Patient's questions

Dear patient,
You've had an organ transplant. Your life has significantly changed. We want to help. We would like to offer you some important information and advice on how to take your immunosuppressant drugs and on your proper healthcare regimen.


What is Equoral® capsules?


Equoral® is a prescription medication that helps prevent your body from rejecting your newly transplanted organ. More specifically, it inhibits certain types of white blood cells from multiplying and attacking your newly transplanted organ. As a result, you increase the chances that your body will accept your new organ. In most cases, you'll be taking Equoral® with other medications that will work together to suppress your immune system. There are only two differences: the name and the price. Equoral® and Neoral®* are brand forms of cyclosporine. It is simply a name given to the drug by its manufacturer. Equoral® has been clinically proven to be bio-equivalent to Neoral®*.

What makes Equoral® equivalent to Neoral®*?

  • They have the same active ingredients.
  • Both are available in the same forms, capsules and oral solution.
  • The medications are both taken the same way.
  • They have the same effect on your body in controlled tests.
  • They meet the FDA's requirements for bio-equivalence.
* Neoral® is a registered trademark of Novartis Corporation.

What are generic drugs?

A generic drug replicates a brand-name drug in dosage, safety, strength, quality and performance.

Are generic drugs as safe as brand-name drugs?

Yes. The FDA requires that all drugs be proven safe and effective.

Do generic drugs take longer to work in the body?

No. Generic drugs work in the same amount of time and in the same manner as the brand-name drug.

If brand-name drugs and generic drugs have the same active ingredients, why do they look different?

Trademark law does not allow a generic drug to look exactly like the brand-name drug. However, a generic drug must contain the same active ingredient even though colors, flavors and certain other inactive ingredients may be different.

Why are generic drugs less expensive than brand counterparts?

Generic drugs are less expensive because their manufacturers don't have the investment costs of developing a new drug from scratch. New drugs are developed under patent protection. The patent is designed to help protect investment in research and development, marketing and promotion, by giving the company the sole right to sell the drug while the patent is in effect.

As patents near expiration, manufacturers can apply to the FDA to sell generic versions. Because generic manufacturers don't have the same development costs, they can sell their product at substantially lower costs. Today, almost half of all prescriptions are filled with generic drugs. (1)

(1 IMS Data, 2005)

Where can I find additional information on generic drugs?

Contact your physician, pharmacist or insurance company for information on generic drugs. You can also visit the FDA website at www.fda.gov/cder/ogd/index.htm for additional information.

The health information contained herein is provided for individual educational purposes only and is not intended as a replacement for discussions with a healthcare provider. Only physicians experienced in the management of systemic immunosuppressive therapy for the indicated disease should prescribe Equoral® capsules and oral solution. All healthcare decisions regarding patient care must be made by a licensed healthcare provider who is qualified to prescribe Equoral® and will take individual circumstances into consideration.

Immunosuppressant drugs

You've had an organ transplant. But your new organ is still a stranger to your body's immune system, which resists and attacks all foreign invaders, such as viruses and bacteria. Immunosuppressant keep your immune system from attacking your new organ. However, these drugs also may weaken your body's immune defenses against contagious diseases, and even cancer. Both of these factors must be balanced, so that your drug therapy still prevents organ rejection, but your immune system remains strong enough to fight off other infections and diseases. The most critical need for immunosuppressant therapy is during the period immediately after your transplant, when the largest dosage is prescribed. This is sometimes decreased over a period of months, and perhaps discontinued eventually. In some cases, however effective immunosuppressant therapy may still be required years after your transplant and often for the rest of your life.


Dosage is critical. YOU MUST NEVER CHANGE THE DOSAGE YOURSELF OR STOP TAKING THE DRUG! It could cause the rejection of the organ or keep it from functioning properly. It could be fatal.

Immunosuppressants can have some undesirable side effects and can be harmful in higher doses, like many other drugs. Establishing and maintaining the correct dosage is essential, and must be carefully monitored by your doctor. Your doctor will closely watch the levels of the drug in your blood through regular simple blood tests. At first, these tests must be quite frequent to establish the correct dosage level. You must carefully follow the instructions of the doctor or nurse during this testing, and don't be afraid to ask questions if the instructions are complicated. Your active cooperation is necessary for optimum results.

