Pediatric Liver Transplant
Medications

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Medications Associated with Liver Transplantation

After your child’s liver transplant, the transplant team at Cincinnati Children’s will prescribe a number of special medications. These help your child’s body accept the transplanted liver and protect him or her from infection and some complications.

Prescriptions

The liver transplant coordinator renews prescriptions 8 am-4:30 pm Monday through Friday. Please monitor your medication supply and call the liver transplant office when a refill is needed.

Remember: caring for the new liver is a lifelong commitment, requiring frequent blood tests and daily medications for the rest of your child's life. If you experience any problems refilling medications through your pharmacist, contact the liver care team immediately.

The following medications are commonly prescribed after a liver transplant:

Aldactone (Spironolactone)

Purpose: Eliminates extra fluid from the body by increasing urine flow.
Side effects: Headache, fever, rash, loss of appetite, nausea, vomiting and increase in serum potassium level
Administration: Comes in liquid or pill form

Lasix (Furosemide)

Purpose: Eliminates fluid from the body by increasing urine flow.
Side effects: Dizziness, weakness, dry mouth, increased urination and low potassium level
Administration: Comes in tablet or liquid form

Mycelex, Mycostatin, Nilstat (Nystatin)

Purpose: Prevents fungal infections in the mouth and throat.
Side effects: Mild diarrhea and nausea
Administration: Comes in liquid or wafer form. Do not allow your child to eat or drink for 30 minutes after the dose.

Mylanta, Maalox (Aluminum Hydroxide, Magnesium Hydroxide)

Purpose: Reduces stomach acid.
Side effects: Diarrhea
Administration: Comes in liquid or chewable tablet form. Give at least two hours before and two hours after Cyclosporin, Neoral or Prograf.

Neoral (Cyclosporine Microemulsion)

Purpose: Helps prevent rejection. Administered for lifetime.
Side effects: Trembling and shaking hands, kidney dysfunction, high blood pressure, increased susceptibility to infection, increased hair growth, headache, leg cramps, swollen gums, nausea or vomiting
Administration: Comes in liquid or capsule form. Must be given within 15 minutes of the scheduled time, in the same form each time. This medication may not be taken with grapefruit juice, which interferes with the absorption of the medicine. If your child vomits within 30 minutes after the dose, the entire dose must be given again. If your child vomits 30 minutes to one hour after the dose, one half of the dose must be given again. If your child vomits more than one hour after the dose, there is no need to give the dose again. Your child will take this medication for the rest of his or her life.

Norvasc (Amlodipine)

Purpose: Helps keep blood pressure normal and protects the kidneys from the side effects of your child’s other medications.
Side effects: Headache, irregular heartbeat, dizziness, fatigue, nausea and lowered blood pressure.
Administration: Comes in a pill form. May be crushed and mixed with liquid or food.

Nifedipine (Procardia)

Purpose: Anti-hypertensive agent (helps to lower blood pressure). Given intermittently for high blood pressure.
Side effects: Dizziness, headache, nausea, weakness, shortness of breath, cough, irregular heartbeat and low blood pressure
Administration: Comes in liquid-filled capsule

OKT3

Purpose: Treats severe rejection that has not responded to other medications.
Side effects: Fever, chills, shortness of breath, wheezing, increased susceptibility to infection, diarrhea and severe allergic reaction.
Administration: Given in the hospital through an IV

Pantoprazole (Protonix)

Purpose: Treats and maintains healing of erosive esophagitis associated with gastroesophageal reflux disease (GERD). The medication serves as adjunctive therapy of duodenal ulcers associated with Helicobacter pylori.
Side effects: Headache, dizziness, vertigo, insomnia, anxiety, fever, nervousness, confusion, depression, sudden changes in emotions and hallucinations
Administration: Comes in pill form

Pentamidine (NebuPent, Pentam-300)

Purpose: Prevents pneumonia caused by Pneumocystis carinii in patients who cannot tolerate or fail to respond to Bactrim.
Side effects: Dizziness, fever, fatigue and delirium
Administration: Given as a breathing treatment (inhaled) or through an IV

Peridex (Chlorhexidine Gluconate)

Purpose: Prevents or treats infections in the mouth.
Side effects: Darkened teeth
Administration: Mouth rinse; do not allow your child to swallow the medication. Do not allow your child to eat or drink for 30 minutes after the dose.

