Schedules change often
Medication schedules change after almost every clinic visit based on lab results. Always re-confirm the current schedule after each appointment.
Golden rules
Never miss a dose
Anti-rejection meds must be taken every day, on time, for life. Missing doses can cause rejection of the kidney.
- Take meds at the same time every day (a 30-minute window is okay).
- No grapefruit or grapefruit juice — ever.
- Always carry a 2-day supply when leaving the house.
- Refill prescriptions 1 week before running out.
- Check with the transplant team before starting any new medicine — including over-the-counter.
Daily medication schedule
| Time | Medication | Dose / Notes |
|---|---|---|
| 7:30 AM | Levothyroxine 137 mcg | Take on empty stomach if this is how she was instructed. The pasted list shows the med but not timing/directions, so verify. |
| 8:00 AM | Tacrolimus / Prograf | 4 mg = 4 capsules. Must be taken at 8 AM. |
| 8:00 AM | Hydralazine | 25 mg — every 8 hours. |
| 8:00 AM with breakfast | Prednisone | 10 mg daily. |
| 8:00 AM with breakfast | Mycophenolate / Myfortic | 180 mg — 1 tablet. |
| 8:00 AM with breakfast | Carvedilol / Coreg | 25 mg — 1 tablet. |
| 8:00 AM with breakfast | Amlodipine / Norvasc | 10 mg daily. Take 5 mg if SBP < 120 mmHg, per instructions. |
| 8:00 AM with breakfast | Letermovir / Prevymis | 480 mg daily. |
| 8:00 AM with breakfast | Fluconazole / Diflucan | 200 mg daily. |
| 8:00 AM with breakfast | Aspirin | 81 mg daily. |
| 8:00 AM with breakfast | Multivitamin | 1 tablet daily. |
| 8:00 AM with breakfast | Zinc sulfate | 220 mg daily with morning meal. |
| 8:00 AM with breakfast | Culturelle probiotic | 1 capsule. |
| Midday / lunch | Ceftriaxone / Rocephin | 2 g IV daily via catheter, if still actively prescribed. Keep same time daily if possible. |
| 4:00 PM | Hydralazine | 25 mg — second daily dose. |
| 6:00 PM with dinner | Carvedilol / Coreg | 25 mg — second daily dose. |
| 6:00 PM with dinner | Mycophenolate / Myfortic | 180 mg — second daily dose. |
| 6:00 PM with dinner | Culturelle probiotic | 1 capsule — second daily dose. |
| 8:00 PM | Tacrolimus / Prograf | 5 mg = 5 capsules. Must be taken at 8 PM. |
| 10:00 PM bedtime | Rosuvastatin / Crestor | 5 mg at bedtime. |
| 10:00 PM bedtime, if needed | Melatonin | 5 mg as needed for insomnia. |
| 12:00 AM midnight | Hydralazine | 25 mg — third dose to keep every 8 hours. Ask the care team if they want this exact overnight timing or a modified schedule. |
Meds with special schedules
| Medication | Schedule |
|---|---|
| Famotidine / Pepcid 10 mg | Every other day. Best placed 8 AM with breakfast on scheduled days unless told otherwise. |
| Bactrim 400-80 mg | 1 tablet 3 times per week. Commonly Mon/Wed/Fri, but verify assigned days. Take with breakfast. |
| Valganciclovir / Valcyte 450 mg | Listed as 3 times per week, but instructions say wait to take until doctor tells you to start again due to leukopenia. Do not restart unless cleared. |
| Levofloxacin 250 mg | Every other day for 1 dose only, if that dose has not already been completed. Verify before giving. |
As-needed meds
| Medication | When to use |
|---|---|
| Tylenol / acetaminophen | 650 mg every 6 hours as needed for mild pain or fever. Watch total daily acetaminophen limits. |
| Oxycodone 5 mg | Every 6 hours as needed for acute pain. Avoid mixing with other sedating meds unless approved. |
| Methocarbamol / Robaxin 500 mg | Up to 4 times daily as needed for muscle spasms. Can cause sleepiness. |
| Miralax | 17 g up to 2 times daily as needed for constipation. |
| Bisacodyl suppository | 10 mg rectally up to 2 times daily as needed for constipation. |
Cleanest pill box grouping
- Morning breakfast, 8 AM: biggest group — transplant meds, BP meds, infection prevention, supplements.
- Dinner, 6 PM: second dose meds.
- 8 PM: tacrolimus only, ideally kept consistent.
- Bedtime, 10 PM: statin and optional melatonin.
- Hydralazine: the awkward one — 8 AM / 4 PM / midnight unless the care team adjusts it.
Missed a dose?
- If it's within 2 hours of the missed time — take it now.
- If it's been longer — call the transplant coordinator before doubling up.
- Never take a double dose without medical advice.