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What is immuno­suppression?

Immunosuppression helps fight kidney, liver, and heart transplant rejection

When it comes to a kidney, liver, or heart transplant, your body usually sees a new organ as an invader. The body uses its self-defense, the immunity system, to protect against things that could harm it, like germs and viruses. Left to its own devices, the immune system can attack a newly transplanted organ much like it would a foreign substance.

Immunosuppressants are drugs that can fool the immune system into thinking that the transplanted organ is part of the body. Immunosuppressants enable the new organ and the body to coexist peacefully.1,2

Because an immunosuppressant fools your immune system into overlooking a transplanted organ, the immune system may also overlook potential harms to the body. This may make a person more susceptible to infection and other illnesses.3,4

Tips: How to avoid infections while on immunosuppressant therapy2
  • Wash your hands often
  • Stay away from people who may be sick
  • Avoid people who have recently received vaccinations (some vaccines contain live viruses)
  • Stay away from crowds of people
  • Have someone else clean out the cat’s litter box
  • Clean and cover cuts and scratches; call your doctor if you see signs of infection
  • Maintain good oral health by brushing and flossing daily
  • Practice safe sex to avoid sexually transmitted diseases
Talk to your healthcare provider for additional suggestions

What should you know about immunosuppressant therapy?

The attending doctor will decide how long you take an immunosuppressant after transplantation. They are most familiar with you and your medical history.

Over time, the healthcare team may change the immunosuppressant therapy and dosages. They will work to find the combination that best prevents rejection, while keeping side effects to a minimum.2

  • Take immunosuppressant medications exactly the way your doctor prescribes to help avoid complications2
  • Check with your transplant team before taking any new medicines, even over-the-counter medicines5
  • If any of your medications becomes soft, sticky, hard or cracked, or has a notably different color or odor, ask your pharmacist to replace it5
  • Keep a list of your medications with you at all times5
  • Use pillboxes to organize your doses—either weekly or daily—ahead of time and keep track of what you take2
  • Call the pharmacy for refills before you run out of medication2

What are the warning signs of transplant rejection?

The specific symptoms of transplant rejection partially depend on which organ was transplanted—kidney, liver, or heart.

For example, if the body is rejecting a kidney, the patient may produce less urine. If the body is rejecting the liver, the patient may bleed easily and their skin may turn yellow. If the body is rejecting the heart, the patient may experience shortness of breath and have difficulty exercising.3

In general, symptoms of transplant rejection may include:

  • Chills
  • Aches
  • Shortness of breath
  • Nausea
  • Coughing
  • General discomfort
  • Uneasiness

Symptoms rarely include fever, pain, or swelling in the area of the transplanted organ.

If you ever suspect you are experiencing the symptoms of transplant rejection, it’s essential that you contact your healthcare team.

USE6,7

GENGRAF® Capsules (cyclosporine capsules, USP [MODIFIED]) and GENGRAF® Oral Solution (cyclosporine oral solution, USP [MODIFIED]) are prescription medicines used to help prevent organ rejection in people who have received a kidney, liver, or heart transplant. Cyclosporine (MODIFIED) has been used with other immunosuppressants, such as azathioprine and corticosteroids.

IMPORTANT SAFETY INFORMATION6,7

WARNING

While you are on this treatment, it is important to be under the care of a doctor who has experience treating and monitoring organ transplant patients who are taking medicines like GENGRAF.

GENGRAF is an immunosuppressant, a drug that reduces the body’s ability to fight illness and disease. Immunosuppressant drugs may increase your chances of getting an infection and certain types of cancers. In organ transplant patients, using GENGRAF with other immunosuppressants may increase this effect.

Different formulations of cyclosporine deliver different amounts of medicine. Do not switch formulations of cyclosporine without your doctor’s permission and direction, as switching formulations may require a dosage change.

GENGRAF can cause high blood pressure and kidney problems. This risk increases the longer you take GENGRAF and with higher doses. Ongoing laboratory tests must be performed to monitor your kidney function while you are being treated with GENGRAF.

  • Do not take GENGRAF if you are allergic to cyclosporine or any of the ingredients in GENGRAF.
  • Occasionally patients have developed a condition that causes damage to the small blood vessels, which may result in graft failure.
  • Occasionally some patients have experienced abnormally high levels of potassium in their blood.
  • Cases of liver damage, including liver failure, have been reported in patients treated with cyclosporine. In some cases, fatal outcomes have been reported. Most reports included patients who also had other medical conditions. Ongoing laboratory tests must be performed to monitor your liver function while you are being treated with GENGRAF.
  • Patients receiving immunosuppressants, including cyclosporine, are at an increased risk of developing lymphomas and other types of cancers, especially skin cancers. Some of these cancers may be fatal. You should avoid excess sun exposure, including tanning booths.
  • Transplant patients taking cyclosporine are at an increased risk for serious infections, some of which may have fatal outcomes. Infections may include the polyoma virus, which may have a serious and sometimes fatal outcome.
  • There have been reports of convulsions (uncontrolled shaking of the body) in patients taking cyclosporine and, in particular, in patients also taking high doses of corticosteroids.
  • High blood pressure is a common side effect of taking cyclosporine.
  • During treatment with cyclosporine, vaccination may be less effective, and the use of vaccines containing live viruses should be avoided.
  • You should take GENGRAF exactly as prescribed by your physician. This includes taking your medication on the same schedule every day. You should avoid grapefruit and grapefruit juice while taking GENGRAF.
  • Tell your doctor about any other medications, vitamins, nutritional supplements, or herbal products you are taking. GENGRAF and other medicines may affect each other, causing side effects. GENGRAF may affect the way other medicines work, and other medicines may affect how GENGRAF works.
  • If you are or are planning to become pregnant, tell your doctor right away and follow the instructions you receive about taking GENGRAF.
  • The most common side effects include kidney problems, high blood pressure, abnormal hair growth on your body or face, tremor, headache, nausea, vomiting, swollen or painful gums, low number of white blood cells, urinary tract infections, and other infections.

