Prednisone is an oral (you take it by mouth) corticosteroid medicine. It’s often one of the first medicines used to treat GN. It weakens your immune system to stop inflammation (damage) in your body. Prednisone replaces a hormone called cortisol that your body makes when you’re stressed or sick. When you take it, prednisone weakens your body's immune system to stop it from attacking healthy cells and tissues.

What are the side effects?

Prednisone has many possible side effects. Your healthcare provider has prescribed this medicine because not taking it is more dangerous to you than any side effects. This is not a list of all the side effects. Talk to your doctor, pharmacist, or your GN healthcare team to learn more about prednisone. They can also help you manage any side effects.

Common side effects of prednisone may include:

• heartburn, upset stomach (nausea)
• trouble sleeping, mood changes (feeling very happy or very sad)
• sweating more than usual
• growing more
• acne (pimples)
• thinned skin that bruises easily
• weight gain (usually around the waist) and a rounder face
• feeling very hungry
• high blood pressure
• swelling
• changes to your period (menstrual cycle)

More serious side effects may include:

• muscle weakness
• high blood sugar
• seizures
• depression
• feeling confused or unsure of what’s real
• serious infection
• stomach sores (ulcers)
• osteoporosis (thinning of the bones) if you take it for a long time
• osteonecrosis (loss of blood supply to your bones), which is rare
• cataracts (cloudy eye lens) if you take if for a long time
• glaucoma (an eye disease)
• slow wound healing

How do I take it?

It’s best to take this medicine in the morning with food. If you’ve been taking prednisone for a long time, do not stop it suddenly. Your healthcare provider will help you lower the dose slowly until it’s safe to stop taking it.

Do I need any other medicines?

You may need to take other medicines when you take prednisone to lower your risk of side effects. This may include medicines to protect your bones (calcium, vitamin D, and bisphosphonates) and an antibiotic to protect against a rare lung infection called PJP (Pneumocystis jirovecii).

Can prednisone interact with other medicines?

Talk to your doctor or pharmacist before you take any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before you get any vaccines. When you’re taking prednisone, you have a higher risk of getting an infection or the vaccine may not work as well.

What if I’m pregnant?

If you’re pregnant, thinking about getting pregnant, or breastfeeding, tell your healthcare provider before taking prednisone. They can help you decide if prednisone is safe for you and your baby.

Learn more about prednisone.

Prednisone is an oral (you take it by mouth) corticosteroid medicine. It weakens your child’s immune system to stop it from attacking healthy cells and tissues. Prednisone replaces a hormone called cortisol that your child’s body makes when they’re stressed or sick.

What are the side effects for my child?

Like most medicines, prednisone can have side effects. Many of these are rare. Your child’s healthcare provider has prescribed this medicine because not taking it is more dangerous to your child than any side effects. This is not a list of all the side effects. Talk to your child’s doctor, pharmacist or the pediatric nephrology clinic (children’s kidney clinic) team to learn more about prednisone. They can also help manage any side effects your child may have.

Common side effects of prednisone may include:

• heartburn, upset stomach (nausea) (Your child´s healthcare provider may give them medicine to help protect their stomach.)
• problems with how your child acts (behaviour) (Your child may have tantrums, be moody, have trouble sleeping, or have bad dreams. This should get better as their dose goes down.)
• gaining weight and feeling very hungry¬ (You can help by making sure your child gets lots of exercise and eats fruits, vegetables, whole grains, and low-fat proteins, and by paying attention to portion sizes.)
• high blood pressure (Your child’s healthcare provider may give them medicine to lower their blood pressure.)
• growing more hair or getting acne (pimples)
• thinner skin that bruises easily

Prednisone can make it harder for your child to fight infections. All family members should wash their hands well and often. Keep your child away from people who are sick (coughing, sneezing, runny nose).

Call your pediatric nephrology clinic or your child’s doctor if your child has any signs of infection (such as fever, cough and cold symptoms) that are very bad or last longer than 7 days.

Be sure to tell all your child’s healthcare providers about your child’s prednisone while they’re taking it and for 12 months after they stop. This is because your child may need to take prednisone for a short time if they’re unwell or have surgery, as it can take time for your child’s body to make cortisol normally.

If your child takes prednisone for a long time, there are other side effects that you need to know about:

• Prednisone can slow your child’s growth and affect puberty (for example, their periods may not be regular).
• Your child may take longer to heal from injury or after surgery.
• Your child’s bones may become weaker. Your child’s doctor or dietitian will make sure they’re getting enough calcium and vitamin D from food, supplements, or both.
• Your child’s hip bone can get damaged. They may limp or have trouble walking or moving around. This is rare.
• Prednisone can cause high blood sugar (diabetes). Your child may be more thirsty than usual, need to pee more often, or start wetting the bed at night.
• Your child may have some vision problems. Take your child for regular visits to the eye doctor.

