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Packing on the Pounds from Meds?

Hi All,

Many of us, as Tx patients, struggle with weight gain and what worked before the Tx just doesn't seem enough anymore.  We all know about Prednisone/ Prograf connection to blood sugar levels and weight gain, but what other necessary medicines affect this battle?  Not much is made of side effects, however these are real for many and they are sometimes are not considered in your plan of care.  I would like to hear from members, what they have learned about the meds we take and their effects, wanted or otherwise.

The cause of weight gain seems to be simple, ingesting more calories that we burn, however diet and exercise alone, may not be enough.  It shouldn't be that hard to reverse the trend!  Examination of your prescribed medication should be reviewed yearly with your Tx team because newer drugs become available and issues with others develop over time.  Basal metabolic rate (BMR) is the amount of energy expended while at rest.  Our medications can affect this.

One such drug is Metoprolol Tartrate(Lopressor,) a safe and effective drug designed to lower high blood pressure in the Beta Blocker class (Beta blockers are a class of drugs that are particularly used to manage cardiac arrhythmias, and to protect the heart from a second heart attack after a first heart attack.)   By design, this med maintains lower pressure by lowering the heart rate, which unfortunately can lower Basal Metabolism overall.  I have learned from others that once doses were lowered that the "pounds just melt away."  It is easy to see the correlation, which prompted me to search for alternatives. One med I found is Cozaar (Losartan,) which lowers pressure by easing tension of blood vessels and has fewer side effects reportedly.  Is anyone presently taking this med?  If so, what side effects have you noticed?

How about you?  What have you experienced with commonly prescribed medications or their unwanted side effects?  Your input would be  greatly appreiciated!

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  • Hi,
    I have written earlier about the same problem of weight gain following my liver transplant . Metroprolol also put weight on me. So my Dr lowered my dose of metoprolol and added chrolothaladone , a very small dose. The weight started to melt away. I only have 1 lb left to loose. While I am very grateful for my transplant , I was very upset and uncomfortable from all the weight gain. No matter what I did , I could not take the weight off until my Dr changed my meds. I hope this information helps others.
    • I credit your post for starting my research....thank you very much.  I am on 50 mg of Metoprolol and 25 mg Chlorthalidone BID.  I want to be taken off Metoprolol completely, without switching to another beta-blocker.  I will ask to regulate my BP with an ARB (angiotensin receptor blocker} however I believe it might not be the right fit because of the dehydration risk.  I took the vasodilator Vasotec but it was discontinued because it raised my blood potassium level too high.  We shall see.....time to ask more questions.  Again thank you for both posts! 

  • Great thread thanks!  I have struggles with weight gain too, and can't seem to lose, no matter how healthy I eat or how much I exercise.  I'm not on Prednisone any longer, but have taken Prograf and Myfortic for almost 8 years.  It never occurred to me that it might be the medications, but I don't see that I can do anything about that.  I am just happy to be rejection free and doing well.  Your suggestion of reviewing all meds annually is a very good one, so I will do that an my next annual in November.  Thanks!

    • As always, make no changes on your own, consult your Tx team!  I am not sure Prograf directly contributes to weight gain, it does affect blood sugar levels and makes 20% of users to become Type II diabetics (lucky me!)  Beta-Blocker reduce BP by lowering heart rate (and other effects) and I believe slows metabolism significantly.  It is always the best policy to ASK, ASK, ASK to learn what is the best option for you.

  • HI Norm - I take Losartan and before that Diovan.  These drugs are basically the same (angiotensin receptor blockers (ARB). These are really good drugs to have in our BP control cocktail but one big warning  - be careful about the dosage because this medication can cause damage to the kidney if you are taking it while dehydrated.  I was taking a high dose of Diovan and got the flu and became dehydrated.  I ended up in the hospital with acute renal failure of my fist transplant and my nephrologist told me that it was due to the Diovan.  He said that if I got the flu or became dehydrated I should stop taking it (it would have been nice if he told me that before I ended up in the hospital).  I had no idea and just kept taking my meds as usual.  Since my second transplant, I have been on Losartan 50mg ( half the dose I was on before) and the Tx nephrologists don't want increases in the dosage.  I take a cocktail of Amlodipine, Losartan, Nadolol, and intermittent Lasix. 
    I am very interested by what you said about Betablockers because I have been on Nadolol for almost 35 years and when I think back, I stafted gaining weight after I started taking it.  My Docotors have tried to change it to other beta blockers but they just don't work.  When I stop the nadolol my BP goes very high.  It seems my body has become very dependent on it.  And with the prednisone, tacro, insulin etc.   I am quite plump (-:.  My BMI is 30.  Regular excercise works best for me for losing weight but I can't seem to maintain it due to periodic fatigue episodes that last days to weeks.  And I don't have great discipline.  This is a good thread.  thanks.

