Important Tips Take medications at the same time every day Ask Transplant Team before getting vaccinations NO OTC or Herbals without asking your trans

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Medications Post Lung Transplant Stacey Balducci, Pharm.D. Office: (212) 305-32923292 Email: anb9056@nyp.org Liver Transplant Pharmacist

Important Tips Take medications at the same time every day Ask Transplant Team before getting vaccinations NO OTC or Herbals without asking your transplant team Only use Tylenol l (acetaminophen) over the counter for pain or fever. Do NOT use over the counter ibuprofen (Advil, Motrin), naproxen (Alleve), or aspirin. If there is any change made to your medications by a health care practitioner that is NOT on your transplant team make sure that you let your transplant team know BEFORE the change takes place Watch for signs and symptoms of infection

Typical Medication List Post Transplant Prograf Imuran Prednisone Bactrim Valcyte Nystatin Fosamax Materna Calcium Magnesium Oxide Colace Prevacid

Immunosuppuression Prograf (tacrolimus)** Neoral (cyclosporine) Imuran (azathioprine)** i Cellcept (mycophenolate) Prednisone** Rapamune (sirolimus)

Prograf (tacrolimus) No Grapefruit or Grapefruit Juice Two Hours Window Rule for Missed dose On clinic i days, do not take your Prograf until your blood is drawn

Prograf (tacrolimus) High blood pressure (hypertension) Kidney damage Trembling or shaking of hands Nausea and vomiting Headache High blood sugar Hair loss Infection

Neoral (Cyclosporine) ONLY BRAND! Sensitive to light. Keep in blister pack until ready to use No Grapefruit or Grapefruit Juice Two Hours Window Rule for Missed dose On clinic days, do not take your cyclosporine until your blood is drawn Brush twice daily, floss regularly and see your dentist regularly

Neoral (Cyclosporine): Side Effects High blood pressure (hypertension) Kidney damage Trembling or shaking of hands Nausea and vomiting High blood sugar Infection Headache Increased hair growth Bleeding, tender or enlarged gums

Imuran (azathioprine): Side Effects Decreased Blood Cells (platelets, white blood cells) Nausea or vomiting Diarrhea Infection

Cellcept (Mycophenolate) Separate Magnesium, Aluminum, and Iron containing medications (i.e. Maalox, Mylanta, Materna) by at least 2 hours from Cellcept.

Cellcept (Mycophenolate) Stomach upset ( heartburn ) Diarrhea Low white blood cells Stomach ulcer or bleeding Infection

Prednisone: Side Effects Nervousness, confusion, or excitement Depression or mood changes Restlessness or trouble sleeping Water retention (edema) Infection Increased appetite/weight gain Increased blood sugar Nausea (upset stomach) Osteoporosis (weakening of the bones)

Rapamune (Sirolimus) Decreased wound healing High blood pressure High cholesterol l Headache Low white blood cells Nausea, vomiting and diarrhea Infection

Rapamune (Sirolimus) Liquid The liquid suspension must be mixed with water or orange juice only Mix the liquid suspension in a glass or plastic cup only (no styrofoam) Store the liquid id suspension in the refrigerator

Prophylactic or Preventative Antibiotics i Bactrim (sulfamethoxazole/trimethoprim) Valctye (valganciclovir) Nystatin ti Liquid id or Mycelex (clotrimazole) l Troches

Bactrim (SMZ/TMP) Prevents PCP (Pneumocystis carinii pneumonia) Lifelong medication Do not take if you have a Sulfa Allergy Low dose: Usually 3 times a week Side effects: Increased sensitivity of skin to sunlight (sunburn) Metallic taste in mouth Itching or skin rash Kidney damage

Valcyte (valganciclovir): Side Effects Decreased white blood cells (cells that fight infection) Decreased platelets (cells that help blood clot) Decreased red blood cells Kidney damage Diarrhea Headache Nausea and vomiting Neuropathy (pins and needle sensation in hands or feet)

Nystatin Swish one teaspoonful of nystatin around in your mouth for as long as possible, then gargle and swallow Take this medicine 4 times daily, after meals and after brushing teeth If you wear dentures, remove dentures when you swish and swallow Shake the bottle before measuring out each dose Do not eat, drink, or brush teeth for 15 to 20 minutes after taking Nystatin

Mycelex (Clotrimazole) Dissolve one troche on tongue. Do not swallow or chew. Take this medicine at the same time every day Take this medicine i 4 daily, after meals and at bedtime Do not eat, drink, or brush teeth for 15 to 20 minutes after taking Mycelex

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