Results of Heart Transplantation

IMMUNOSUPPRESSIVE MEDICATIONS

The immune system is the body's defense system. It provides the body's resistance to disease-causing agents and is responsible for its defense. If the immune system is strong, the body overcomes the disease-causing agent and illness does not occur. After a heart transplant, medications that suppress the defense system are used so that the person's defense system does not reject the transplanted heart. Therefore, as long as you use these medications, you need to protect yourself better against disease-causing agents. The amount and duration of use of these medications are arranged by the doctor following you and are changed according to your condition.
Immunosuppressive medications suppress and weaken the body's immune system. In other words, they reduce the power that your body normally has to attack and reject foreign tissue. They help your body accept the new organ. While these medications prevent rejection, they also reduce your body's resistance to infections (catching germs). While you are using immunosuppressive medications, your body becomes open to infections; in addition, you must not receive live virus vaccines during this treatment. You need to consult your transplant team about the use of any medication and vaccine.

General Side Effects of the Medications

Opportunistic infections; diseases such as cytomegalovirus, fungal infections and herpes simplex (cold sores) are observed more frequently.
An increase in malignant diseases may be observed. For this reason, you should have the doctor check-ups mentioned above done regularly.
Do not change medication doses or skip doses unless recommended by your physician. Use them at the recommended dose and in accordance with the instructions for use. Whenever you are going to take any medication, even a very simple one, and even if it has been recommended by another physician, be sure to consult your doctor before taking it. Do not forget to take your medications with you when you travel. Do not swap medications with others. Even if the ingredients of the medications are the same, do not change medications without asking your doctor.

Prednisolone (Deltacortil)

It has an immunosuppressive effect.
The prednisolone dose is reduced gradually until the maintenance dose is reached. Unless your doctor tells you otherwise, you will continue to take prednisolone. If you take it as a single dose, you should take it after breakfast in the morning, on a full stomach.

Side effects

It may cause salt and water retention in the body, and increased stomach acid and sweating.
The risk of fungal infection in the mouth increases. Acne (pimples) and increased hair growth may be observed on the skin. In the long term it may cause bone and muscle weakness.
It may cause cataracts and a rise in blood sugar. Psychological problems are observed more frequently.

Prograf (Tacrolimus)

It blocks the function of T cells, preventing them from damaging the transplanted organ. Its mechanism of action is similar to that of cyclosporine, and the two are never used together.
The points mentioned above for cyclosporine apply equally to tacrolimus.
High blood levels impair kidney function. For this reason, blood levels must be monitored closely. Be sure to have your blood level checked at the times your doctor tells you. For blood levels to give accurate results, be sure to take your medications regularly at the specified times. The medication dose is adjusted according to the tacrolimus level in the blood. Its side effects are similar to those of cyclosporine. Although cosmetic side effects (hair growth, gum swelling, etc.) are seen less often, drug-induced diabetes and neurological findings may be observed more frequently.

Do not take your medication with grapefruit juice. Grapefruit juice affects the blood level. Do not drink grapefruit juice for at least 2 hours before and 2 hours after the medication time. Some medications (such as ketoconazole and erythromycin) can greatly affect the tacrolimus level. Therefore, as mentioned before, even if another physician recommends it, be sure to ask your doctor before starting any medication.

Take your medication only with water.

Cellcept (Mycophenolate Mofetil - MMF) and Myfortic (Mycophenolate sodium)

Cellcept, an inosine monophosphate dehydrogenase inhibitor, prevents the body from rejecting the transplanted organ. It is generally used together with cyclosporine, tacrolimus and/or sirolimus.

Antacids containing magnesium and aluminum hydroxide reduce absorption and therefore should not be taken together with it.
The most common side effects are diarrhea, a decrease in white blood cell count, nausea and vomiting.
It causes an increased tendency to various infections.

Cyclosporine (Neoral - Sandimmun)

It is a medication that suppresses the immune system. It works by preventing the activation of T cells. It has two forms: oily liquid and capsule. Both are taken by mouth. The capsule form is swallowed with a little liquid like other medications. If you will be using the liquid form, your nurse or doctor will teach you how to measure the dose. You need to mix the dose appropriate for you with room-temperature milk, chocolate milk or orange juice and drink it immediately. However, you must make sure that no medication is left in the container in which you prepared it. One thing to remember: never take cyclosporine together with grapefruit juice! If you have taken the medication, do not eat grapefruit for at least two hours.