    • Hi India,

      Thank you so much for this reply.  I will be pushing my nephrologist to enact a switch.  I am presently on both Metoprolol and Chlorthalidone(diuretic) to control BP.  I have a need to maintain circulation to my lower extremities, Losartan will help this, while Metoprolol has my metabolism so low, I cannot function. they just work differently.  I am not a big fan of Beta-Blockers because the side effects experienced by my mother (auditory and visual hallucinations, fainting...)  I had to threaten to sue a quack to have a different medication prescribed!  My hope is a newer drug will become available.  Again, thank you so much for the reply!

  • No matter what my transplant nephs say, I truly believe that prednisone contributes to weight gain. I'm told that I'm on a maintenance dose which is the same as what my body would produce and thus shouldn't contribute to weight gain. Weight gain I'm told is caused more from feeling better after transplant. I was able to lose weight after transplant until prednisone was added. I'm not so sure in my case if Prograf contributes as it wasn't until prednisone was added to my immunosuppressive mix of drugs 3 months post kidney transplant that my hunger issues began and weight gain started. It makes sense that prednisone lowers our basal metabolism but I also wonder if it creates some kind of chemical change in our brains that causes such an "always hungry even after meals" that is a challenge to handle.

    I take simvastatin, which helps with cholesterol challenges that can occur with tacrolimus. I'm fortunate that I have no side effects with simvastatin, which I took prior to my kidney transplant as well. imalso take ranitidine(Zantac) along with my immunosuppressive medications and have no side effects from that drug.
    My biggest side effects from tacrolimus has been hair loss, and tremors both of which are much better now than they were when I first received the transplant. Mycophenolate lowered my white blood cell count, which prompted adding prednisone 3 months post transplant. That was not a great side effect of Mycophenolate as it could have affected the kidney negatively by increasing my risk of infection. Prednisone at 4mg. daily is a medication I'm not overly fond of as the hunger issues are challenging but I'm also thankful that it along with with Mycophenolate and tacrolimus are keeping my kidney transplant happy and healthy in its new home.
    Prior to my kidney transplant, I was on several hypertensive medications. When I initially was diagnosed with high blood pressure, it took 4 different hypertension meds before I was able to tolerate one-Norvasc. More hypertension meds were added over the years as my kidney function declined and my high blood pressure was more of a challenge and fortunately I had no side effects(weight gain or otherwise) with those-Diovan, Lopressor, and Losartan. Since my kidney transplant in May 2015, my blood pressure has been great and I no longer take any hypertension medications.
    I wish you well as you search for medications with the least amount of side effects for your body to keep it healthy!
    With kidney transplant joy,
    • Life can be great when medications are in balance.  I only worry when I've been on a medication for more than 5 years.  That's about the length of time it takes for newer (and hopefully better) drugs to enter the marketplace.  I've been on Beta-blockers for over 15 years and found the best policy to review my medications yearly with my Tx nephrologist, better to be as proactive as possible.

      • Kidneyboy, where did you hear that?? I spoke with a pharmaceutical rep once and he told me it can take DECADES to come up with new drugs. Even AFTER you've developed the drug it can take up to ANOTHER 5 years just for FDA approval! Most people on here take Prednisone and that came out in the 1940s yet nothing better has come out since! We all take tacrolimus yet that's been around for decades with nothing better in sight.
        • That's not the point of the post.  I was speaking of the time from human trials to FDA approval and reviewing your medications on a regular basis.  I am old enough to have witnessed this process in real time.  Perhaps I did not state this clearly enough.  

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