Immunosuppressant drugs are targeted specifically, and are not commonly used in general medical practice. In addition, drug interactions with your other medication can significantly influence the level of immunosuppressant in your blood. If it reduces the level, it can decrease the drug's efficiency, making it less effective and increasing the risk of organ rejection. If it increases the level of the immunosuppressant in your blood, it could reach the toxic levels. Therefore, you MUST always inform your doctor that you are taking immunosuppressants.


Other basic principles:

It is very important for you to be aware that your overall lifestyle can significantly affect your health and the function of your organ. Diet, exercise and social habits like drinking and especially smoking can seriously affect the success of your transplant. Your body may still be recovering from the disease or injury that made your transplant necessary, so you must treat it well. Also, the side effects of immunosuppressant drugs can sometimes mean an increased risk of diseases like high blood pressure, diabetes, obesity, and others.

Nutrition and diet

Proper nutrition and good eating habits have a strong impact on anyone's general health, but they are even more important for the post-transplant patient. They are especially important as a daily defense against opportunistic infections that could attack your weakened immune system. Since some drugs used in post-transplant therapy can cause undesirable metabolic effects, such as a dramatic increase in appetite and resultant weight gain, obesity is often a serious problem in post-transplant patients. Watch your diet carefully, and watch your health too. Report any sudden changes to your physician. Your diet should include lots of fresh fruits and vegetables, whole-grain baked goods, lean meat, fish, poultry, low-fat milk and dairy products. It is essential to drink adequate fluids - at least 2 liters daily. Water is best but tea and low-sodium mineral waters are also OK. Avoid fatty and high sodium foods such as smoked meat and fish, fatty meats, sweets, baked goods from white processed flour, etc.

Alcohol

Drinking any alcoholic beverage after transplantation is not recommended. Alcohol combined with many vitally important post-transplant drugs can result in liver damage, or even failure.

Smoking

It's a well-known, confirmed scientific fact that smoking is hazardous to your health. In addition, there are many specific studies indicating that smoking has a negative influence on the long-term function of the transplanted organ. So, give up smoking! Now! If you need help kicking this life-threatening habit, contact a specialist.

Movement, physical & mental activity

Exercise is vital to both your physical and mental health. So try to walk, cycle, or swim as soon as possible during recovery. Consult your physician about other sports activities you may prefer. Mental activity and social activity can help you recover as well. Try to resume a normal life style. Reading, meeting friends, working on your hobbies, or beginning new hobbies all can help you feel better and make you feel stronger as well.

High blood pressure

High blood pressure or hypertension is frequently found in post-transplant patients. It can be already present before the transplant, possibly caused by the same illness that made the transplant necessary, or it can often be caused by drug interactions, poor diet, stress or it can be a side effect of your immunosuppressant drug. If high blood pressure is not treated, it can damage your heart and increase the rate of arteriosclerosis ("hardening" of blood vessels or arteries). This in turn can cause other serious complications, which can significantly affect your quality of life. So, you must regularly check your blood pressure and take any prescribed high blood pressure medication as directed by your doctor. We recommend getting a home blood pressure monitoring kit, and using it daily. You and your doctor must work together to determine the most suitable blood pressure medication for you. Changing your life style can also reduce high blood pressure. Follow a low-sodium and low-fat diet, give up smoking & get regular exercise and sleep.

Diabetes

Diabetes (diabetes mellitus) is a disease in which the level of sugar in your blood increases. Some of your immunosuppressant drugs could possibly cause elevated blood sugar level. If you become diabetic, your doctor will prescribe diet and medication to control this problem. You can help control or even prevent diabetes as a side effect by losing weight, following your diet restrictions, and exercising regularly.

Remember these basic guidelines!

Try to take your drugs daily at the same time every day at regular intervals. For example, if you take your immunosuppressant twice a day, use a 12-hour interval that's convenient and easy to remember, i.e. 8 a.m. and 8 p.m.

Never change your own drug dosage, and never stop a drug yourself. Follow your doctor's orders.

Never take a drug after the expiration date stamped on packet.

Store all drugs in a dry place, out of the sunlight, unless there are different storage instructions on the package, such as "refrigerate".

Do not start taking any drug, prescription or over-the-counter, without permission of your doctor.

If you see another doctor besides your transplant doctor, always tell them you are taking an immunosuppressant drug and give the name and dosage. Also, contact your transplant doctor and report any new prescribed medications. A list of medications and dosages is a good idea.

Always keep in touch with your transplant center doctor. Communicate any noticeable changes in your health.

Always check to make sure that you have enough drugs to last until your next doctor's visit.

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