How does my child take prednisone?

Prednisone comes as pills or liquid. Your child’s healthcare team will tell you exactly how much to give your child and when to give it. Make sure you understand all the instructions. If your child takes prednisone for a long time, they must not stop taking it suddenly. When it’s time, your child’s healthcare provider will help you slowly lower the dose until it’s safe for your child to stop taking it.

If your child missed a dose and you remember later the same day, give the missed dose right away. If your child is taking prednisone every day and you forgot a dose from the day before, skip that dose. Give your child their dose for today.

If your child is taking prednisone every other day and you forgot the dose from the day before, give that dose today. Tomorrow, continue the schedule of every other day. Call your child’s doctor or pharmacist if you have questions about missing a dose.

If your child throws up less than 30 minutes after taking prednisone, give the dose again, only once. If they throw up after 30 minutes of taking it, do not give the dose again.

Can prednisone interact with other medicines?

Talk to your child’s doctor or pharmacist before you give your child any new medicines (non-prescription and prescription), herbal products, or vitamins.

Some live vaccines (like measles, mumps, rubella [MMR] vaccine or chickenpox vaccine) aren’t safe while your child is taking prednisone. It’s still important for your child to have their regular vaccines, but you may need to wait until after they’re done taking prednisone. Talk to your child’s healthcare provider before they get any vaccines.

What if my child is pregnant?

If your older child or teen is pregnant, might be pregnant, or is breastfeeding, talk to your child’s healthcare provider before they take prednisone to make sure it’s safe for their baby.

Learn more about prednisone.

Azathioprine is medicine that weakens your immune. It stops your body from making white blood cells and prevents them from working. White blood cells help your body fight infections and diseases, and cause a lot of the damage (inflammation) in kidney disease. In high doses, azathioprine has been used to treat cancer and given to people after an organ transplant. In lower doses, it can weaken the immune system for people with GN.

Your healthcare provider may order a test (TPMT or thiopurine methyltransferase test) to find out if your body can process this medicine. Based on the test results, your healthcare provider will decide what dose is best for you or if you need a different medicine.

Your healthcare provider may also prescribe this medicine with others that weaken the immune system, such as prednisone.

What are the side effects?

Like most medicines, azathioprine can have side effects. Many of these are rare. Your healthcare provider has prescribed this medicine because not taking it is more dangerous to you than any side effects. This is not a list of all the side effects. Talk to your doctor, pharmacist, or your GN healthcare team to learn more about azathioprine. They can also help you manage any side effects.

Common side effects may include:

• low blood cell counts (bone marrow suppression)
• being at a higher risk of getting an infection
• liver damage (toxicity)
• nausea (upset stomach), throwing up, diarrhea (watery poop)
• muscle aches
• fever
• rash

A more serious side effect is having a slightly higher risk of cancer, especially skin cancer and blood cancer.

Stay out of the sun and don’t use sunlamps or tanning beds because this medicine can make your skin more sensitive to the sun. Wear sunscreen, sunglasses, and cover up with clothing to protect yourself from the sun.

How do I take it?

Take this medicine with food. This makes it less likely to upset your stomach.

Can azathioprine interact with other medicines?

Don’t take this medicine with gout medicines such as allopurinol (Zyloprim) or febuxostat (Uloric). They can make the effects of azathioprine stronger.

Talk to your doctor or pharmacist before you take any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before you get any vaccines. When you’re taking azathioprine, you could have a higher risk of getting an infection or the vaccine may not work as well.

What if I’m pregnant?

Ask your healthcare provider if it’s safe to take this medicine when you’re pregnant or breastfeeding. It’s best to talk about it before you get pregnant, if possible.

Azathioprine is a medicine that weakens your child’s immune system. It stops the body from making white blood cells and prevents them from working. White blood cells help the body fight infections and diseases, and cause a lot of the damage (inflammation) in kidney disease. In high doses, azathioprine has been used to treat cancer and given to people after an organ transplant. In lower doses, it can weaken the immune system for children with GN. Your child’s healthcare provider may also prescribe this medicine with others that weaken the immune system, such as prednisone.

What are the side effects?

Like most medicines, azathioprine can have side effects. Many of these are rare. Your child’s healthcare provider has prescribed this medicine because not taking it is more dangerous to your child than any side effects. This is not a list of all the side effects. Talk to your child’s doctor, pharmacist, or the pediatric nephrology clinic (children’s kidney clinic) to learn more about azathioprine. They can also help manage any side effects your child may have.

