Managing your maintenance medications

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Maintenance medications are usually taken to control side effects from the transplant medications or transplant surgery itself.

Tablets in prescription bottle

This page lists several medication options for each side effect, but you will not need to take all of them! The links will take you to pages aimed at parents, but they can still give you good information.

No matter which maintenance medication you may need to take, it is important to know how to manage your medication doses, for instance if you miss or vomit a medication or if you experience diarrhea.

Medications to treat high blood pressure

Amlodipine
Enalapril
Metoprolol
Nadolol
Propranolol
Nifedipine

Medications to prevent or treat stomach pains or prevent acid reflux

Lansoprazole
Omeprazole
Ranitidine

Medication to help digestion of food or prevent acid reflux

Domperidone

Medications to thin the blood (to prevent or treat blood clots)

Acetylsalicylic acid (ASA) (Aspirin®)
Enoxaparin
Tinzaparin
Warfarin

Medications to lower cholesterol or triglycerides

Atorvastatin
Pravastatin

Medications to increase minerals and/or electrolytes

Magnesium (magnesium hydroxide or magnesium oxide)
Phosphate Novartis (tablets) or phosphate sodium (liquid)​
Potassium chloride

Medications to remove fluid (by helping you pee more)

Spironolactone and hydrochlorothiazide (Aldactazide®)
Furosemide

Medications to prevent or treat infection

Amoxicillin
Cytomegalovirus immune​ globulin (Cytogam®)​
Fluconazole
Ketoconazole
Penicillin
Voriconazole

Medications to bind potassium

Sodium polystyrene sulfonate (Kayexalate®)​

Medication to relax bladder

Oxybutynin

You can stop many of these medications later, when your condition is more stable.​

Managing your doses of maintenance medications

What to do if you miss a dose

  • Take the missed dose as soon as you remember.
  • If it is almost time for the next dose, skip the missed dose. Take the next dose at the regular time.
  • Never take two doses to make up for the missed dose.
  • Call your transplant team if you have missed more than one dose or if you have trouble remembering to take your medicine.

What to do if you vomit a dose

When you take a dose of medication, it usually takes an hour to pass from your stomach into your blood. The transplant pharmacist will talk with you about this after your transplant.

  • If you throw up more than one hour after taking a dose: do not repeat the dose.
  • If you throw up less than one hour after taking a dose: talk to your transplant team to check if you need to repeat it. We will decide based on what is going on with you at that time (for example if your blood pressure has been very high).
  • If you repeat a dose and you throw it up too, do not repeat it again.

Keep track of any vomited or repeated doses and talk to your transplant team or family doctor if you are vomiting a lot. Use this chart to help you decide when to call for advice.

You may not feel like eating or drinking when you are vomiting (even if does not happen around your medicine times). But you risk becoming dehydrated if you do not drink.

What to do if you have diarrhea (watery stools)

Diarrhea (watery stools) can reduce the amount of medicine that passes from your stomach into your blood. Frequent diarrhea could result in too little medicine reaching your blood.

Frequent diarrhea can also cause you to become dehydrated. This chart will help you decide if you need to contact your transplant team or family doctor for help with managing diarrhea.

Taking maintenance medicines with other medicines

As a general guide, always call your transplant team before using any new medications, whether:

  • your doctor prescribes them
  • you buy them “over-the-counter” at a drugstore
  • they are herbal or natural medications.

You can find out what other medications you should avoid or delay on each maintenance medication page.

How the transplant team checks how well the maintenance medication is working

The transplant team will do blood work at each clinic visit to see if the maintenance medication is working. If you are taking a blood pressure medicine, the team will check your blood pressure and may teach you how to check it at home.

How to store your maintenance medicines

  • Keep your medications out of reach of any small children.
  • Store tablets at room temperature in a cool, dry place away from sunlight.
  • Ask your transplant team where to store suspensions (liquid medications). Some liquids need to be stored in the refrigerator, but others can remain at room temperature.
  • Never store your medications in the bathroom or near heat sources in the kitchen.

Other important tips

  • Keep a list of all of your medications in your wallet or purse so you can show it to doctors, nurses and pharmacists when needed.
  • Make sure that your family doctor and dentist know which medications you are taking before you have any treatments.
  • If you are sexually active, be aware that some maintenance medications can cause birth defects if they are taken at the time of conception or during pregnancy. Always use a condom, not only to prevent pregnancy but also to prevent sexually transmitted infections.

If there comes a time when you want to have a child, you can talk to your transplant team. Changes to your medications may be possible to ensure a safe pregnancy for you and your partner.

What to do if someone else takes your medications

Call your local poison information centre.

If you live in Ontario, call the Ontario Poison Centre. The calls are free.

  • Call (416) 813-5900 if you live in Toronto.
  • Call 1-800-268-9017 if you live elsewhere in Ontario.

Last updated: November 30th 2017