Medication times

In summary, the following rules should always be followed for taking medication: 

• The medications should be taken regularly at the same time, as recommended by the doctor.

• The dose should not be changed even if the patient feels very well or is suffering short-term from side effects of the medications.

• If a much higher dose than the recommended one has been taken accidentally or more than one dose of the medication has been forgotten, the doctor should be informed.

If the medication is forgotten only once, the patient should continue to keep to the normal schedule (and not take a double dose the next time).

Additional medications not prescribed by the treating doctor should never be purchased in a pharmacy or drug store and taken. Because of the complex mechanisms of the immunosuppressive drugs, they are known to have considerable interactions with other, often completely harmless medications. For instance, taking St. John’s wort, a herbal medication frequently used for depression, can greatly reduce the serum levels of the immunosuppressive drugs and lead to rejection reactions.

In addition, the basic immunosuppressive drugs ciclosporin and tacrolimus should not be taken with grapefruit juice. This is metabolised by a similar enzyme and can therefore inhibit breakdown of the drugs. This can lead to considerably raised levels of the medications, which in turn can result in major side effects.