Medication Process Of Kidney Transplant Patients

Infection and rejection are the two big nightmares after organ transplant surgeries. Kidney transplant medications ensure that your transplant surgery is successful and that you stay healthy for a long time. To maintain your health after a transplant, you need to take all the medications prescribed by your transplant team. 

You may not get used to kidney transplant medications initially, as some are powerful. So your transplant team will monitor the levels of these drugs in your body to decide the accurate dose for your condition. Hence it will take some time for your body to adjust to the new kidney and kidney transplant medications.

What Drugs Do Kidney Transplant Patients Need To Take?

After the kidney transplant is successful, your transplant team will prescribe a medication plan suitable for your condition. Do not skip or change these medications at any cost. Before taking medications, ensure that you and your caretakers are aware of the purpose of each drug. You should know the names, dose and timing of each medication. Ask the physician or nurse if you are not sure.

1. Medications that suppress the immune system:

Our immune systems are designed in such a way that it responds to and destroy foreign substances in our bodies. Hence it naturally perceives the transplanted organ as a foreign agent and destroys it. To prevent this from happening, your transplant team will suggest medications to suppress your immune system.

When the immune system is suppressed, it does not cause problems for the transplanted kidney. Over time, the power of the immune response decreases and subsequently, the doses of medicines will also be reduced. Immunosuppressants are also termed anti-rejection medicines because they stop the body from rejecting the transplanted organ. 

Usually, immune-suppressing agents will be prescribed in two phases: induction phase and maintenance phase. The induction phase involves using potent immunosuppressants immediately after the transplant surgery, and the maintenance phase consists of the use of immunosuppressants for the long term. Two or more immunosuppressants will be used as a combination therapy to get the best results in this phase.

• Cyclosporine: Cyclosporine acts by releasing substances in the body that induce inflammation and block the immune cells from attacking the transplanted organ.
• Tacrolimus: Tacrolimus is an effective kidney transplant medication you will take after your surgery. Your transplant team will monitor you to ensure that the dose of this medicine is optimum. Tacrolimus works by suppressing your immune system to stop your body from rejecting the new kidney. Some side effects include low magnesium and high potassium levels in the blood, high blood pressure, increased risk of diabetes, decreased kidney function, sleep disturbances, tremors, etc. 
• Sirolimus: Though sirolimus is similar to tacrolimus, its effect has to be monitored by your healthcare team closely. This medicine might lead to swelling of legs, frothy urine, rashes and anaemia. Tell your healthcare team if you take medication for seizure, high blood pressure or tuberculosis before you begin this therapy.
• Mycophenolic acid: Mycophenolic acid is a kidney transplant medication indicated to prevent rejection of the new kidney. It is available in the form of mycophenolate mofetil and mycophenolate sodium. Usually, this medicine will be prescribed along with tacrolimus, and you need to take one in the morning and evening.
• Prednisolone: Prednisolone is a corticosteroid that is indicated for various purposes due to its anti-inflammatory and anti-allergic properties. They bind to glucocorticoids in the body to prevent inflammation and allergies. During the initial days of your transplant, this medicine will be injected through your vein. After five days of this treatment, if your doctor feels you need more of this medicine, you will be prescribed an oral form of Prednisolone. Some common side effects of corticosteroids include mood swings, high blood pressure, allergic reactions, vision problems. Get in touch with your transplant team right away if you have stomach pain, bleeding ulcers, blood in cough or breathlessness.
• Azathioprine: Azathioprine is usually indicated for autoimmune conditions like rheumatoid arthritis, lupus, inflammatory bowel diseases. This medicine is also helpful to suppress your immune system to stop your body from rejecting the new kidney. However, pay attention to purplish lumps and allergic reactions after taking this medicine and contact your transplant team if you get these reactions.

 2. Kidney transplant medications to prevent infections:

Since you will be put on immune-suppressing medications, you are more likely to suffer from infections. Your body will need medicines to stop bacteria, viruses and fungi from invading your organs. Hence, your healthcare team will prescribe drugs to prevent infection and complications.

• Antibacterial medicines: Sulfamethoxazole/trimethoprim is usually indicated after six months of transplant surgery to prevent pneumonia due to bacterial infections. Some side effects include high potassium levels, low blood counts and increased sensitivity to sunlight. Ensure that you wear skin protective clothes and sunscreen before stepping out in the sun.
• Antiviral drugs: You need to take antiviral medications (Valganicyclovir) once a day for 3 to 6 months of transplant surgery to prevent cytomegalovirus (CMV) virus infection. Drink plenty of water during this treatment.
• Antifungal drugs: Antifungal medicines prevent the fungi from causing problems in your mouth, throat and food pipe. This regimen is indicated four times a day for a month of the transplant. One vital piece of information to keep in mind is that you should not eat or drink anything for 10-15 minutes after taking this medicine. Watch out for side effects like upset stomach and diarrhoea.

3. Medications to reduce heartburn:

Kidney transplant medications like steroids can be complex on your stomach lining that it causes acidity, heartburn, indigestion and stomach ulcers. It would help if you took some medicines that control acidity and heartburn to prevent this. Some tablets may be available without prescription but do not take any medication without consulting your transplant team.

4. Medications for constipation:

Post kidney transplant, your movements will be restricted for a few days. The surgery, immobility and kidney transplant medications take a toll on your bowel health, resulting in constipation. Let your transplant team know if the bowel movement did not happen after the transplant or it hurts during one. You will need to take constipation-relieving medications.

5. Pain-relieving medicines:

A kidney transplant medication regimen also involves pain killers to overcome the initial pain after surgery. If you feel like you need pain medications after your discharge from your hospital, you should inform your transplant team regarding this and take only those medications they approve.

7. Electrolyte treatment:

Some kidney transplant medications can alter the composition of electrolytes in your body. Your transplant team will prescribe medications that increase or decrease electrolyte levels, depending on your body's needs. The most commonly prescribed electrolyte medications are phosphorous, magnesium oxide and potassium-lowering supplements.

Important Points To Consider:

Long-term use of medicines that suppress the immune system can make your skin sensitive to the sun and cause skin cancer. Ensure that you apply good quality sunscreen before stepping out in the sun.

Do not lift heavy objects or perform intense exercises after recovery from surgery. Do not take any over-the-counter medications or herbal supplements without consulting your transplant team. Be prompt on your healthcare check-ups and ensure that you always have a sufficient stock of your medicines. Consult your transplant team immediately if you experience any weird reactions or symptoms after taking your pills.