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Ask your Pharmacist: Kidney-Transplant patients

Monday, 31st March, 2014 4:49pm
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Ask your Pharmacist: Kidney-Transplant patients

What Over-the-Counter (OTC) medication can you take?

Part 1

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

Organ Donor Awareness Week is this week (March 29th to April 5th). Give the gift of life by getting an organ donor card from the Irish Kidney Association on LoCall 1890 543639 or logon to www.ika.ie. While I specifically deal with kidney transplants this week, much of the advice I give is true for any type of transplant (eg) Heart, lung, liver. Kidney failure has many causes including diabetes, high blood pressure and injury. Kidney failure causes a build-up of waste products and fluids leading to tiredness and fatigue, oedema (swelling), nausea and poor appetite and even death if a suitable donor is not found.

Medication to avoid

When you have a kidney transplant, medication called immunosuppressants are prescribed to prevent the body rejecting the new kidney. Some medications interfere with the immunosuppressive medications. Antibiotics to avoid include clarithromycin (Klacid®), erythromycin and azithromycin (Zithromax®). Other drugs to avoid include the antifungal fluconazole (Diflucan®) and the heart rhythm drug diltiazem (Dilzem®).

AVOID grapefruit or grapefruit juice when prescribed immunosuppressants like Neoral®, Prograf® or Rapamune®; grapefruit changes the metabolism of these medications. Avoid antacids such as Rennies®, Maalox® or Gaviscon® within 2 hours of taking your medications as they may reduce absorption of many anti-rejection drugs.

Herbal preparations and supplements

Herbs can cause serious interactions with kidney transplant drugs and can also affect the kidneys. *Some herbs reduce the effectiveness of transplant rejection medication. *Herbs may not be pure because of unregulated manufacture procedures. There have been reports of herbs containing bacteria, pesticides and metals including lead and mercury. *Some herbs are toxic effects to the liver, kidneys, and heart, especially when taken with other medication including changes in blood pressure, blood sugar and potassium levels leading to risk of bleeding and transplant rejection. *Dosages can vary from pill to pill, manufacturer to manufacturer or from what is stated on the label. To be safe, transplant patients should avoid herbal preparations.

What Over the Counter Medication is safe?

Headache, Fever, and Body Aches

Paracetamol eases mild pain and fever and is safe for kidney transplant patients (but use in caution if you had a liver transplant). Non-steroidal anti-inflammatory drugs (NSAIDs) must be avoided as they can harm the kidneys and interact with some immunosuppressants. Ibuprofen (Nurofen®) is a common NSAID sold over the counter. Aspirin is a relation of NSAIDs so should also be avoided unless prescribed for medical reasons (eg) low dose aspirin to prevent clots

Sneezing, Itching and Runny Nose

Antihistamines can be safely used by transplant patients. Loratadine (Clarityn®) and cetirizine (Zirtek®) are recommended as they cause less drowsiness than other anti-histamines. Chlorpheniramine (Piriton®) is also safe to use but is best used at bedtime as it causes more drowsiness. Avoid combination (multi-symptom) cold, sinus, and flu products (Benilyn Day & Night®, Benylin 4Flu®, Nurofen Cold and Flu®). Treat each symptom individually to avoid accidentally taking a drug that can cause kidney problems.

Sore Throat

Most throat lozenges (eg. Strepsils®) are safe to use and there are sugar free versions for diabetics.

To be continued next week.

Disclaimer: Consult with your healthcare professional before making any changes recommended.

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