Most transplant patients need to take three main types of medications:
- immunosuppressants
- preventive anti-infectives
- maintenance medicines.
Some teens also need to take over-the-counter medicines (OTCs) for headaches, colds, seasonal allergies or other everyday conditions.
Immunosuppressants
Immunosuppressants are also known as anti-rejection medications. They work by suppressing, or weakening, your immune system.
Normally, your immune system attacks anything that is “foreign” to your body. Usually this means it attacks germs (such as viruses and bacteria) that can cause infection, but it can also mean that it attacks your transplant organ. But when your immune system is weaker, it cannot attack the organ.
You need to keep your immune system weaker with anti-rejection medications for the rest of your life. You must never stop taking these medications. As time passes after your transplant, however, your immune system becomes more familiar with your transplanted organ and your transplant team will prescribe lower doses of some of the anti-rejection medications.
Preventive anti-infectives
As their name suggests, preventive anti-infectives are medicines that help prevent infections. You need them because the immunosuppressant(s) you are taking make your immune system weaker and may leave you at greater risk for developing certain infections after transplant.
Possible post-transplant infections include:
- cytomegalovirus (CMV) – a viral infection
- Epstein Barr virus (EBV) – a viral infection
- thrush – a fungal infection usually seen in the mouth or throat
- pneumocystis jirovecii pneumonia (PCP) – a serious lung infection.
Medications that may help prevent common post-transplant infections include:
- cotrimoxazole (trimethoprim-sulfamethoxazole)
- nystatin
- valganciclovir
- ganciclovir.
You normally need to take these medications for three to six months after transplant. Some patients may need to continue some anti-infective medicines for many years. You might also need to start anti-infectives again if you are treated for steroid-resistant organ rejection.
Aside from taking anti-infectives, you can play a major part in stopping infections by also:
- washing your hands carefully
- avoiding close contact with people who are sick
- avoiding crowded public spaces such as movie theatres or malls for the first three months after your transplant if you have a new lung. (You do not need to avoid public spaces for this long if you have received another organ.)
Your transplant team will recommend how long you should stay home from school after your transplant. You can still do school work at home, though, so that you don’t get too far behind in your classes!
Maintenance medications
Maintenance medications are usually used to control the side effects of the transplant or other transplant medications. They are used for different reasons, for example to:
- treat high blood pressure
- prevent or treat stomach aches and pains
- prevent or treat blood clots
- increase minerals or electrolytes, for example magnesium or potassium.
Your team will give you the ok to stop taking most maintenance medications once your condition becomes more stable after the transplant.
Over-the-counter medicines
There are rules about which over-the-counter medicines you can take when you are taking transplant medications. You can find out more on the page about over-the-counter medicines.
Review the handout Five Questions to Ask About My Medicine. It will help you be better prepared to discuss your medications with your health-care team.
