Even missing a single dose may make it more likely for you to have a rejection. The only time you should skip a dose is if your doctor or other health care team member tells you to do so. If you are not sure, call your doctor.
Also, when you have a clinic visit, you should not take your immunosuppressant medicines until your blood is drawn for lab work. Because of the large number of pills you may need to take each day, forgetting a dose is easy to do. You can do three things to help you remember your medicine:. Take it as soon as you remember and call your doctor. If it is time for the next dose, do not take a double dose. Even though you are taking your medicines every day, you may still develop rejection of the kidney transplant.
You need to know your body very well. If you have any of the following, you should call your transplant center right away:. The transplant center will probably ask you to have some blood tests and maybe other tests.
The long-term success of your kidney transplant depends largely on careful follow-up and a good working relationship between you and your transplant team. One of the side effects of these drugs is an increased chance of infections. This is more of a problem in the early period after a transplant or following treatment of a rejection because the dosage of these drugs is higher at these times.
You should call the transplant center if you have:. However, sometimes serious and even life-threatening infections may happen. Taking an immunosuppressant might make you more likely to get sick from a common illness, like a cold.
For example, you might be more likely to get an unusual pneumonia resulting from a fungal infection. Not all immunosuppressive therapies affect the immune system in the same way. Some affect the immune system more strongly than others, which may put you at greater risk of infection.
Your immunosuppressant might put you at greater risk of certain types of infections, but not others. For example, you might be at greater risk of bacterial infections but not have much of an increased risk of infections from viruses or parasites.
Your specific risks may vary based on the specific immunosuppressant you are taking, the dosage, and your whole medical situation. Fortunately, there are some steps that can help you lower your risk of infection while taking an immunosuppressant.
These tips may also be helpful for people who have reduced ability to fight off infections from another cause , like certain genetic illnesses or HIV.
People who are taking immunosuppressive therapies may be more likely to have severe and even life-threatening disease from COVID Such people may need extra precautions, such as the following:.
The Centers for Disease Control and your local health department can continue to provide you with up-to-date guidance. If you are taking an immunosuppressive therapy, it may be worth talking about your current treatment with your doctor. For some immunosuppressive therapies, an increased dose might increase your risk of having severe complications from COVID However, it is not completely straightforward.
Some immunosuppressive therapies are actually being studied as possible treatments for some severe symptoms of COVID such as cytokine storm. However, do not stop taking your immunosuppressive therapies without talking to your doctor. For many people, this would be a much greater medical risk.
Instead, you can have a conversation about whether lowering your current dosage of your immunosuppressant or switching to another treatment might make sense for you. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.
Overview of infections in the immunocompromised host. Microbiol Spectrum. Biologic therapy for autoimmune diseases: an update. BMC Med. Arthritis Rheumatol. Enderby C, Keller CA. An overview of immunosuppression in solid organ transplantation. Am J Manag Care. Davulcu EA, Vural F. Immunosuppressive agents in hematopoietic stem cell transplantation. Trends in Transplant. Adverse reactions to biologic agents and their medical management. Nat Rev Rheumatol. Long-term cancer risk of immunosuppressive regimens after kidney transplantation.
J Am Soc Nephrol. Infection risk and safety of corticosteroid use. Rheum Dis Clin North Am. Centers for Disease Control and Prevention. Prevention and control—immunocompromised persons. Updated April 3, Updated May 14, Your Privacy Rights.
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Before Taking. Immunosuppressive drugs include small-molecule drugs, depleting and nondepleting protein drugs polyclonal and monoclonal antibodies , fusion proteins, intravenous immune globulin, and glucocorticoids. Small-molecule immunosuppressive agents include calcineurin-inhibitors cyclosporine, tacrolimus , Target-of-Rapamycin Inhibitors Sirolimus, Everolimus , inhibitors of nucleotide synthesis and azathioprine.
The review covers the mode of action of these drugs with a special focus on belatacept, a new promising fusion protein. Different immuo-suppressive strategies mean also different safety profiles.
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