Immunosuppression Medications & Levels

Resource Category: Medical Complications and Future Medical Needs, Immunosuppression, Supported by American Legion Child Welfare Foundation Grant

Resource Type: Info Sheet

Age of Child: <5, 6-12, 13+

Years Since Transplant: <2, 3-5, 5+

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Types of medications use to prevent rejection

Immunosuppression medications or “anti-rejection” medications are important medicines after transplant to prevent the body from rejecting the transplanted organ. The transplant team will check blood levels of certain immunosuppressant medications and adjust the dose accordingly to meet a goal level.

Tacrolimus Level/Prograf/FK/FK-506

A type of anti-rejection medicine called a “calcineurin inhibitor”. This medicine helps to reduce the immune system to help prevent the body from rejecting the transplanted organ. The dose of this medicine is based on a “trough” level that is measured approximately 10-12 hours after the last dose. The transplant team will ensure the patient does not take a dose before the level is drawn. Side effects can present when the level is too high, including headache, tremors, and rarely, seizures.

Cyclosporine Level/Sandimmune/Neoral

An anti-rejection medicine that works the same way as Tacrolimus. This medicine helps to reduce the immune system to help prevent the body from rejecting the transplanted organ. Similarly, to Tacrolimus, the cyclosporine level is drawn approximately 10-12 hours after the last dose. The transplant team will ensure the patient does not take a dose before the level is drawn and then adjust the dose of the medication to reach a goal level.

Mycophenolate Mofetil/Mycophenolic Acid/Cellcept/Myfortic

A type of anti-rejection medicine that is used in conjunction with Tacrolimus, Cyclosporine, or Sirolimus. This medicine helps to reduce the immune system to help prevent the body from rejecting the transplanted organ. The most common side effects noted include diarrhea and gastrointestinal discomfort. Of note, caution is needed for women of childbearing years, as this medicine can cause birth defects.

Azathioprine/Imuran

A type of anti-rejection medicine. This medicine helps to reduce the immune system to help prevent the body from rejecting the transplanted organ. Before this medicine is started, the transplant team will check a “TPMT” level to make sure that the body can break down the medicine. Once initiated, the transplant team may check a “6-MP” level to measure the amount of medicine in the blood.

Sirolimus/Rapamune

A type of anti-rejection medicine. This medicine helps to reduce the immune system to help prevent the body from rejecting the transplanted organ.

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This information should not replace medical advice from your doctors or medical team. We encourage our readers to follow their transplant team's medical advice and reach out to their doctors and medical team for further recommendations.