Transplant Medications – What do I take?

OK, so all of us who are post transplant are very similar, but we're all completely different, so there's quite a few standard medications that we're on, but depending upon other conditions, interactions, body chemistry, etc they can be quite diverse. Overall the immune suppression medications are the same, but there might be some differences.

I went into my lung transplant as an otherwise pretty healthy 43 year old male. I was in good shape thankfully due to the rapid deterioration of my lungs, so I didn't lose much muscle mass or live much of a sedentary life beforehand. I wasn't on any regular medications other than an anti-anxiety medication that I started taking a couple months earlier.

These are the medications that are absolutely essential for life. To be blunt, if you don't take these as prescribed, the risk of rejection or death goes up quite a bit. Missing a single dose can cause your immune suppression to plummet, opening the door for your body to start producing antibodies to begin the rejection process. If you miss a single dose, call your transplant center for guidance as taking the next dose too soon could cause a problematic spike in your levels.

Medication -Tacrolimus

Dosage - Currently 4mg AM, 4mg PM

What it does - Makes white blood cells less likely to attack donor organ

Notes - Medication blood absorbtion levels are tested regularly with small adjustments to dosage. Too low level increases change of rejection, too high causes organ damage.

 

Medication - Mycophenolic Acid

Dosage - 720mg twice each day

What it does - Reduces immune system through a variety of ways, also reduces inflammation.

Notes - This is an alternate to Mycophenolate, my transplant pharmacist suggested this as it can reduce digestive issues.

 

Medication - Prednisone

Dosage - 10mg daily

What it does - Reduces inflammation and slows immune system

Notes - Prednisone has a number of side effects, face swelling AKA "moon face", acne, mood swings, and weight gain are all common. Prednisone also pulls calcium from bones making them brittle over time.

Medication - Bactrim / Sulfamethoxazole-trimethoprim 400-80mg

Dosage - 1 pill daily

What it does - General antibiotic (prophylaxis ) to help prevent infections due to immune suppression

Notes - Nothing I can think of

Medication - Apixaban (Eliquis)

Dosage - 2.5mg AM and 2.5mg PM

What it does - This is an anti-coagulant (blood thinner)

Notes - I have taken this medication for a year now due to having a pulmonary embolism (blood clot in my lung). I need to be extra concerned about cuts/bruising.

Medication - Pantoprazole (Protonix)

Dosage - 40mg AM

What it does - Reduces stomach acid production

Notes - Reflux and "silent aspiration" is one of the leading causes of rejection due to damage and infection of the lungs, so this is taken to reduce those chances.

Medication - Carvedilol (Coreg)

Dosage - 6.25mg AM and 6.25mg PM

What it does - Beta blocker and Alpha1 blocker - Reduces heart rate, blood pressure, etc

Notes - I was prescribed this due to multiple episodes of SVT (Super Ventricular Tachycardia) that happened shortly after transplant.

Medication - Trazodone

Dosage - 50mg before bed

What it does - Sleep aid

Notes - Since transplant I have had frequent insomnia. I don't take this one every day as it causes grogginess, but I'll take it when I really feel like I need a full night's sleep

Medication - Rizatriptan (Maxalt-MLT)

Dosage - 10mg as needed

What it does - For migraines, multiple effects

Notes - I have had chronic debilitating migraines from damaged vocal cords. Rizatriptan helps to get over the migraine sooner. My complaint is that I still feel the need for immediate bed rest for at least a few hours after taking it as the only way I can describe how it feels is that it "resets" your brain.

Medication - Amitriptyline 10mg

Dosage - One tablet every morning

What it does - For migraines, neuro transmitter regulation

Notes - This is a new medication we're trying for migraine prevention. I was taking topirimate (Topamax) but was having many side effects like memory problems, brain fog, etc. which made it difficult to work.

Medication - Dulera (mometasone-formoterol) inhaler

Dosage - 1 puff AM, 1 puff PM

What it does - Relaxes muscles around airways

Notes - This is a new one for me as I recently developed some chest tightness and congestion that my doctors are still trying to diagnose.

Medication - Azithromycin 250mg

Dosage - 250mg pill AM

What it does - Antibiotic that also reduces inflammation and suppresses immune system

Notes - This was prescribed along with the Dulera inhaler for the chest tightness and congestion.

Medication - Doxycycline hyclate 100g

Dosage - 1 pill AM, 1 pill PM

What it does - Antibiotic

Notes - I've had a rash on my body and the dermatologist is hoping that a long course of this antibiotic will help clear it up.

Medication - Benzoyl peroxide 10% external wash

Dosage - Wash body with and let sit for 3-5 min every 3 days

What it does - Kills acne causing bacteria and unclogs pores

Notes - Prescribed to try and eliminate body rash

Medication - Botox

Dosage - Administered by injections in clinic. Varies

What it does - disrupts nerve function to muscles

Notes - I receive injections in the scalp, neck, and shoulders every few months for muscle tension related migraines from the damaged vocal cord nerve.

Medication - Albuterol

Dosage - 1-2 puffs as needed

What it does - relaxes muscles in airway

Notes - I don't know if this medication has any benefit anymore post transplant, but I keep it on hand if I have congestion or tightness.

Medication - Metroclopramide (Reglan) 5mg

Dosage - 1 tablet as needed

What it does - Reduces nausea

Notes - Good to have in case of nausea to reduce the chance of aspiration (inhalation) of vomit. I frequently take this when migraines are so severe that it causes nasuea.

Name - Calcium carbonate-vitamin D 600-10 MG-MCG ea

Dosage - 1 tablet AM, 1 tablet PM

What it does - Calcium supplement

Notes - Helps body maintain calcium levels due to lifetime prednisone use

Name - Magnesium-Biglycinate 100mg ea

Dosage - 2 tablets AM, 3 tablets PM

What it does - Magnesium supplement

Notes - Magnesium deficiency is common post-transplant and can cause many issues. Note: magnesium should be taken 2 hours apart from tacrolimus and mycophenolate.

Name - Vitamin B12

Dosage - 1 tablet AM

What it does - Viamin B12 supplement

Notes - I was diagnosed with a B12 deficiency

Name - Vitamin D

Dosage - 1 tablet AM

What it does - Viamin D supplement is important post transplant, namely skin cancer risk reduction

Notes - Medications reduce the levels of vitamin-D in the body, transplant patients are at a higher skin cancer risk and typically avoid the sun, lowering vitamin-D production.  Taking vitamin D as a transplant recipient has multiple benefits.

Name - Melatonin

Dosage - 5mg 1 hour before bed

What it does - Melatonin is a naturally produced chemical that signals your brain that it's time to sleep

Notes - Used to help treat insomnia

Name - Cetirizine Hydrochloride Tablets, 10 mg

Dosage - 1 tablet AM

What it does - OTC generic allergy medication

Notes - I have mild seasonal allergies, but the main reason I take this medication is to help know if I'm at the early stages of an illness that could otherwise be mistaken for allergies

As you can see, we take a lot of medications! Some people take more, some people take less--each of us is different!

If you're looking for a good case to sort and store your medications, this is the cases I have been using for the last year. The compartments are easy to open and each day is removable so that you can easily remove a day or two to take with you instead of the entire week. There's 4 compartments per day and I liked it so much I eventually purchased two.

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