POLL: Anti-rejection medications

[okarol]

The poll is designed so that you can vote for 3 items. If this isn't enough, please let me know. Or if I have omitted a medication, please tell me so I can improve the poll. Thanks.

[willieandwinnie]

Len is only taking 1 mg of Prograf daily. He did have Zenapax before and after transplant. Transplant doctor said his prograf levels are just where he wants them. Now, if we could get this diet thing staightened out, but that's another long story.

Great poll okarol, I'm always wondering what other transplant patients are taking. Call me Noisy.

[okarol]

Any new meds out there?

[willieandwinnie]

okarol, Imuran isn't on your poll list. Len was on it for a very short period of time and is now just on prograf again.  I'm surprised there hasn't been any response to this thread!

[monrein]

I listed prednisone, cyclosporine(neoral) and cellcept, although I was taken off the cyclo and switched to cellcept when my kidney began to decline from the cyclo.   I tapered down the cyclo as the cellcept was gradually increased and the transition took about a year I think.

I have been on prednisone for 23 years, most of the time just a 5mg. dose.

[okarol]

okarol, Imuran isn't on your poll list. Len was on it for a very short period of time and is now just on prograf again.  I'm surprised there hasn't been any response to this thread!

Thanks waw - I added it.

[Chris]

I can't remember how I did the last poll, but weren't we able to take the poll without inputing a message?

[okarol]

Yes, you can vote on the poll, and in this case you can choose 3 meds. You don't have to post a message.
If you have already voted I think it doesn't allow you to change your vote.

[Chris]

Hmm, don't remember doing this one. Thought it was a new one till I checked the original thread after reading your reply.

[MIbarra]

I'm on 3mg of prograf in the am, 2mg at night. 1 gram of cellcept and currently 7.5mg of prednisone.

I feel like I'm on a lot. 

[Chris]

I'm on 2 mg of Prograf in the AM and PM and right now I am on (2) 250 mg capsules of CellCept in the AM and PM, but will be going back down to my usual dosage of 250 mg in the AM and PM soon. Then there is the other meds I am on for a total of 11 Medications, but would have been 12 if I didn't have a problem with Lipitor. My list will be shrinking again next month if test come back good with the other meds I am on. Shall we compare what meds we are on? That might be interesting o see what we are all on. Wish I had a floppy drive still, I would like to pull up my med list hen I was on dialysis.

[knmiller]

Hey guys,

A few questions for you.  Immediately following transplant, typically what medicines are you put on...of course I know each individual is different, but is there a rhyme or reason as to what's prescribes and how/when?

Also, do any of you know if there are any generic equivalents to the following drugs?

Cellcept
Neoral
Prograf
Rapamune
I think Cyclosporin is a generic, right?

Any help would be great!

[Chris]

Hey guys,

A few questions for you.  Immediately following transplant, typically what medicines are you put on...of course I know each individual is different, but is there a rhyme or reason as to what's prescribes and how/when?

Also, do any of you know if there are any generic equivalents to the following drugs?

Cellcept
Neoral
Prograf
Rapamune
I think Cyclosporin is a generic, right?

Any help would be great!

Each center has their own protocol they follow on what meds they use. But it also depends on your size and weight for dosage calculations if I remember right.
Prograf just came off the protection list as of April 2008, so there maybe a generic form coming sometime after it meets all the FDA approvals (might be a few years). Cyclosporin is the original name and others are based off it. See picture below.

[Chris]

Another book to look for at the library is called Organ and Tissue Transplantation, Nursing Care from Procurement through Rehabilitation by M.K. Gaedeke Norris and Mary Anne House (ISBN 0803665873). The book is about 12 years old  but contains useful information that is comprehendable by the non medical service community. There maybe other books useful also at your local library or local college that can be useful. hat is how I found this book. American Transplant Association puts out another useful book and newsletter that is $12 a year, but if you can not afford it, they will send you the book and newsletters.

[knmiller]

Many thanks for your help.  I just priced out my anti-rejection pills and discovered a HUGE difference between Neoral and Cyclosporine...Since Cyclosporin is a generic, I get it for $10...if I was to get Neoral, which if I'm understanding this correctly-is the Brand name version for Cyclosporine- it will cost in upwards of $700 after insurance...

Why would any doctor prescribe Neoral over Cyclosporine and if my doctor does, can I request Cyclosproine instead?  Are there any differences between the two that I need to be aware of?

