Medication

Important Points
Your body may think that your new organ is different, and it may try to reject (attack) it. You will be taking special drugs, called anti-rejection drugs, to help prevent this. One of the reasons transplants are so much more successful today is because of the new drugs that have been and are still being developed. While the risk of rejecting your new organ decreases as time goes on, it never goes away.

• It is extremely important to take all of your medications every day and on time;
• You may be taking these drugs for the rest of your life;
• You may be taking many different drugs every day;
• You may still be taking drugs that you took before your transplant;
• You may also be taking drugs to help with some of the side effects and prevent complications from all these different drugs;
• Never change your doses on your own.

It is important to learn how to manage these medications and their side effects as part of your daily life. If you feel overwhelmed, talk with your transplant team and support groups to learn about what has helped other patients make this post-transplant change.

Helpful Tips About Your Medications:

• Learn everything you can about your medicines. Your physician, transplant coordinator, pharmacist, support groups and educational seminars can help
• Capsules should be swallowed whole and never crushed, chewed or opened
• Some medications should never be taken with grapefruit juice – ask your pharmacist
• Many medications can be kept in their original containers or foil wrap until you are ready to take them. Check the directions
• Always check with you transplant team before taking any new medicines, even the ones you buy over-the-counter
• Keep all medications out of the reach of children
• In case you are ever in an accident and are unconscious, wear or carry some form of identification with a listing of medications at all times, for example, a bracelet or necklace that states that you are a transplant patient and take steroids
• If any medicine has a different odor or color, or if it is soft, sticky, hard or cracked, it is probably spoiled (bad) and should be replaced. Talk to your pharmacist
• When taking a new drug, ask your pharmacist to just fill a few day?s worth at first so that if you cannot take the medication, you will not waste money on drugs that cannot be returned.
• Let your insurance company and transplant team know if you are having trouble paying for your medicines
• Carry a list of all the medicines you are taking with you in your wallet or purse
• Try to buy all your medicines from the same pharmacy. Many of them keep a profile on you so they can tell you if a new drug will cause problems if taken with your other medications
• Keep a list of all your medications and doses in your wallet or purse. Share this list with your other doctors

Unwanted hair growth can be removed with shaving, waxing and hair removal (depilatory) products.

It is not possible to take all of your medications at one time, they are spread throughout the day. Taking your medications may frequently interrupt your daily routines of living. The more you can organize ahead of time, the less you will be interrupted on a daily basis.

Tips About Organizing Your Medications:

• Use tools to help organize your medicines. For example a pill box, small snack baggies labeled with days of the week and times of the day, an alarm clock or watch, and charts may work for you
• Ask your transplant team to help you set up your medicine times to fit your schedule
• Set up a time each week to sort out your medicines for the whole next week and put them into containers
• Get into a routine, take your meds at the same time each day
• Keep track of how much medicine you have left. Don?t ever run out, even for one dose
• Mark your calendar so you remember to order your meds ahead of time
• Having family and friends help you at first will make this job easier. It may help to have a family member or friend help you sort out and reorder your pills at first
• Keep your meds in a cool, dry place. Keep them out of the sun and extreme heat (like in a car trunk when you are traveling).

Tips on Traveling:

• Always take some extra doses of your meds when you travel in case you get delayed or miss a plane or train, etc
• Never pack your meds in your luggage, always carry them with you
• Mail order pharmacies can ship your medicines to you when you are away from home
• Keeping a letter from your doctor about your medications may help if you have any problems with customs when traveling overseas
• Limit your sun exposure and use a sunscreen.

Questions to Ask:

Be sure to ask questions. The more information you have, the more comfortable you and your family may feel about your new medications.

• Which side effects can my drugs cause?
• Which side effects should I call about? Who should I call?
• Which drugs should I take with food?
• Which drugs should I take on an empty stomach? How soon can I eat after taking them?
• What time should I take each of my medications? (some drugs should be taken 12 hours apart)
• Does it matter what time of day I take my once-a-day medications?

Questions For Your Transplant Team or Pharmacist:

• What do each of my medicines do?
• What are the side effects of each of my medicines?
• Which side effects should I call you about?
• What should I do if I miss a dose of medicine?
• Who should I call when I need a new prescription?
• Are generics OK to use?
• Should I take antibiotics before and after dental visits? For any other procedures?
• Which over-the-counter medicines should I avoid (such as ibuprofen, Motrin)?
• What vaccines should I get every year (flu, hepatitis, tetanus, etc.)?
• Can I take aspirin, calcium, vitamins, mineral supplements?
• Should I avoid children who have had a vaccine? Which vaccines? For how long?
• Which of my medications should I take on an empty stomach and which should I take with food?
• Is it OK for me to have an alcoholic beverage? What kind? How much? How often?

Questions for Your Pharmacy

• Is someone available 24 hours a day if I have questions or concerns or need to reorder my drugs?
• Will you waive my co-pay?
• Do you charge for delivery?
• How fast can you get my medications to me?
• Ask your pharmacy if they have any educational materials they can send you.
• Do you always keep my medications in stock?

Side Effects

Sometimes medications cause effects that are not wanted. These are called side effects. You may experience some side effects from your anti-rejection drugs, or you might not have any problems. The following are some of the more common side effects associated with the anti-rejection drugs. We are including this list so that you will be aware that these problems may be caused by your medications. Talk to your transplant team – they can help you manage any side effects.

These side effects can include:

• Anxiety
• Mood swings
• Trouble sleeping
• Tremors (shaking)
• Nausea/diarrhea
• Headache
• Unwanted hair growth
• Vomiting
• Hair loss
• Increased appetite
• Increased blood sugar
• Weight gain
• High BP
• Gum overgrowth
• Tingling hands and feet
• Swelling of feet, hands, abdomen or face