If you’re exploring the possibility of a kidney transplant, you’ll need to learn about anti-rejection medications, which are also called immunosuppressants.*

What do immunosuppressants do?

When a new organ is placed in your body, your immune system recognizes it as a foreign object. In response, it tries to protect your body by “rejecting” the new kidney and attacking it the same way it would a virus. Immunosuppressant drugs reduce your immune system’s ability to attack, thus making rejection less likely. 

Unless you’re receiving a kidney from a twin, in the event that you have one, you’ll need to take anti-rejection medications every day for the rest of your life post-transplant. Missing even a single dose can result in rejection of the new kidney. 

If you do miss a dose, take your medication as soon as you remember, and contact your healthcare provider, but do not double up on doses.

What are the signs of kidney rejection?

Even when you take your medications as instructed and follow all of your doctors’ healthy lifestyle suggestions, organ rejection is still a possibility. 

Call your transplant center immediately if you experience:

• a decrease in urine output;
• a fever higher than 100 degrees;
• blood in your urine;
• aches or tenderness near your new kidney;
• flu-like symptoms (chills, muscle aches, cough, headache, fatigue); and/or
• a weight gain of more than 3 pounds in two days.

Side effects of immunosuppressants

Stomach upset is the most common side effect of immunosuppressants. This usually only occurs during the first six months after your transplant—when the dosage is at its highest. 

The more serious side effect, however, is an increased vulnerability to infections. 

Contact your transplant center if you have any of the following symptoms:

• a fever of 100 degrees or higher;
• fluid leakage from your surgical site;
• a burning sensation while urinating; and/or
• a persistent cough or cold.

Foods and drugs that react with immunosuppressants

There are several foods and drugs that can interfere with your immunosuppressants. Grapefruit juice and grapefruit products, along with St. John’s Wort and other herbals, are the most common edibles that can cause fluctuations in the immunosuppressant levels in your blood.

Some medications that can react with immunosuppressants include:

• erythromycin (an antibiotic);
• anti-tuberculosis medicines;
• anti-seizure drugs; and
• blood pressure medications (such as Verapamil, cardizem, and diltiazem).

Before starting immunosuppressants, speak to both your physician and pharmacist about any possible interactions that could, or may, occur between the anti-rejection medications and any other drugs or supplements that you’re taking.

*National Kidney Foundation. (2020, Jun. 2). Immunosuppressants.