Azathioprine can make it harder for your child to fight infections. All family members should wash their hands well and often. Keep your child away from people who are sick (coughing, sneezing, runny nose). Contact the pediatric nephrology clinic if your child has any of the following:

• any signs of infection (such as fever, cough and cold symptoms) that are very bad or last longer than 7 days

Other common side effects may include:

• low blood cell counts (bone marrow suppression) (Your child will have regular blood tests to check for this.)
• liver problems (Your child will have regular blood tests to check for this.)
• upset stomach, throwing up, diarrhea (watery poop)
• muscle aches
• fever
• rash

A more serious side effect is having a slightly higher risk of cancer, especially skin cancer and blood cancer.

How does my child take it?

Give your child this medicine with food to help with stomach upset.

If your child throws up less than 30 minutes after taking their medicine, give them another dose, only once. If it’s after 30 minutes, don’t give them another dose.

If your child missed their last dose, give the missed dose as soon as you remember. If it’s almost time for the next dose, skip the missed dose. Give the next dose at the regular time. Don’t give your child 2 doses at a time to make up for 1 missed dose.

Can azathioprine interact with other medicines?

Talk to your child’s doctor or pharmacist before you give your child any new medicines (non-prescription and prescription), herbal products, or vitamins.

Some live vaccines (like measles, mumps, rubella [MMR] vaccine or chickenpox vaccine) aren’t safe while your child is taking azathioprine. It’s still important for your child to have their regular vaccines, but you may need to wait until after they’re done taking this medicine. Talk to your child’s healthcare provider before they get any vaccines.

What if my child is pregnant?

For older children and teens, ask their healthcare provider if it’s safe to take this medicine when they’re pregnant or breastfeeding. It’s best to talk about it before your child gets pregnant, if possible.

Learn more about azathioprine.

Mycophenolate mofetil (MMF) is a medicine that weakens your immune system. It stops the body from making white blood cells and prevents them from working. White blood cells help the body fight infections and diseases, and cause a lot of the damage (inflammation) in kidney disease. MMF is most commonly used for people who have had organ transplants, but it’s also used to treat people with GN. Your healthcare provider may also prescribe this medicine with other medicines that weaken the immune system, such as prednisone.

What are the side effects?

Like most medicines, MMF can have side effects. Many of these are rare. Your healthcare provider has prescribed this medicine because not taking it is more dangerous to you than any side effects. This is not a list of all the side effects. Talk to your doctor, pharmacist, or your GN healthcare team to learn more about MMF. They can also help you manage any side effects.

Common side effects may include:

• heartburn, upset stomach (nausea), throwing up
• diarrhea (watery poop)
• headache
• swelling
• high blood pressure

More serious side effects may include:

• low red blood cells, low white blood cells, and low platelets¬ (Contact your healthcare provider if you notice you’re more tired than usual, you have bleeding, or easy bruising.)
• higher risk of blood cancer and skin cancer
• stomach sores (ulcers) or bleeding

Stay out of the sun and don’t use sunlamps or tanning beds because this medicine can make your skin more sensitive to the sun. Wear sunscreen, sunglasses, and cover up with clothing to protect yourself from the sun.

How do I take it?

You can take MMF with food or without food.

Can MMF interact with other medicines?

Don’t take MMF at the same time as aluminum-containing antacids. They cause your body to absorb less of the medicine.

This medicine interacts with many other drugs. Talk to your doctor or pharmacist before you take any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before you get any vaccines. Do not get any live vaccines while you’re taking MMF because you have a higher risk of infection. You can get inactivated (not live) vaccines, but they may not work as well.

What if I’m pregnant?

If you’re pregnant or think you might be pregnant, you should not take this medicine because it can harm your baby (cause birth defects). If you’re able to get pregnant and are sexually active, you need to use birth control while taking this medicine and for at least 3 months after you’ve finished taking it.

This medicine can also cause birth defects through sperm. If you could get someone else pregnant, use condoms while taking this medicine and for at least 3 months after you’ve finished taking it to make sure your partner doesn’t get pregnant.

Talk to your healthcare provider about what type of birth control is best for you. Some types of hormonal birth control (like the pill or patch) may not work well while you’re taking MMF.

Mycophenolate mofetil (MMF) is a medicine that weakens your child’s immune system. It stops the body from making white blood cells and prevents them from working. White blood cells help the body fight infections and diseases, and cause a lot of the damage (inflammation) in kidney disease. MMF is most commonly used for people who have had organ transplants, but it’s also used to treat people with GN. Your child’s healthcare provider may also prescribe this medicine with other medicines that weaken their immune system, such as prednisone.

What are the side effects?

Like most medicines, MMF can have side effects. Many of these are rare. Your child’s healthcare provider has prescribed this medicine because not taking it is more dangerous to your child than any side effects. This is not a list of all the side effects. Talk to your child’s doctor, pharmacist, or the pediatric nephrology clinic (children’s kidney clinic) team to learn more about MMF. They can also help manage any side effects your child may have.

