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         Anti-rejection                TRANSPLANT MEDICATION COMBINATIONS
         medications are
         taken orally (by               Prograf                      Neoral                    Rapamune
                                                          or                           or
         mouth) and form               (Tacrolimus)                (Cyclosporin)                (Sirolimus)
         the mainstay of
         your post transplant
         treatment.                                                    AND
         All patients take a
         combination of the                           Mycolat                     Myfortic
         following three                                                or
                                                   (Mycophenolate)             (Mycophenolate)
         groups of
         ● Prednisolone                                                AND
         ● Prograf (Tacrolimus)
           or Advagraf
         ● Mycolat                                               Prednisolone

        Prednisolone is a steroid drug, available in 5mg         Some side effects of this medication include:
        tablets, and should be taken once daily, in the       increased appetite, weight gain, bone loss,
        morning, and always with food. The dose of            increased risk of infections, acne, elevated blood
        Prednisolone may be high at first, usually starting   sugars, joint pain and muscle weakness, increased
        at 20mg daily, but will be tapered down over the      sensitivity to the sun, mood changes, increased
        first three months. Never stop taking this            blood pressure, cataracts and glaucoma.
        medication abruptly.

        Prograf (Tacrolimus)
        This medication is available in oral capsules, strength
        0.5mgs, 1mg and 5mgs. Take Prograf in two divided doses
        at the same time each day, twelve hours apart. Take Prograf
        on an empty stomach, one hour before or two hours after
        meals. Grapefruit and grapefruit juice will interact with
        Tacrolimus and must be avoided. Possible side effects of
        this medication include: tremor, headaches, nausea,
        vomiting or diarrhoea, high potassium levels, hypertension,
        hair loss and diabetes.
           You transplant team will measure the level of Prograf, in your blood, each time you come to the clinic.
        For the first 3 months, after transplant, your doctor will adjust the dose to achieve a level of 6 to 12mg/ml.
        After 3 months they will be aiming for a lower level of around 6 to 10mg/ml and after 6 months they will
        aim for a level closer to 6 to 8mg/ml. A high a level of Prograf may result in a higher serum creatinine.
        Other drugs may interfere with Prograf. If your GP, or any other doctor prescribes a new medication, check
        with your transplant team before starting it. Your nephrologist may prescribe you Advagraf. This drug is in
        the same family as Prograf but unlike Prograf it is taken once a day, in the morning.

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