Before your surgery you may be taking many medicines to treat your kidney disease. When you have a kidney transplant, the number, and types of medicines you take will change. Some medicines you’ll take for a short time until you recover, and others you’ll need to take for as long as you have your kidney transplant.

It is very important you take your medicines as prescribed.

You’ll get medicine to help you manage pain after your surgery. You may get pain medicine that you take by mouth or through your intravenous (IV) line. Sometimes a patient-controlled analgesia (PCA) pump is used so you can give yourself pain medicine through your IV as soon as you need it.

Some children who receive a kidney transplant may have a gastrostomy tube (G-Tube) before their kidney transplant. For children with a G-Tube, many of their medicines can be given using this tube. Your pediatric transplant team will talk to you about which medicines can be given using a G-Tube.

Your body won’t want to accept your new kidney. Your immune system will try to fight against it because it sees the kidney as a stranger to your body. To stop your body from rejecting the transplanted kidney, you’ll need to take some medicines. These are called immunosuppressant medicines or anti-rejection medicines. You might start getting these medicines before surgery and will need to keep taking them after surgery.

For your transplant to be successful, you must take your immunosuppressant medicines every day, for as long as you have your transplanted kidney.

When you have a weakened immune system because of taking immunosuppressant medicines you are immunocompromised.

• immuno = refers to your immune system that helps your body fight infections
• compromised = weakened

You and your family will need to be extra careful and watch for infections more closely. When your immune system is weaker, it’s harder for your body to fight off an infection and destroy abnormal cells or viruses. This can put you at higher risk for some types of infections and cancers. Some of the medicines you’ll get will help prevent some types of infection.

Taking so many medicines every day can be hard. But it’s very important. Missing doses could cause your body to reject the new kidney. 

Always carry an up-to-date list of your medicines with you. There are several ways you can keep a list of your medicines. Choose the method that works best for you. You can:

• keep an electronic list of your medicines using the Alberta Health MyHealth Records​ app
  
• write out the medicines you take on a paper list – Medicine Lists and Tools
• ask for an updated medicine list each time you visit the clinic

Never stop taking each of your medicines as directed. Your transplant team will work with you to make a plan to help you take your medicines regularly. If you have difficulty with anything related to your medicines, you can work with your transplant pharmacist.

What can I do to help me remember to take my medicines?

Your medicines will likely change many times in the first few months after your transplant. It’s important to have a plan and be organized so you remember to take all your medicines when you’re supposed to. This can be challenging for some people.

Use 1 or more of these tips to help you remember to take your medicines.

• Use a daily or weekly pill box (also called a dosette).
• Set an alarm on your phone.
• Use a medicine reminder app on your phone.
• Ask your pharmacist to package your medicines in blister packs.
• Take your medicines at the same time as other activities that are part of your daily routine, such as eating breakfast or brushing your teeth.
• Put a reminder note or sign in a place where you will see it.
• Ask someone to remind you to take your medicines.

“Pill burden” is one way to describe the large amount of the daily medicines you’ll need to take. At times this can seem complicated.

Talk to your pharmacist and post-transplant team if you need help with taking your medicines.

What are the side effects of immunosuppressant medicines?

These medicines have many different side effects. You and your post-transplant team may spend the first few years after your transplant learning about what medicines and doses are right for you and how to manage the side effects. Talk to your transplant team if you have any questions or concerns.

As your kidney starts to work better, your medicine doses may change, and their side effects will often become less.

Your transplant team will talk to you about your risk of side effects from your medicine. It’s hard to predict what side effects a person may have after a transplant. You know your body best. Tell your transplant team if you notice any side effects so they can help you manage them.

Possible side effects of kidney transplant medicines include:

• nausea, diarrhea, heartburn, or vomiting
• tremors (shaking that you can’t control) or tingling in the hands or feet
• abnormal levels of electrolytes (such as potassium and magnesium) in your blood
• high blood pressure
• changes in your white or red blood cell count
• increased appetite and weight gain
• mood changes
• anxiety
• night sweats, dreams that seem real (called vivid dreams), sleep problems
• headaches
• rounding of the face (called “moon face”)
• weaker bones or osteoporosis
• changes to hair growth – having more or less
• higher blood glucose levels
• higher risk of infections and certain cancers

If you have problems with your medicines, your transplant team can help you to deal with them.

What happens if I don’t take my medicines?

If you stop taking your immunosuppressant medicines, your body will start to reject your new kidney. This also puts you at risk for other health problems. If your body starts rejecting your new kidney, you’ll need treatment as you risk losing your new kidney.

Losing your kidney in this way might make it harder to find a matched kidney in the future. Your body will have made more antibodies to attack any new kidney. This may lower your chance of getting another kidney transplant or make you unable to have another kidney transplant. For these reasons, don’t stop or change the way you take your medicines without talking to the transplant team first.

Many medicines can interact with your immunosuppressant medicines. Talk to your transplant team before taking any new medicines. This includes medicines prescribed by other doctors. Avoid over-the-counter medicines unless you talk to your transplant team first about them. This includes:

• ibuprofen – Advil, Motrin
• naproxen – Aleve
• aspirin – ​ASA
• supplements, vitamins
• herbal medicines

What about using alcohol, cannabis, or other drugs?

You may also wonder how alcohol, cannabis, or other recreational drugs interact with your medicines. In the first few weeks after your transplant avoid alcohol. Having a drink once in a while is fine for most people but check with the transplant team first.

If you choose to use cannabis, be sure to talk to the transplant team before using any form of cannabis. Some ways of using cannabis carry more risks than others after transplant, so it is important to discuss your options with the transplant team.

Recreational drugs and high-risk activities have many effects that can’t always be predicted. It is strongly recommended that you do not use any of these drugs or engage in high-risk activities. The potential for damage to your new kidney is too great to risk it.

Food and drug interactions

Some foods can interact or change how some medicines work. This means that you may get too much or too little of the medicine you’re taking.

If you take transplant or blood pressure medicines, you’ll be asked to avoid these fruits:

• grapefruit
• pomelo
• tangelo
• star fruit
• any products made with these fruits like juices, jams, or marmalades

Herbal supplements and teas

Before taking any over-the-counter vitamins, minerals, or herbal products or teas, check with your kidney transplant team. Herbal supplements and some teas may interact with your medicines. ​