MMF can make it harder for your child to fight infections. All family members should wash their hands well and often. Keep your child away from people who are sick (coughing, sneezing, runny nose). Contact your pediatric nephrology clinic or doctor if your child has any signs of infection (such as fever, cough and cold symptoms) that are very bad or last longer than 7 days.

Other side effects may include:

• heartburn, throwing up, stomach upset (nausea) (Your child may get medicine to help protect their stomach.)
• diarrhea (watery poop)
• low red blood cells, white blood cells, and platelets (Your child will need to do regular blood work to check for this. Contact your child’s healthcare provider if you notice your child is more tired than usual, has bleeding, or is bruising easily.)
• liver problems

If your child takes MMF for a long time, they may have a slightly higher risk of skin or blood cancers. This medicine can make your child’s skin more sensitive to the sun. Make sure they wear sunscreen, sunglasses, and cover them up with clothing to protect them from the sun.

How does my child take MMF?

Food affects how your child’s body absorbs MMF. Your child should always take MMF the same way, either always with food, or always without food (for example, 1 hour before or 2 hours after meals). Giving MMF with food may help if it gives your child an upset stomach or diarrhea.

If your child throws up less than 30 minutes after taking MMF, give the dose again, only once. If it’s been longer than 30 minutes, do not give the dose again.

If your child missed their last dose, give the missed dose as soon as you remember. If it’s almost time for their next dose, skip the missed dose. Give the next dose at the regular time. Do not give your child 2 doses at a time to make up for 1 missed dose.

Can MMF interact with other medicines?

Talk to your child’s doctor or pharmacist before you give your child any new medicines (non-prescription and prescription), herbal products, or vitamins.

Some live vaccines (like measles, mumps, rubella [MMR] vaccine or chickenpox vaccine) aren’t safe while your child is taking MMF. It’s still important for your child to have their regular vaccines, but you may need to wait until after they’re done taking MMF. Talk to your child’s healthcare provider before they get any vaccines.

What if my child is pregnant?

If your child is pregnant or might be pregnant, they should not take this medicine because it can harm their baby (cause birth defects). If your child is able to get pregnant and is sexually active, they need to use birth control while taking this medicine and for at least 3 months after they’ve finished taking it.

This medicine can also cause birth defects through sperm. If your child could get someone else pregnant, your child should use condoms while taking this medicine and for at least 3 months after they have finished taking it.

Talk to your child’s healthcare provider about what type of birth control is best for your child. Some types of hormonal birth control (like the pill or patch) may not work well while your child is taking MMF. .

Learn more about mycophenolate mofetil.

Cyclophosphamide, in high doses, is a chemotherapy drug to kill cancer cells. In lower doses, it can also weaken the immune system in people with kidney disease. It does this by stopping the body from making white blood cells, and by preventing white blood cells from working. White blood cells cause a lot of the inflammation (damage) related to kidney disease. Your healthcare provider may also prescribe this medicine with other medicines that weaken the immune system, such as prednisone.

What are the side effects?

Like most medicines, cyclophosphamide can have side effects. Many of these are rare. Your healthcare provider has prescribed this medicine because not taking it is more dangerous to you than any side effects. This is not a list of all the side effects. Talk to your doctor, pharmacist, or your GN healthcare team to learn more about cyclophosphamide. They can also help you manage any side effects.

Common side effects may include:

• headache
• feeling very tired
• upset stomach (nausea), throwing up
• hair loss (usually stops after you stop taking this medicine)

More serious side effects may include:

• low cell counts (hemoglobin, white blood cells, platelets)
• serious infections
• problems getting pregnant or getting someone else pregnant (fertility problems)
• bladder problems (toxicity)
• slightly higher risk of cancer (less than 1%)

How do I take it?

You can take this medicine intravenously (through a vein) or orally (by mouth). If you take it by mouth, take it in the morning with food. If you take it intravenously, your healthcare team will order other medicines along with the cyclophosphamide.

Can cyclophosphamide interact with other medicines?

Talk to your doctor or pharmacist before you take any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before you get any vaccines. When you’re taking cyclophosphamide, you could have a higher risk of getting an infection if you get a live vaccine. Inactive (not live) vaccines may not work as well.

It is important to stay hydrated and drink plenty of water while on oral cyclophosphamide, or 1-2 days after getting IV cyclophosphamide. This prevents bladder irritation or injury.

What if I’m pregnant?

If you’re pregnant or you think you might be pregnant, you should not take this medicine. If you are sexually active, you need to use birth control while you’re taking this medicine. Talk to your healthcare provider about what type of birth control is best for you.

Learn more about cyclophosphamide:

• oral
• injection

Cyclophosphamide, in high doses, is a chemotherapy drug to kill cancer cells. In lower doses, it can also weaken the immune system in people with kidney disease. It does this by stopping the body from making white blood cells and by preventing white blood cells from working. White blood cells cause a lot of the damage (inflammation) related to GN. Your healthcare provider may also prescribe this medicine to your child with other medicines that weaken the immune, such as prednisone.