Baby Aspirin

Purpose: Prevents blood clots after transplantation. It is typically administered for 100 days after the transplant.
Side effects: Nausea, vomiting, rash, bleeding and ulcers
Administration: Give with food or after meals to help prevent stomach upset

Prednisone

Purpose: Helps prevent rejection.
Side effects: Fluid retention, weight gain, increased appetite, increased blood sugar, brittle bones, muscle weakness, round full face, thin arms and legs, mood swings, difficulty sleeping, stomach ulcers and sweating
Administration: Comes in a liquid and tablet form. May be crushed and mixed with liquid or food.

Prograf (Tacrolimus, Fk506)

Purpose: Helps prevent rejection. Administered for the child’s lifetime.
Side effects: High blood pressure, high blood sugar, trembling, shaking hands, kidney dysfunction, headaches, increased susceptibility to infection, nausea, diarrhea, high potassium levels, hair loss, sleep disturbances and lymphoproliferative disorder
Administration: Comes in capsule or liquid form. Must be given within 15 minutes of the scheduled time. Must be given the same way each dose and on an empty stomach. Your child may not eat 60 minutes before and 60 minutes after taking Prograf. If your child is on tube feeding, you must stop the tube feedings one hour before and not resume until one hour after giving Prograf. The medication may not be taken with grapefruit juice, as this interferes with the absorption of the medication. If your child vomits within 30 minutes after the dose, the entire dose must be given again. If your child vomits 30 minutes to one hour after the dose, one half of the dose must be given again. If your child vomits more than one hour after the dose, there is no need to give the dose again.

Rapamune (Sirolimus)

Purpose: Helps prevent rejection.
Side effects: Increased susceptibility to infection, increased triglyceride and cholesterol levels, decreased potassium levels, rash
Administration: Comes in liquid and pill form

Sandimmune (Cyclosporine)

Purpose: Helps prevent rejection.
Side effects: Trembling and shaking hands, kidney dysfunction, high blood pressure, increased susceptibility to infection, increased hair growth, headache, leg cramps, swollen gums, nausea or vomiting, high potassium levels, sleep disturbances and lymphoproliferative disorder
Administration: Comes in liquid and capsule form. Must be given within 15 minutes of scheduled time. Must be given the same way each dose; for example, mix with milk or juice or give by itself. The medication may not be taken with grapefruit juice, as this interferes with the absorption of the medication. If your child vomits 30 minutes after the dose, the entire dose must be given again. If your child vomits 30 minutes to one hour after the dose, one half of the dose must be given again. If your child vomits more than one hour after the dose, there is no need to give the dose again.

Zantac (Ranitidine)

Purpose: Helps prevent or treat ulcers.
Side effects: Headache, constipation, nausea, dizziness, fever and fatigue
Administration: Comes in liquid or pill form

Bactrim (Trimethoprim and Sulfamethoxazole)

Cellcept (Mycophenolate Mofetil)

Purpose: Helps prevent rejection.
Side effects: Increased susceptibility to infection, decreased blood levels of white blood cells and platelets, nausea, vomiting and diarrhea
Administration: Comes in liquid or capsule form

Cytogam (Cytomegalovirus Hyper-Immunoglobulin)

Purpose: Used to prevent and treat infections from cytomegalovirus (CMV) and Epstein-Barr virus (EBV).
Side effects: Fever, chills, shortness of breath and nausea
Administration: Given through an IV

Diflucan (Fluconazole)

Purpose: Prevents fungal infections.
Side effects: Nausea, vomiting, diarrhea, headache, rash and kidney problems
Administration: Comes in liquid or pill form

Enalapril (Vasotec, Vasotec IV)

Purpose: Manages mild to severe hypertension.
Side effects: Fatigue, vertigo, insomnia, dizziness and headache
Administration: Comes in pill form

Gancyclovir / Ganciclovir

Purpose: Prevents and treats viral infections.
Side effects: Swelling, irregular heartbeat, high blood pressure, kidney problems, decreased blood cell counts, headache, seizures, nervousness, dizziness, nausea, vomiting and diarrhea
Administration: Given through an IV or by mouth

Imuran (Azathioprine)

Purpose: Helps prevent rejection.
Side effects: Increased susceptibility to infection, decreased blood levels of white blood cells, red blood cells and platelets, nausea and vomiting
Administration: Comes in a liquid and tablet form

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Pediatric Liver Transplant Medications

Medications Associated with Liver Transplantation

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Pediatric Liver Transplant
Medications