Table 1

Major side effects of commonly used immunosuppression

ImmunosuppressantSide effects
Calcineurin inhibitorsRenal impairment
Infections (viral, bacterial and fungal) increased risk
Hyperuricaemia
Gout
Hypertension
Hypercholesterolaemia
Glucose intolerance
Hypomagnesaemia
Hyperkalaemia
Headaches/migraines
Insomnia
Tremor
Hirsuitism
Gum hypertrophy
MycophenolateDiarrhoea
Leucopenia
Teratogenic (should be avoided by mother prior to and during pregnancy and male patients planning to father children. Men should use condoms during treatment and for at least 90 days after cessation of treatment. Female partners should also use a highly effective method of contraception for this duration.)
Infections (viral, bacterial and fungal)
CorticosteroidsSodium retention
Fluid retention
Potassium depletion
Infections (viral, bacterial and fungal)
Hypertension
Carbohydrate intolerance and diabetes mellitus
Cushingoid facies
Growth retardation
Menstrual irregularities
Ophthalmological issues, for example, cataracts, glaucoma
Osteoporosis and increased fracture risk, aseptic necrosis of femoral head
Myopathy
Muscle weakness
Increased bruising
Skin thinning/acne
Altered mood
Headaches
Peptic ulceration
Pancreatitis
mTORiInfections (viral, bacterial and fungal)
Thrombocytopenia and leucopenia
Impaired wound healing
Lymphocoele
Rash
Menstrual disorders
Interstitial lung disease
Hyperlipidaemia
Proteinuria
Possible increased risk of hepatic artery thrombosis
Infections (viral, bacterial and fungal)
Hepatotoxicity
Bone marrow suppression
  • mTORi, mTOR inhibitor.