| Medication |
Dose |
Side Effects |
| Tacrolimus |
0.15-0.2 mg/kg/day po divided q12h |
Alopecia, pruritus, photosensitivity, constipation, diarrhea, nausea, vomiting, anemia, leukocytosis, thrombocytopenia, headache, insomnia, paresthesia, tremor, seizure, leukoencephalopathy (rare), nephrotoxicity, hypertension, cardiomyopathy, prolonged QT interval, , diabetes mellitus, hypercholesterolemia,lymphoproliferative disease, , hypomagnesemia, hyperkalemia, hypophosphatemia, |
| Cyclosporine (modified) |
First two weeks after transplant 15 mg/kg/day po divided q12h then 4-12 mg/kg/day po divided bid |
Nephrotoxicity, hypertension, edema, arrhythmia,hirsutism, gingival hyperplasia, gynecomastia, diarrhea,
leukopenia, hypomagnesemia, hyperkalemia, hyperuricemia hyperglycemia, hyperlipidemia, tremor, paresthesia, leg cramps, weakness, encephalopathy, progressive multifocal leukoencephalopathy, seizure |
| Sirolimus |
loading dose of 3mg/m2, maintenance dose of 1mg/m2/d |
Hyperlipidemia, proteinuria, myelosuppression, pneumonitis, hypersensitivity reactions, hepatic artery thrombosis, poor wound healing, mouth ulcers, acne, edema, anemia, thrombocytopenia, arthralgia, headache, increased serum creatinine, fever, pain, progressive multifocal leukoencephalopathy |
| Mycophenolatemofetil |
10-15 mg/kg/dosepo BID (max 1 gram per dose) |
Diarrhea, abdominal pain, constipation, nausea, teratogenic, neutropenia, anemia, thrombocytopenia, constipation, nausea, hypertension, edema, opportunistic infections, hyperglycemia, hypocalcemia, hypokalemia, hypomagnesemia, hypercholesterolemia, pleural effusion, lymphoma, progressive multifocal leukoencephalopathy |
| Corticosteroids |
Induction with high dose methylprednisolone IV 20 mg/kg/dose (max 1 gram) weaned over 5 days to maintenance prednisone or prednisolone of approximately 0.2 mg/kg/dose po daily |
Hypertension, impaired wound healing,gastrointestinal ulcers, diabetes mellitus, fluid retention, adrenal insufficiency, depression, mood swings, insomnia, cataracts, weight gain,
osteopenia, pancreatitis, cosmetic (acne, cushing, striae), decreased growth |
| Basiliximab |
weight < 35kg: 10 mg IV x2
weight ≥ 35kg: 20 mg IV x2
1st dose given within 2h of transplant, 2nd dose on day 4 |
Hypersensitivity reaction, abdominal pain, vomiting, asthenia, dizziness, insomnia, edema, hypertension, anemia, dysuria, cough, dyspnea, fever |
| Rituximab |
375 mg/m2 iv weekly for 4 weeks |
Cytokine-release storm, increased risk of viral infections (cytomegalovirus, BK virus, polyomavirus JC, herpes simplex virus, varicella zoster, parvovirus B19), serum sickness, lymphopenia, neutropenia, leukopenia, thrombocytopenia, anemia |
| Antithymocyte globulin (rabbit) |
1.5 mg/kg/day administered by IV infusion for 7 to 14 days |
Cytokine-release storm, serum sickness, thrombocytopenia, leukopenia, neutropenia, hypertension, peripheral edema, post-transplant lymphoproliferative disease, hyperkalemia |
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