References:

1. UNOS. Talking about transplantation: what every patient needs to know [brochure]. https://www.unos.org/wp-content/uploads/unos/WEPNTK.pdf. Accessed July 23, 2020.

2. WebMD. Living with immunosuppression after an organ transplant. https://www.webmd.com/a-to-z-guides/organ-transplants-antirejection-medicines-topic-overview#1. Reviewed June 4, 2017. Accessed July 23, 2020.

3. US Medline Plus. US National Library of Medicine. Transplant rejection. https://medlineplus.gov/ency/article/000815.htm. Updated April 5, 2018. Accessed July 23, 2020.

4. National Institutes of Health. Organ transplants and cancer risk. https://www.nih.gov/news-events/nih-research-matters/organ-transplants-cancer-risk. Published November 21, 2011. Accessed July 23, 2020.

5. UNOS Transplant Living. Preventing rejection. https://transplantliving.org/after-the-transplant/preventing-rejection/. Accessed July 23, 2020.

6. GENGRAF Capsules [package insert]. North Chicago, IL: AbbVie Inc.

7. GENGRAF Oral Solution [package insert]. North Chicago, IL: AbbVie Inc.

Please see full Prescribing Information for additional information about GENGRAF Capsules.

Please see full Prescribing Information for additional information about GENGRAF Oral Solution.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

If you are having difficulty paying for your medicine, AbbVie may be able to help. Visit AbbVie.com/myAbbVieAssist to learn more.

If you have any questions about AbbVie's Gengraf.com website that have not been answered, click here. This website and the information contained herein is intended for use by U.S. residents only and is provided for informational purposes only.

+

USE6,7

GENGRAF® Capsules (cyclosporine capsules, USP [MODIFIED]) and GENGRAF® Oral Solution (cyclosporine oral solution, USP [MODIFIED]) are prescription medicines used to help prevent organ rejection in people who have received a kidney, liver, or heart transplant. Cyclosporine (MODIFIED) has been used with other immunosuppressants, such as azathioprine and corticosteroids.

IMPORTANT SAFETY INFORMATION6,7

WARNING

While you are on this treatment, it is important to be under the care of a doctor who has experience treating and monitoring organ transplant patients who are taking medicines like GENGRAF.

GENGRAF is an immunosuppressant, a drug that reduces the body’s ability to fight illness and disease. Immunosuppressant drugs may increase your chances of getting an infection and certain types of cancers. In organ transplant patients, using GENGRAF with other immunosuppressants may increase this effect.

Different formulations of cyclosporine deliver different amounts of medicine. Do not switch formulations of cyclosporine without your doctor’s permission and direction, as switching formulations may require a dosage change.

GENGRAF can cause high blood pressure and kidney problems. This risk increases the longer you take GENGRAF and with higher doses. Ongoing laboratory tests must be performed to monitor your kidney function while you are being treated with GENGRAF.

  • Do not take GENGRAF if you are allergic to cyclosporine or any of the ingredients in GENGRAF.
  • Occasionally patients have developed a condition that causes damage to the small blood vessels, which may result in graft failure.
  • Occasionally some patients have experienced abnormally high levels of potassium in their blood.
  • Cases of liver damage, including liver failure, have been reported in patients treated with cyclosporine. In some cases, fatal outcomes have been reported. Most reports included patients who also had other medical conditions. Ongoing laboratory tests must be performed to monitor your liver function while you are being treated with GENGRAF.
  • Patients receiving immunosuppressants, including cyclosporine, are at an increased risk of developing lymphomas and other types of cancers, especially skin cancers. Some of these cancers may be fatal. You should avoid excess sun exposure, including tanning booths.
  • Transplant patients taking cyclosporine are at an increased risk for serious infections, some of which may have fatal outcomes. Infections may include the polyoma virus, which may have a serious and sometimes fatal outcome.
  • There have been reports of convulsions (uncontrolled shaking of the body) in patients taking cyclosporine and, in particular, in patients also taking high doses of corticosteroids.
  • High blood pressure is a common side effect of taking cyclosporine.
  • During treatment with cyclosporine, vaccination may be less effective, and the use of vaccines containing live viruses should be avoided.
  • You should take GENGRAF exactly as prescribed by your physician. This includes taking your medication on the same schedule every day. You should avoid grapefruit and grapefruit juice while taking GENGRAF.
  • Tell your doctor about any other medications, vitamins, nutritional supplements, or herbal products you are taking. GENGRAF and other medicines may affect each other, causing side effects. GENGRAF may affect the way other medicines work, and other medicines may affect how GENGRAF works.
  • If you are or are planning to become pregnant, tell your doctor right away and follow the instructions you receive about taking GENGRAF.
  • The most common side effects include kidney problems, high blood pressure, abnormal hair growth on your body or face, tremor, headache, nausea, vomiting, swollen or painful gums, low number of white blood cells, urinary tract infections, and other infections.