What are the side effects?

Like most medicines, cyclophosphamide can have side effects. Many of these are rare. Your child’s healthcare provider has prescribed this medicine because not taking it is more dangerous to your child than any side effects. This is not a list of all the side effects. Talk to your child’s doctor, pharmacist, or pediatric nephrology clinic (children’s kidney clinic) to learn more about cyclophosphamide. They can also help manage any side effects your child may have.

Cyclophosphamide can make it harder for your child to fight infections. All family members should wash their hands well and often. Keep your child away from people who are sick (coughing, sneezing, runny nose). Call the pediatric nephrology clinic or your child’s healthcare provider if your child has any signs of infection (such as fever, cough and cold symptoms) that are very bad or last longer than 7 days Other side effects may include:

• headache
• upset stomach, throwing up, diarrhea (watery poop)
• face turning red and warm (flushing)
• hair loss (This tends to happen only with higher doses. Hair grows back after your child stops taking cyclophosphamide.)
• feeling very weak or tired
• sores in the mouth or throat
• bleeding or bruising easily
• low red blood cells, white blood cells, and platelets (Your child will need to have regular blood tests to check for this. Contact your child’s healthcare provider if you notice your child is more tired than usual, has bleeding, or is bruising easily.)
• problems getting pregnant or getting someone else pregnant later in life (This is rare when this medicine is used for kidney disease.)
• very low risk of cancer

How does my child take cyclophosphamide?

Your child may get this medicine by mouth (as a pill or liquid) or injected into a vein through an IV (intravenous). If your child takes it by mouth, they should take it in the morning with food. It’s important for your child to take their dose early in the day so they have time to drink and pee a lot. This helps with bladder problems.

If your child throws up less than 30 minutes after taking cyclophosphamide, give the dose again, only once. If it’s been longer than 30 minutes, do not give the dose again.

If your child missed their last dose, give the missed dose as soon as you remember. If it’s almost time for their next dose, skip the missed dose. Give the next dose at the regular time. Do not give your child 2 doses at a time to make up for 1 missed dose.

It is important your child stays hydrated and drinks plenty of water while on oral cyclophosphamide, or 1-2 days after getting IV cyclophosphamide. This prevents bladder irritation or toxicity.

Can cyclophosphamide interact with other medicines?

Talk to your child’s doctor or pharmacist before you give your child any new medicines (non-prescription and prescription), herbal products, or vitamins.

Some live vaccines (like measles, mumps, rubella (MMR) vaccine or chickenpox vaccine) aren’t safe while your child is taking cyclophosphamide. It’s still important for your child to have their regular vaccines, but you may need to wait until after they’re done taking cyclophosphamide. Talk to your child’s healthcare provider before they get any vaccines.

What if my child is pregnant?

If your older child or teen is pregnant or might be pregnant, they should not take this medicine. If they are sexually active, they need to use birth control while they are taking this medicine. Talk to your child’s healthcare provider about what type of birth control is best for them.

Learn more about cyclophosphamide:

• oral
• injection

Rituximab is biologic medicine. This means it’s made from a living source. It’s a special antibody (protein the body makes to fight infections and diseases) that targets certain cells and weakens your immune system. It can be used to kill some cancer cells and for some types of autoimmune disease (where your body attacks its own healthy cells and tissues). Your healthcare provider may also prescribe this medicine with other medicines that weaken your immune system, such as prednisone.

What are the side effects?

Like most medicines, rituximab can have side effects. Many of these are rare. Your healthcare provider has prescribed this medicine because not taking it is more dangerous to you than any side effects. This is not a list of all the side effects. Talk to your doctor, pharmacist, or your GN healthcare team to learn more about rituximab. They can also help you manage any side effects.

Common side effects may include:

• headache
• fever
• upset stomach (nausea), throwing up
• low white blood cell counts
• mild or moderate allergic reactions when you get the medicine, including feeling itchy, getting a rash, or having a heavy feeling in your chest

More serious side effects may include:

• serious allergic reactions when you get the medicine, including throat swelling and low blood pressure (anaphylaxis)
• serious infections, including from bacteria, viruses, and fungi, or long-term infections that come back (such as hepatitis)
• very rare serious skin problems (such as Stevens Johnson syndrome)
• a rare nerve disorder that usually leads to death (progressive multifocal leukoencephalopathy or PML). Tell your healthcare provider if you:
  • feel confused
  • have changes in your vision
  • start acting different than is normal for you
  • have problems speaking
  • have weakness on one side of your body or problems with balance

How do I take it?

For kidney disease, you take rituximab as a series of intravenous infusions, where the medicine is put into your vein with an IV. Each infusion can take 4 to 8 hours.

Can rituximab interact with other medicines?

