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Medications
You
can call (352) 265-0751 to make a referral to the heart
transplant program at the Shands Transplant Center at the
University of Florida.
After heart transplant surgery you will take a variety of
medicines. Some of these drugs you will only take for a
short time and others you will take every day for the rest
of your life. The success of your transplant depends on
you taking these medicines, understanding how they work,
and what side effects to expect.
Tips
| Storage | Before taking
| Drug information
Tips
You are
responsible for taking the medications that have been prescribed
for you. It is important to talk to your physicians about
the medications you will be taking.
Find
out:
- Name
and purpose of each medication
- When
to take each medication
- How
to take each medication
- How
long to continue taking each medication
- Side
effects
- What
to do if you forget to take a dose
- When
to order more medication
- How
to obtain your medication
- What
you should avoid when taking the medications
Continue
taking the medicines as directed by your physician after
you are released from hospital. It is important to control
your immune system with antirejection medications. If your
immune system recognizes your new heart as foreign, it will
try to reject it.
Some
medications must be taken for the rest of your transplanted
heart's life.
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Storing
your medications
Keep medications in the original container, tightly capped.
If you use a special container to hold your pills, keep
the container tightly sealed.
Use
the following storage tips:
-
Store in a cool, dry place away from direct sunlight
- Don't
store medications in the bathroom-moisture can cause them
to lose their strength
-
Don't allow liquid medications to freeze
- Don't
store medications in the refrigerator unless your doctor
or pharmacist advises you to do so
- Keep
all medications away from children
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Before
you take your medications
Ask your nurse, transplant coordinator or pharmacist to
help you choose the best times to take your medications.
Try to take each medication at the same time every day.
Follow a written schedule. Do no cut or crush a tablet unless
you are advised to do so.
Notify
your transplant coordinator if you:
- Can't
take your medicines by mouth because of illness
- Have
a long illness (nausea, vomiting, diarrhea)
- Think
the directions on the label may be different from what
you were told
- Have
trouble removing child-resistant caps
- Have
a reason to take aspirin, Tylenol (acetaminophen), Advil
(ibuprofen), other pain relievers, cold remedies or diet
pills
- Feel
you are having a reaction to your medications
- Have
a change in health or eating habits
- Have
a new prescription from your local doctor or a change
in a current prescription
- Experience
any unusual symptoms or side effects
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Drug
information
Immunosuppressants work by suppressing your body's immune
system in order to prevent rejection of your new heart.
These can cause side effects. Specific side effects for
each drug are explained below. Medication dosage is based
on regular blood samples. Your transplant coordinator will
notify you of any changes in your medication or dose.
Cyclosporine
(Neoral)
Type - Immunosuppressant
Purpose - Suppress the immune system of your body; prevent
rejection of your new heart.
Comments - Must be taken daily for the rest of your life;
we recommend taking the drug after meals. You must not skip
doses of this medication.
Side effects - Increase in blood pressure, tremors (shaky
hands), cramping of the arms, hands, legs and feet, hair
growth, changes in kidney and liver function, anxiety, swollen
gums, susceptibility to infections.
Tacrolimus
(Prograf; also called FK506)
Type - Immunosuppressant
Purpose - Prevent rejection
Comments - Must be taken everyday to prevent rejection
Side effects - Headaches, hand tingling or feet tingling
joint pain, high blood sugar, kidney problems, tremors
Prednisone
(Deltasone)
Type - Steroid; an immunosuppressant
Purpose - Prednisone steroid is used after your transplant
to inhibit or decrease inflammation (redness, swelling,
destruction of small blood vessels).
Comments - Once you begin taking steroids your body adjusts
to the drug in order to function properly. It is very important
that you take this drug exactly as prescribed. Taking this
drug must never be stopped or discontinued all at once.
Instead, the dose must be gradually reduced or tapered.
Just stopping the drug may cause serious side effects.
Side effects - Mood swings (euphoria, depression, easy to
anger, easy to laugh), increased appetite, weight gain,
muscle weakness, joint pain, fragile skin, easy bruising,
increased likelihood of sunburning (use sunscreen), softening
of bones, rounded face, growth of fine hair about the face,
arms, body
Azathioprine
(Imuran)
Type - Immunosuppressant
Purpose - Suppress the immune system of your body; prevent
rejection of your new heart.
Comments - This drug reduces white blood cells that help
to fight infections in your body.
Side effects - Easy bruising, skin irritations, mild hair
loss, intestinal irritation, anemia
Cellcept
(Mycophenolate Mofetil)
Type - Immunosuppressant
Purpose - Prevent rejection
Side effects - gastrointestinal (GI) upset such as nausea,
vomiting, diarrhea
Methotrexate
Type - Immunosuppressant
Purpose - Prevent rejection
Comments - Usually taken only once a week
Side effects - Gastrointestinal (GI) upset such as nausea,
vomiting, diarrhea
Antiinfection
medications fight infections if an infection does occur.
If infected, the bacteria or virus causing the infection
is identified and tested to determine which drug is most
effective against it.
Bactrim
(Septra; SMZ/TMP)
Type - Oral antibiotic
Purpose - Prevention of bacterial infection
Side effects - Skin rashes and irritations, nausea, headache
Acyclovir
(Zovirax)
Type - Antiviral drug
Purpose: CMV, Herpes, Shingles
Comments - Acyclovir can be given orally or intravenously
Side effects - Nausea, vomiting, low blood pressure, headaches
Mycelex
or Mycostatin
Type - Antifungal
Purpose - Prevent mouth infections
Intravenous
antirejection medicine fight new organ rejection. If you
experience an episode of rejection, the primary anti-rejection
medicines you will receive after a transplant is steroids
(prednisone taken by mouth or the intravenous form of prednisone
called Solu-medrol).
Your
doctors may decide that you need an additional drug such
as OKT3. OKT3 is a drug that is administered through a vein
(IV). It works by affecting antibodies in your blood stream
to minimize rejection of the new heart. Remember that your
immune system works by forming antibodies to fight against
antigens (foreign living substances). OKT3 is administered
in the hospital. The side effects include: fever, headaches,
nausea, diarrhea, abdominal cramping and low blood pressure
(rare).
Anti-Hypertension
Medications keep your blood pressure from becoming too high.
Because the drug Cyclosporine may cause your blood pressure
to go up, you may need to take one or more anti-hypertension
medications. Patients usually are started on an antihypertension
medication within one to two days after transplantation.
The most commonly prescribed antihypertension medications
are Vasotec, Norvasc, Cardizem CD and Cardura.
Diuretics
help to eliminate excess fluid buildup in the body. By eliminating
excess body fluid, diuretics also help to lower the blood
pressure.
Furosemide (Lasix)
Type - Diuretic
Comments: Lasix works by stimulating the release of excess
body fluid through the kidney. This drug causes you to urinate
more frequently and in most cases, in larger quantity. Lasix
also causes the release of potassium from your bloodstream.
Follow any instructions concerning potassium replacement
with drugs or food carefully.
Side effects - Muscle weakness, dizziness, leg cramps
Other
medications
Pravachol or Lipitor may be used to lower your cholesterol
blood level.
Calcium,
vitamin E, folic acid, magnesium oxiade and potassium are
possible supplements that may be required to help maintain
adequate levels in your blood.
Axid,
Pepcid and Prilosec are drugs that may be used to prevent
the development of ulcer disease.
Statistics
Success rate and various other statistics regarding the
Shands Transplant Center at UF are available from the Scientific
Registry of Transplant Recipients at ustransplant.org.
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