Thanks again for your help!

[Chris]

Neoral is a modified form of Cyclosporine. Hence added cost for all the research and more ingredients I guess. I forgot which one came first without looking it up again, but I think Cyclosporine came out before Prednisone as the first Anti-Rejection medication in the early years of organ transplantation.

[donnia]

I am on Myfortic, Prednisone and Rapamune

[pelagia]

I added the info for my husband.  He's on cellcept, prograf and prednisone.  As I mentioned in another thread, he also had 3 infusions of zenapax, a "therapeutic humanized monoclonal antibody" that may be (from what I've been reading) less toxic to the kidney than some of the other immunosuppresive drugs during the early stages following transplant.  The zenapax was given on days 0, 6 and 21.  I assume that they lowered the dose on something else as a result.

In addition he is taking a slew of other drugs - antiviral, antibacterial, antifungal, blood pressure meds, minerals, pepcid and baby aspirin.  I'm probably forgetting something.  The other day I figured out that the retail cost of these drugs is about $4200 per month (more than half of that is for the antiviral Valcyte, while the prednisone cost only a few dollars a month).  YIKES.  He stops taking the Valcyte after 3 months unless an infection kicks up. 

I never thought much of our health insurance plan before we experienced this major health challenge.  In the past all we ever had to deal with relatively routine healthcare, and what seemed like a lot of deductibles, co-pays, etc.  But when it came time for the nephrectomies and transplant, almost everything was covered.   For the drugs, our actual monthly co-pays are only a few hundred dollars a month, so I am extremely thankful for my job and my employer (Commonwealth of Virginia).

Someone mentioned generics earlier and I have to say that I am getting more and more wary of them.  I read a thread someplace about a generic blood pressure med that does not seem to work anything like the brand name Toprol-XL.  Do they run the generics through any kinds of trials?

[donnia]

My transplant coordinator told me to never accept a generic for my Myfortic or Rapamune.

[Chris]

When Prograf comes out as a generic, I'm not going to be the first in line to try it, especially if it is a bigger pill like one of my generic Norvasc was. There beter be eough scientific data on the generic for me to even consider it.

[KT0930]

I think Cyclosporine came out before Prednisone as the first Anti-Rejection medication in the early years of organ transplantation.

I had my first transplant in January 1982, and was on imuran and prednisone. Cyclosporine was approved by the FDA that same year, but I was not put on it until at least 16 years later when that transplant began to fail. For almost the entire life of that kidney I was on 5mg prednisone and 50 mg imuran.

For my most recent transplant, 5 months ago, I'm on 3 mg prograf AM and 4 mg PM; 750 mg AM & PM of cellcept; and 5 mg prednisone. They're having trouble figuring out the prograf dosage, they want my levels a little higher since it's my third transplant, but my body isn't cooperating - one month it's a tad high, the next month it's a bit low. Maybe it'll get straightened out...

[Chris]

I think Cyclosporine came out before Prednisone as the first Anti-Rejection medication in the early years of organ transplantation.

I had my first transplant in January 1982, and was on imuran and prednisone. Cyclosporine was approved by the FDA that same year, but I was not put on it until at least 16 years later when that transplant began to fail. For almost the entire life of that kidney I was on 5mg prednisone and 50 mg imuran.

For my most recent transplant, 5 months ago, I'm on 3 mg prograf AM and 4 mg PM; 750 mg AM & PM of cellcept; and 5 mg prednisone. They're having trouble figuring out the prograf dosage, they want my levels a little higher since it's my third transplant, but my body isn't cooperating - one month it's a tad high, the next month it's a bit low. Maybe it'll get straightened out...

Reminds me,, I still need to reread my book to remember which was the first immunosuppressant.

[MyRenalRomance]

My aniti-rejection meds are:
PROGRAF        9 mg twice a day
PREDNISONE 15 mg once a day (on a tapering schedule - should be off by mid Dec)
CELLCEPT    750 mg twice a day

Th rest of my meds include:  Pentamidine treatments once a month, Valcyte, Nystatin, Iron, Vit C, Multi Vitamin, Colace, Prilosec, and Enteric coated baby asprin.

The only meds from pre-transplant I'm continuiung with are Fortical, Ambien CR, Valium,  Provera, Vitamin C, and Prilosec.

I was taking 16 meds pre-transplant and I'm taking 16 post-transplant.  (Even Steven!!!)