Talk to your doctor or pharmacist before you take any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before you get any vaccines. When you’re taking rituximab, you have a higher risk of getting an infection, or the vaccine may not work as well.

What if I’m pregnant?

If you’re pregnant or you think you might be pregnant, you should not take this medicine. You need to use birth control while you’re taking rituximab. Ask your healthcare provider what type of birth control is best for you. If you’re planning to get pregnant, talk to your healthcare provider before you start trying.

Rituximab is a biologic medicine. This means it’s made from a living source. It’s a special antibody (protein the body makes to fight off infections and diseases) that targets certain cells and weakens your child’s immune system. It can be used to kill some cancer cells and for some types of autoimmune disease (where the body attacks its own healthy cells and tissues). Your child’s healthcare provider may also prescribe this medicine with other medicines that weaken the immune system, such as prednisone.

What are the side effects?

Like most medicines, rituximab can have side effects. Many of these are rare. Your child’s healthcare provider has prescribed this medicine because not taking it is more dangerous to your child than any side effects. This is not a list of all the side effects. Talk to your child’s doctor, pharmacist, or their pediatric nephrology (children’s kidney) team to learn more about rituximab. They can also help manage any side effects your child may have.

Common side effects may include:

• headache
• fever
• upset stomach (nausea), throwing up, diarrhea

Your child could also have a mild or moderate allergic reaction when they get this medicine, including feeling itchy, getting a rash, or having a heavy feeling in your chest. Your child will get medicine before they get rituximab to help stop this from happening.

More serious side effects may include:

• serious allergic reactions, including throat swelling and low blood pressure (anaphylaxis)
• low white blood cell counts
• serious infections
• very rare serious skin problems (such as Stevens Johnson syndrome)
• a rare nerve disorder that usually leads to death (progressive multifocal leukoencephalopathy or PML). Tell your child’s healthcare provider if your child:
  • feels confused
  • has changes in vision
  • starts acting different than is normal for them
  • has problems speaking
  • has weakness on one side of their body or problems with balance

How does my child take rituximab?

For kidney disease, your child will get rituximab as a series of intravenous infusions, where the medicine is put into their vein with an IV. This is usually once a week or every 2 weeks for 1 to 4 doses. For some types of GN, your child may get the infusions every 6 months. Each infusion can take up to 8 hours.

Can rituximab interact with other medicines?

Talk to your child’s doctor or pharmacist before you give your child any new medicines (non-prescription and prescription), herbal products, or vitamins.

Some live vaccines (like measles, mumps, rubella [MMR] vaccine or chickenpox vaccine) aren’t safe while your child is taking rituximab. It’s still important for your child to have their regular vaccines, but you may need to wait until after they’re done taking rituximab. Talk to your child’s healthcare provider before they get any vaccines.

What if my child is pregnant?

If your older child or teen is pregnant or might be pregnant, they should not take this medicine. It’s best to talk about this before your child gets pregnant. Your child needs to use birth control while they’re taking rituximab. Ask your child’s healthcare provider what type of birth control is best for your child.

Learn more about rituximab.

Cyclosporine is a medicine called a calcineurin inhibitor. It weakens your immune system by stopping your body from making white blood cells, which help your body fight infections and diseases and cause a lot of the damage (inflammation) related to kidney disease. Cyclosporine is most commonly used for people after organ transplants, but it’s also often used to treat people with GN. Your healthcare provider may also prescribe this medicine with other medicines that weaken your immune system, such as prednisone.

What are the side effects?

Like most medicines, cyclosporine can have side effects. Many of these are rare. Your healthcare provider has prescribed this medicine because not taking it is more dangerous to you than any side effects. This is not a list of all the side effects. Talk to your doctor, pharmacist, or your GN healthcare team to learn more about cyclosporine. They can also help manage any side effects.

The most common side effects of cyclosporine may include:

• high blood pressure
• upset stomach (nausea) and throwing up, diarrhea (watery poop)
• hair growth
• shaking (tremors)
• headache
• high cholesterol
• swelling
• gums getting larger

More serious side effects of cyclosporine may include:

• kidneys not working properly
• serious infection (from a bacteria or virus)
• risk of cancer, especially skin cancer

Cyclosporine can make your skin more sensitive to the sun. When you’re taking this medicine, stay out of the sun and don’t use sunlamps or tanning beds. Wear sunscreen, sunglasses, and cover up with clothing to protect yourself from the sun.

How do I take it?

Take this medicine regularly at the same time every day. You can take it with or without food, but try to take it the same way each time.

While you’re taking this medicine, you’ll need to have regular blood tests. Follow the exact instructions from your healthcare provider for how to do the blood tests, or the results may not be right.

Can cyclosporine interact with other medicines?

