Drugs

I seem to be on allot of drugs. My anti rejection drugs are a low dosage due to the EBV. The doctors are trying to allow my immune system to strengthen to fight off the virus that came with the Kidney, a virus I did not have.

List Updated May 14 2023

TimeMedicationDosagePurpose
9:00 AMTacrolimus (Adagraph)4 mgAnti rejection
9:00 AMPrednisone7.5 mgAnti rejection
9:00 AMVitamin D1000 I.U.Sunshine
9:00 AMSodium Bicarbonate600 mg Acidosis
NoonElemental Iron300 mgSupplement
NoonB121000mgSupplement
NoonSodium Bicarbonate600 mgAcidosis
5:00 PMApo Sulphate (Septra)
Cotrimoxazole
80mgAntibiotic
5:00 PMSodium Bicarbonate600mgAcidosis
10:00 PMBizoprolol5 mgBlood Pressure
10:00 PMAmlodopine7.5 mgBlood Pressure
10:00 PMCoversyl8 mgBlood Pressure
10:00 PMVitamin D1,000 IUSunshine
10:00 PMWarfarin (Coumadin)*Anti Coagulant
10:00 PMSodium Bicarbonate600 mgAcidosis
* 4 mg Monday, Wednesday, Friday and Saturday; 6mg Sunday Tuesday and Thursday

Other Drugs I have been on or offered

Valgancylovire 450 mgAnti viralStopped Nov 2018
Azathioprine75 mg to 50 mg to noneanti rejectionside effects nausea was difficult
Pantoloctabletacid refluxdiscontinued after June 22 2019
THCsmall cookieControl EBVLow (micro) dose every second day for about 6 months see note below
Rosuvastatin5mgCholesterolNot Started: see note below
Forxiga (Dapagliflozin)10mgProlong life of kidneyCaused Swelling, stopped after 2 days see note below

Comments on side effects

Valgancylovire: Valganciclovir is an antiviral. It is used to treat infections caused by viruses. This medicine is also used to prevent Cytomegalovirus (CMV). CMV disease in patients who have received a kideny transplant.

One study claims ValGCV prevents CMV and may modify EBV infection risk:

Pediatric Transplant 2017 Feb;21 The efficacy of valganciclovir for prevention of infections with cytomegalovirus and Epstein-Barr virus after kidney transplant in children

Another said it had no effect on EBV but was effective for CMV

Pediatric Transplant 2019 May;23(3) Epub 2019 Feb 20. Cytomegalovirus and Epstein-Barr virus infections among pediatric kidney transplant recipients at a center using universal Valganciclovir Prophylaxis Grant Paulsen; Pia Cumagun; Emily Mixon

~*~

Pantoloc: Pantoprazole is a proton pump inhibitors (PPIs). It was prescribed because of gastroesophageal reflux disease (GERD, reflux esophagitis). It reduces the amount of acid the stomach produces. When on dialysis I was on a PPI and across the board they discontinued use for all patients in the dialysis unit due to an increase in dementia.

Curr Gastroenterol Rep. 2010 Dec; PMID: 20882439
Association of Long-term Proton Pump Inhibitor Therapy with Bone Fractures and effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium Tetsuhide Ito, MD, PhD1 and Robert T. Jensen, MD2

This study shows long-term effects of chronic acid suppression on the absorption of vitamins and nutrients. It does show any relationship with dementia however.

THC: A number of compounds are thought to inhibit EBV. One that has shown to inhibit EBV is THC in vitro. (in a petri dish)

BMC Medicine volume 2, Article number: 34 (2004)
Delta-9 tetrahydrocannabinol (THC) inhibits lytic replication of gamma oncogenic herpesviruses in vitro Medveczky, Sherwood, Klein

After the legalization of Marijuana and checking with my family doctor and 4 nephrologists at the Ottawa General all of whom except 1 said there was no harm in trying I proceeded to test the in vitro results in real life by baking some micro dose cookies.

Over a 6 month trial where I started and stopped the TCH, during which I was being tested monthly for EBV, I found the EBV diminished in correlation with the mirco does. The “study” was not conclusive for the following reasons
1: The hospital regularly mistakenly did EBV binary tests rather than quantitative tests so my results were inconsistent.
2: I did not like the THC “high” leading to inconsistent use
3: My record keeping was not perfect.
4: The doctors became hostile to the idea, making stereotypical comments not able to differentiate between a 60 year old scientifically oriented former president of an international trading company and a 16 year old trying pot for the first time.

In any event the THC interacted with the Tacrolimus leading to severe auditory hallucinations leading me to stop the “experiment” despite a conviction it did have an effect on the EBV

Rosuvastatin: Statins and Risk of New-Onset Diabetes Mellitus
Shah and Goldfine 30 Oct 2012

Statins increase the risk of developing diabetes, increase the risk of memory loss and prevent cardiovascular events in patients who have had a previous heart attack or those with multiple cardiovascular risk factors.

Diabetes mellitus was diagnosed in 27% more patients receiving a statin (rosuvastatin) compared with patients receiving placebo (an identical appearing pill that does not contain medication), but patients receiving the statin had a significant 54% lower risk of heart attack, 48% lower risk of stroke, and 20% lower risk of death from any cause.

Statins are a reductase inhibitor that blocks a critical step in the production of LDL cholesterol in the liver. Aside from lowering LDL, statins reduce inflammation and promote health of the lining of the blood vessels.

For every 40-mg/dL drop in the LDL cholesterol level, there is a 13% reduction in the risk of death from any cause in patients without diabetes. Other medications used to treat high cholesterol (eg, fibrates, niacin, and bile acid sequestrants) have not yet shown a similar degree of benefit for heart health.

The strongest predictors of diabetes includes age, weight, higher blood sugar levels before statin use. Teating 255 patients with statins for 4 years led to 1 extra case of diabetes mellitus, whereas 5.4 cardiovascular events were prevented.

Doctors are confident in a consistent association between statin therapy and the development of new-onset diabetes mellitus or worsening of diabetes mellitus and an improvement in Cardiac outcomes.

Forxiga

Round 1: I took the drug for a few days and was confused, bloated and discontinued use. My dose was 10mg once a day.

Round 2: Dr K insisted I be on a drug due to my kidney GFR of 24. It was explained to me that Forxiga would extend my kidney life. An alternative drug was offered.

Discussed alternatives with pharmacist L

I started Foxiga at 5mg and took it for 2 weeks. The side effects were as follows

~memory loss, “blank brain”
~sleepiness, “always sleep ready”
~excessive urination “more than usual”
~slight / occasional stinging on urination
~dizziness (worsening of)
~Tinnitus (worsening of)
~Hearing loss (worsening of)
~blurring of vision (worsening of)
~no change in weight, in vivid dreams but I think gerd was lessened?

Discussion with Dr F at my clinic visit
~He noted the increase in sugar in urine indicating it was working
~At 10 mg he said we would see more sugar in urine.
~Suggested I stop to see if the symptoms disappear, or continue depending on my tolerance and acceptance of the drug.
~After a few more days with worsening symptoms I decided to stop the drug and see what happens with side effects, Dec 7 last day 5mg

~At my request pharmacist made up blister packs with 10 mg in 2 – 5mg doses to give me flexibility. I have removed from dose and not taken.