Supply of medication after a solid organ transplant

Who is the leaflet for? What is its aim?

This information is for patients and their families / carers who have received a solid organ transplant, are under the care of the Cambridge transplant unit and who have been prescribed any of the following medicines:

• Tacrolimus (Adoport®, Advagraf®, Prograf®), ciclosporin (Neoral®) or sirolimus (Rapamune®)
• Mycophenolate mofetil, mycophenolic acid or azathioprine
• Prednisolone
• Valganciclovir

The aim of this leaflet is to explain how continued supplies of these medicines will be made from Addenbrooke’s hospital.

How does the service work?

After your discharge from hospital and whilst you are under the care of the Cambridge transplant unit, all your supplies of the medicines listed above will continue to be made via the outpatient pharmacy at Addenbrooke’s hospital. For medication other than those listed above you should continue to order further supplies via your GP.

Please follow these steps to obtain a re-supply of your medication during a clinic appointment at Addenbrooke’s hospital; this applies whether your appointment is completed face-to-face or via telephone.

1. Before your transplant outpatient clinic appointment, count the number of tablets you have remaining for each relevant medication listed above, in order to work out how many days’ supply you have left.
2. During your clinic appointment, if you do not have enough medication to last until your next planned follow-up appointment, please ask the doctor to prescribe the medication you require. This applies both to face-to-face and telephone appointments.
3. A prescription will be sent electronically to the outpatient pharmacy who will dispense the medication. You will receive it via one of the following routes:
   1. If you are attending Addenbrooke’s Hospital for a face-to-face appointment, you can collect the medication after your appointment. If you are not able to wait for your prescription to be dispensed, for example if you are using hospital transport or have childcare commitments, please let the doctor know so that arrangements can be made to post the medication to you.
   2. If your appointment was completed via telephone, the medication can be posted to you. If you require it to be sent to an address that is different from your home address, please let the doctor know. The medication will be sent via Royal Mail Special Delivery, or by a local delivery driver, and will require a signature on receipt. If you are not at home to receive the delivery, a card will be left by Royal Mail advising you about where you can collect your medication, or the local delivery driver will return the medication to the outpatient pharmacy who will then post it out to you.

What if I am running out of medication before or after my clinic appointment?

If your medication will not last until your next clinic appointment, please contact the transplant pharmacy team who will arrange for a prescription. The prescription can be collected from the outpatient pharmacy at Addenbrooke’s hospital if you live locally, or posted to you. Please see the details below for how to contact the pharmacy team. Please note if you contact us by telephone, you will reach a voicemail to leave your details. We do not routinely reply to voicemail messages unless we need to contact you to clarify your details. Voicemail messages are checked regularly.

What if I am seen in a different hospital?

If your care is transferred to another hospital, responsibility for prescribing the medicines listed above will also transfer to that hospital. Please ask the clinic doctor at the hospital how to obtain further supplies of your medicines.

If you have had a liver transplant, the supply of medicine from the other hospital will only apply 90 days after your transplant. Before 90 days, medications will be supplied by

Addenbrooke’s hospital, even if you are seen in another hospital. For all other patients, medicines will be supplied by the other hospital as soon as your care is transferred there.

Benefits (advantages)

Supplies of these medicines can be delivered free of charge to your home or chosen address, without the need for you to deal with supply problems in the community.

The transplant unit will be able to monitor your immunosuppression medication and ensure that you are always supplied with the correct brand.

Risks (disadvantages)

You will need to obtain your medicines from two places.

Most medicines will be supplied via your GP. However, any of the medicines listed above that are relevant to you will be supplied via Addenbrooke’s Hospital.

Alternatives

The alternative to this service is for your GP to prescribe all your medication. However, since 2013 GPs have been told by the government that they are not to prescribe the medicines listed above, hence this option may not be available to you. Also, your local pharmacy may not always be able to maintain supply to you of certain transplant medications.

Prescription fees

Unfortunately, transplant patients are not exempt from prescription charges based on organ transplantation. Please see the link below to check if any of the exemption criteria applies to you. Who can get free prescriptions - NHS (opens in a new tab) includes details of a pre-payment certificate, which could be a more cost-effective option depending on the number of medications you require.

Contacts / further information

For further information, and for urgent supplies of these medicines, please contact the transplant pharmacy team on 01223 254934 (a phone message can be left on this number) or email the transplant pharmacy.