Other Medications

Medications after Transplant: What you should know to help your teen

In addition to anti-rejection medications, your teen’s transplant team prescribes other medications to be sure the transplanted organ is functioning well and that your teen is healthy. These medications support transplant health, prevent infections, and help manage any side effects that may occur.

Medications to prevent or treat infections

After transplant, your teen’s immune system is suppressed to prevent rejection - which increases their risk of getting infections. To prevent infection, your transplant team will prescribe antibiotics, antivirals, and antifungals when the risk is greatest – usually early on after transplant or if they are being treated for rejection. 

Antibiotics

• Common antibiotics: ciprofloxacin, trimethoprim-culfamethoxazole (Bactrim™), amoxicillin.
• Why they are needed: Antibiotics help prevent bacterial infections, which may occur after transplant due to the immune system being weakened.
• What your teen should know: These medications are usually prescribed for several weeks or months after surgery. If an infection occurs, your teen may need additional antibiotics. If your teen needs an antibiotic for a common bacterial infection, such as a strep throat or an ear infection, their pediatrician or PCP will prescribe the appropriate medication.

Antivirals

• Common antivirals: xalganciclovir (Valcyte™), acyclovir (Zovirax™), letermovir (Prevymis™).
• Why they are needed: Antivirals protect your teen from viral infections like cytomegalovirus (CMV), herpes, and other viruses more common in transplant patients.
• What your teen should know: These medications may be needed for several months after transplant, especially if your teen is at a higher risk for a viral infection.

Antifungals

• Common antifungals: nystatin (Mycostatin™), fluconazole (Diflucan™), voriconazole (Vfend™).
• Why they are needed: Transplant recipients are at risk for a fungal infection called candida or thrush, which may appear on the lining of the mouth (oral mucosa) or on the tongue.  This can occur early on after transplant or if their immunosuppression is increased during treatment for rejection.
• What your teen should know: Depending on your teen’s risk level, antifungal medications are prescribed for a few weeks or months after transplant. 

Keeping Your Teen Healthy: What You Need to Know!

Here are some additional medications your transplant team may prescribe to treat side effects and to help maintain your teen’s health. Your teen may also be taking medications prescribed by other doctors – these are important, too! If you have questions about your teen’s “non-transplant” medications, be sure to ask their providers. 

• Magnesium: Magnesium oxide, magnesium gluconate, magnesium glycinate
  • Why it is needed: Anti-rejection medications can lower magnesium levels, which may lead to fatigue, weakness, muscle cramps, and loss of appetite. If low levels are not treated, more serious complications may occur such as abnormal heart rhythms, numbness and tingling, and seizures.
  • What your teen should know: Magnesium levels are checked with routine labs and supplements are prescribed if levels are low to prevent complications.
     
• Vitamin D:  Vitamin D₃ (cholecalciferol) or Vitamin D₂ (ergocalciferol)
  • Why it is needed: Vitamin D is an important vitamin for everyone to maintain bone health. Transplant patients are at risk for bone problems particularly if they are taking steroids (prednisone) over a long period of time.  Although steroids may be important in preventing or treating rejection, they may also increase the risk of osteoporosis (weak bones) leading to fractures. Your transplant team and/or pediatrician usually checks your teen’s Vitamin D level at least every year to check if they need a supplement.
  • What your teen should know: Vitamin D helps the body absorb calcium which is essential for bone health. Ensuring your teen gets the right amount of Vitamin D through nutrition and supplements, if prescribed, helps maintain their long-term bone health and density.
     
• Blood Pressure Medications:  amlodipine (Norvasc™), Isradipine (Dynacirc™), enalapril (Vasotec™), nifedipine (Procardia™), carvedilol (Coreg™), clonidine (Catapres™)
  • Why it is needed: Blood pressure (BP) is the force your blood needs to move through the arteries (vessels that carry oxygen-rich blood away from the heart to tissues and organs in the body). High BP (hypertension) is common early on after transplant. It is usually due to anti-rejection medications like steroids but it can also happen if there are kidney problems. If your teen has high blood pressure, medication will be prescribed and the dose adjusted until a normal BP is maintained.
  • What your teen should know: If your teen is prescribed a blood pressure medication, their blood pressure will be monitored regularly to ensure it stays within a healthy range.
     
• Blood Thinner (anticoagulant): Aspirin
• Why it is needed: Blood clots are a possible risk following transplant surgery. They can lead to serious complications after transplant, such as a stroke or damage to other organs. Aspirin helps prevent clots by “thinning” the blood and making it less likely to develop a clot.
• What your teen should know: Aspirin should be taken as directed by your transplant team. Your teen should check with them before taking other medications (including over-the-counter meds) as some can interact with aspirin and affect how well it works.
   
• Stomach and Digestive Health Medications: omeprazole (Prilosec™), pantoprazole (Protonix™), lansoprazole (Prevacid™)
  • Why it is needed: If your teen is prescribed prednisone or other drugs that irritate the lining of the stomach, medications may be prescribed to protect the stomach. These stomach medicines are called Proton Pump Inhibitors (PPIs). They help reduce the amount of acid in the stomach that can irritate parts of the digestive system (esophagus, stomach, or small intestine). Having less acid in the stomach will help prevent or relieve symptoms from acid reflux and stomach ulcers.
  • What your teen should know: If your teen is prescribed a PPI, it’s important they take them as directed to prevent stomach problems. These medications may be prescribed for a short time or longer, depending on your teen’s symptoms and risk for developing stomach ulcers or acid reflux. 

In addition to the essential anti-rejection medications, these other medications are important for your teen’s long-term health. They help prevent infections, support organ function, protect bone health, manage blood pressure, decrease stomach acid, and reduce the risk of blood clots.

Encourage your teen to follow their doctor's instructions carefully and to take all medications as prescribed. If you and your teen have questions about the prescribed medications or notice side effects, contact your transplant care team. They are there to help you every step of the way!

For any questions, concerns, or medication changes, always contact your transplant care team.