You must take care to take your medication at the same time every day! This will help keep the medication at the same level in your blood. If you forget to take the medication and remember within two hours, take the missed dose immediately and continue to keep to your medication times. If you do not remember until the time of the next dose, never take two doses; consult your doctor.

If you have vomiting and/or diarrhea, inform your doctor immediately. Diarrhea causes the medication to be eliminated from the body without benefiting you. This may cause rejection of the transplanted organ. If necessary, the medication will be given to you intravenously in this case. It is also recommended that you avoid using laxatives during this period.

Store your medication in a dry place, at room temperature. Leaving it in direct sunlight, in the refrigerator, or in extreme heat or cold will cause it to lose its effectiveness. In addition, if you are using the liquid form, do not use medication that has been open for more than 60 days. You will need to have your cyclosporine levels in your blood checked regularly with blood tests. On the days of tests, it is recommended that you take your medication exactly as you are told and bring it with you. Be sure to have your blood level checked at the times your doctor tells you. For blood levels to give accurate results, be sure to take your medications regularly at the specified times. The medication dose is adjusted according to the cyclosporine level in the blood.

Do not take your medication with grapefruit juice. Grapefruit juice affects the blood level. Do not drink grapefruit juice for at least 2 hours before and 2 hours after the medication time. Some medications (such as ketoconazole and erythromycin) can greatly affect the cyclosporine level. Therefore, as mentioned before, even if another physician recommends it, be sure to ask your doctor before starting any medication. You can take your medication with milk or orange juice

Side effects

Cyclosporine can cause many side effects. Most commonly, it can cause hypertension. After you start taking the medication, your blood pressure should be measured regularly. If necessary, your doctor may recommend that you take blood pressure medications. Your blood cholesterol and triglyceride levels may also rise. Your kidney and liver function values may increase. For this reason, you need to have your laboratory tests done regularly. It may cause trembling of the hands, headache, leg cramps, gum swelling, and nausea and vomiting. In addition, your hair may become thicker and more irregular, and its shape and distribution may change somewhat.

Because long-term use can cause swelling of the gums, attention must be paid to oral hygiene. It is recommended that you brush your teeth after every meal and visit the dentist for a check-up every 4-6 months. Your dentist should also know that you are using this medication.
Be sure to report any side effects you experience to your doctor. Impairment of kidney function
Increased hair growth, nausea, vomiting, diarrhea and headache may be observed.
Remember that your problems will decrease over time as the medication doses are reduced

Rapamune (Sirolimus)

Rapamune (Sirolimus) prevents your body from rejecting your new kidney by suppressing your immune system. In some cases it is also used to treat acute rejection.
It is used together with cyclosporine and prednisone.
Rapamune (Sirolimus) is available in liquid and tablet forms at dose concentrations of 1 - 5 mg. The liquid form can be mixed with orange juice or with water only. It should be mixed in a glass cup and drunk before it settles. If Rapamune (Sirolimus) is used with cyclosporine (Neoral), it is taken once a day, 4 hours after the morning dose of Neoral. The liquid form must be stored in the refrigerator, while the tablet form should be stored in a cool, dry place.

Side effects

Rapamune may reduce the white blood cell count in the blood and therefore increases susceptibility to infections. It may also reduce the platelet count and increase the tendency to bleeding. These two side effects can be reduced by dose adjustments.

Rapamune may cause indigestion, diarrhea, nosebleeds, headache, joint pain, and increased cholesterol and lipid levels

Certican (Everolimus)

It is a medication that suppresses the immune system. It suppresses the activation and proliferation of T cells. It is for oral use only. It is taken twice a day. The tablets should be swallowed whole with water without being crushed. They should be taken at the same times every day. When taken with fatty foods, grapefruit or grapefruit juice, its absorption decreases. It should be taken with water only.

Side Effects:

General: General pain, muscle weakness, swelling in the hands, feet, arms and legs, wheezing, difficulty breathing, sudden urge to urinate, signs of flu-like infection, fever, chills, sore throat, joint pain, swelling of the glands, new moles and swellings, unexpected bleeding and bruising, fatigue, headache, difficulty swallowing due to swelling of the face, lips, mouth, tongue and throat, shortness of breath and an increase in blood fats may occur.

Dermatological

Acne, heat rash in some areas of the body and skin sensitivity may occur.
Hematological: A drop in blood values due to bone marrow suppression may occur.
Gastrointestinal: Abdominal pain, diarrhea, nausea and vomiting may be seen.