Don’t have grapefruit or grapefruit juice when you’re taking this medicine. These fruits can change the levels of medicine in your body. Cyclosporine can interact with many other medicines, including some medicines for cholesterol, pain, seizures, blood pressure, antifungals, antibiotics, and blood thinners.

Talk to your doctor or pharmacist before you take any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before you get any vaccines. When you’re taking cyclosporine, you have a higher risk of getting an infection, or the vaccine may not work as well.

What if I’m pregnant?

Ask your healthcare provider if it’s safe to take cyclosporine when you’re pregnant or breastfeeding. It’s best to talk about it before you get pregnant.

Cyclosporine is a medicine called a calcineurin inhibitor. It weakens your child’s immune system by stopping the body from making white blood cells. White blood cells help the body fight infections and diseases, and they cause a lot of the damage (inflammation) related to kidney disease. Cyclosporine is most commonly used for people who have had organ transplants, but it’s also used to treat people with GN. Your child’s healthcare provider may also prescribe this medicine with other medicines that weaken their immune system, such as prednisone.

What are the side effects?

Like most medicines, cyclosporine can have side effects. Many of these are rare. Your child’s healthcare provider has prescribed this medicine because not taking it is more dangerous to your child than any side effects. This is not a list of all the side effects. Talk to your child’s doctor, pharmacist, or the pediatric nephrology clinic (children’s kidney clinic) to learn more about cyclosporine. They can also help manage any side effects your child may have.

This medicine can make it harder for your child to fight infections. All family members should wash their hands well and often. Keep your child away from people who are sick (coughing, sneezing, runny nose). Call the pediatric nephrology clinic or your child’s healthcare provider if your child has any signs of infection (such as fever, cough and cold symptoms) that are very bad or last longer than 7 days.

The most common side effects of cyclosporine may include:

• high blood pressure
• upset stomach (nausea) and throwing up, diarrhea (watery poop)
• hair growth
• shaking (tremors)
• headache
• high cholesterol
• swelling
• gums getting larger

More serious side effects of cyclosporine may include:

• kidneys not working properly
• serious infection (from a bacteria or virus)
• risk of cancer, especially skin cancer

This medicine can make your child’s skin more sensitive to the sun. Make sure they wear sunscreen, sunglasses, and cover them up with clothing to protect them from the sun.

How does my child take this medicine?

Your child must take this medicine regularly at the same time every day. They can take it with or without food, but they should take them the same way each time.

While your child is taking this medicine, they’ll need to have regular blood tests. Follow the exact instructions from your healthcare provider for how to do the blood tests, or the results may not be right. If your child throws up less than 30 minutes after taking their medicine, give them another dose, only once. If it’s after 30 minutes, don’t give them another dose.

If your child missed their last dose, give the missed dose as soon as you remember. If it’s almost time for the next dose, skip the missed dose. Give the next dose at the regular time. Don’t give your child 2 doses at a time to make up for 1 missed dose.

Can cyclosporine interact with other medicines?

Don’t give your child grapefruit or grapefruit juice when they’re taking this medicine. These fruits can change the levels of medicine in their body. Cyclosporine can interact with many other medicines, including some medicines for cholesterol, pain, seizures, blood pressure, antibiotics, and blood thinners.

Talk to your doctor or pharmacist before your child takes any new medicines (non-prescription and prescription), herbal products, or vitamins.

Some vaccines (immunizations like measles, mumps, rubella [MMR] or chickenpox vaccine) aren’t safe while your child is taking cyclosporine or tacrolimus. It’s still important for your child to have their regular vaccines, but you may need to wait until after they’re done taking cyclosporine or tacrolimus. Talk to your child’s doctor before they get any vaccines.

While your child is taking cyclosporine, check with their healthcare provider before they get any vaccines. Your child should not get any live vaccines such as measles, mumps, and rubella vaccine and chickenpox vaccine.

What if my child is pregnant?

For older children and teens, ask your child’s healthcare provider if it’s safe for them to take cyclosporine if they’re pregnant, might be pregnant, or breastfeeding. It’s best to talk about it before your child gets pregnant.

Learn more about cyclosporine.

Tacrolimus is a medicine called a calcineurin inhibitor. It weakens your immune system by stopping your body from making white blood cells, which help your body fight infections and diseases, and cause a lot of the damage (inflammation) related to kidney disease. Tacrolimus is most commonly used for people after organ transplants, but it’s also often used to treat people with GN. Your healthcare provider may also prescribe this medicine with other medicines that weaken your immune system, such as prednisone.

What are the side effects?

Like most medicines, tacrolimus can have side effects. Many of these are rare. Your healthcare provider has prescribed this medicine because not taking it is more dangerous to you than any side effects. This is not a list of all the side effects. Talk to your doctor, pharmacist, or your GN healthcare team to learn more about tacrolimus. They can also help you manage any side effects.

