and never let yourself run out.

When you take anti-rejection medicines:

• You will need to get bloodwork done often to monitor your medicine levels. 
• Your blood tests must be done in the morning, before you take your anti-rejection medicines.
  
• Talk with your transplant team before taking any over-the-counter vitamins, medicines, herbal products, supplements, or medicines prescribed by anyone other than your transplant team. Many other medicines can interact with anti-rejection medicines.
• Do not take non-steroidal anti-inflammatory medicines (NSAIDs) like ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), diclofenac (Voltaren), and indomethacin (Indocid). These medicines can affect your kidney function. You can use acetaminophen (Tylenol) but should not take more than 3,000 mg in 24 hours from all sources.
  
• Some foods will interact with your anti-rejection medicines. Talk to the transplant team to learn more about which foods to avoid.
  
• Tell your pharmacist, dentist, and all other healthcare providers that you are taking anti-rejection medicines.
  
• Talk to your transplant team about when to take your anti-rejection medicines if you are travelling to different time zones.
  
• Do not get pregnant or get someone pregnant while on anti-rejection medicines without first talking to a member of the transplant team. Ask the transplant team about using birth control, as some forms of birth control work better with anti-rejection medicines than others.
• Anti-rejection medicines can increase your risk of some types of cancer. For more information, talk to the transplant team.

There are other medicines you might also need to take:

• medicines to protect your stomach from ulcers
  
• antacids (but do not take antacids within 2 hours of taking any anti-rejection medicines)
• antibiotics, antivirals, or both to help protect you against infection
• water pill (also known as a diuretic) to help your body remove extra fluid
• medicines to keep up with essential nutrients like calcium, magnesium, or iron
• medicines to prevent pneumocystis pneumonia, including sulfamethoxazole-trimethoprim, atovaquone, or pentamidine (common brand names of these medicines are  Sulfatrim, Septra, Bactrim, Co-Trimoxazole, and Mepron)
• medicines to prevent or treat cytomegalovirus (CMV), including valganciclovir (common brand name: Valcyte)
• medicines to prevent or treat herpes virus infections, including valacyclovir (common brand name: Valtrex)
• medicines to prevent or treat fungal infections
• medicines to control glucose levels (anti-rejection medicines may worsen existing diabetes or cause newly diagnosed diabetes) 
• medicines to prevent osteoporosis (bone weakening)

• the name and reason for each medicine
  
• when to take each medicine
  
• how to take each medicine
  
• how to store each medicine
  
• side effects of each medicine
• what to do if you forget to take a dose
• when and how to order more medicine so you don't run out

​​​​​​​​​​​​Is the cost of transplant medicines covered by Alberta Health?