TABLE 4.
Common Adverse Effects of Immunosuppressive Medicationsa
| Adverse effect | CNI |
Antimetabolite |
mTOR | GS | ||
|---|---|---|---|---|---|---|
| CYA | Tac | MMF | AZA | |||
| Diabetes | + | ++ | − | − | + | +++ |
| Hypertension | +++ | ++ | − | − | ++ | +++ |
| Hyperlipidemia | ++ | + | − | − | +++ | ++ |
| Chronic kidney disease | +++ | +++ | − | − | ++ | − |
| Osteoporosis | + | + | − | − | − | +++ |
| Bone marrow suppression | − | − | ++ | ++ | + | − |
| Dermatologic | ||||||
| Alopecia | − | ++ | − | +/− | − | − |
| Dermatitis | − | + | − | + | ++ | + |
| Hirsuitism | ++ | − | − | − | − | + |
| Gingival hyperplasia | + | − | − | − | − | − |
| Neurotoxicityb | ||||||
| Headache | ++ | ++ | ++ | + | ++ | + |
| Tremor | ++ | ++ | ++ | − | − | − |
| Seizure | + | + | − | − | − | − |
| Gastrointestinal toxicity | + | + | +++ | + | ++ | + |
a
AZA = azathioprine; CNI = calcineurin inhibitor; CYA = cyclosporine; GS = glucocorticoid; MMF = mycophenolate mofetil; mTOR = mammalian target of rapamycin (sirolimus or everolimus); Tac = tacrolimus; + = infrequent occurrence (3%-20%); ++ = frequent occurrence (20%-49%); +++ = very frequently reported (>50%); − = none reported.
b
Leukoencephalopathy is reported with tacrolimus but at <0.1%.