The most common side effects of tacrolimus may include:

• high blood pressure
• upset stomach (nausea) and throwing up, diarrhea (watery poop)
• hair loss
• shaking (tremors)
• headache
• high cholesterol
• swelling
• diabetes

More serious side effects of tacrolimus may include:

• brain problems such as seizures
• kidney problems
• liver damage (toxicity)
• serious infection (from a bacteria or virus)
• risk of cancer, especially skin cancer

Tacrolimus can make your skin more sensitive to the sun. When you’re taking this medicine, stay out of the sun and don’t use sunlamps or tanning beds. Wear sunscreen, sunglasses, and cover up with clothing to protect yourself from the sun.

How do I take it?

Take this medicine regularly at the same time every day. You can take it with or without food, but try to take it the same way each time.

While you’re taking tacrolimus, you’ll need to have regular blood tests. Follow the exact instructions from your healthcare provider for how to do the blood tests, or the results may not be right.

Can tacrolimus interact with other medicines?

Don’t have grapefruit or grapefruit juice when you’re taking this medicine. These fruits can change the levels of medicine in your body. Tacrolimus can interact with many other medicines, including some medicines for cholesterol, pain, seizures, blood pressure, antifungals, antibiotics, and blood thinners.

Talk to your doctor or pharmacist before you take any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before you get any vaccines. When you’re taking tacrolimus, you have a higher risk of getting an infection, or the vaccine may not work as well.

Check with your healthcare provider before you get any vaccines. When you’re taking tacrolimus, you have a higher risk of getting an infection, or the vaccine may not work as well.

What if I’m pregnant?

Ask your healthcare provider if it’s safe to take tacrolimus when you’re pregnant or breastfeeding. It’s best to talk about it before you get pregnant.

Tacrolimus is a medicine called a calcineurin inhibitor. It weakens your child’s immune system by stopping the body from making white blood cells, which help the body fight infections and diseases and cause a lot of the damage (inflammation) related to kidney disease. Tacrolimus is most commonly used for people after organ transplants, but it’s also used to treat people with GN. Your child’s healthcare provider may also prescribe this medicine with other medicines that weaken the immune system, such as prednisone.

What are the side effects?

Like most medicines, tacrolimus can have side effects. Many of these are rare. Your child’s healthcare provider has prescribed this medicine because not taking it is more dangerous to your child than any side effects. This is not a list of all the side effects. Talk to your child’s doctor, pharmacist, or their pediatric nephrology (children’s kidney) healthcare team to learn more about tacrolimus. They can also help manage any side effects your child may have.

This medicine can make it harder for your child to fight infections. All family members should wash their hands well and often. Keep your child away from people who are sick (coughing, sneezing, runny nose). Call your child’s healthcare provider or the pediatric nephrology clinic team if your child has any signs of infection (such as fever, cough and cold symptoms) that are very bad or last longer than 7 days.

More serious side effects of tacrolimus may include:

• brain problems such as seizures
• kidney problems
• liver damage (toxicity)
• serious infection (from a bacteria or virus)
• risk of cancer, especially skin cancer

This medicine can make your child’s skin more sensitive to the sun. Make sure they wear sunscreen, sunglasses, and cover them up with clothing to protect them from the sun.

How does my child take this medicine?

Your child must take this medicine regularly at the same time every day. They can take it with or without food, but they should take them the same way each time.

While your child is taking this medicine, they’ll need to have regular blood tests. Follow the exact instructions from your healthcare provider for how to do the blood tests, or the results may not be right. If your child throws up less than 30 minutes after taking their medicine, give them another dose, only once. If it’s after 30 minutes, don’t give them another dose.

If your child missed their last dose, give the missed dose as soon as you remember. If it’s almost time for the next dose, skip the missed dose. Give the next dose at the regular time. Don’t give your child 2 doses at a time to make up for 1 missed dose.

Can tacrolimus interact with other medicines?

Don’t give your child grapefruit or grapefruit juice when they’re taking this medicine. These fruits can change the levels of medicine in their body. Tacrolimus can interact with many other medicines, including some medicines for cholesterol, pain, seizures, blood pressure, antifungals, antibiotics, and blood thinners.

Talk to your doctor or pharmacist before your child takes any new medicines (non-prescription and prescription), herbal products, or vitamins.

Check with your healthcare provider before your child gets any vaccines. When taking tacrolimus, your child has a higher risk of getting an infection, or the vaccine may not work as well.

While your child is taking tacrolimus, check with their healthcare provider before they get any vaccines. Your child should not get any live vaccines such as measles, mumps, and rubella vaccine and chickenpox vaccine.

What if my child is pregnant?

For older children and teens, ask your child’s healthcare provider if it’s safe for them to take tacrolimus if they’re pregnant, might be pregnant, or breastfeeding. It’s best to talk about this before your child gets pregnant.

Learn more about tacrolimus.