Here’s a list of generally considered safe OTC medications for heart transplant recipients—but they must still be approved by the transplant team or pharmacist before use:
✅ OTC Medications That Are Often Safe (with approval):
1. Pain / Fever Relief
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Acetaminophen (Tylenol)
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Safe in usual doses (e.g., ≤3,000 mg/day)
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Avoid high doses due to liver concerns.
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Do NOT use NSAIDs like ibuprofen without approval (see below).
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2. Allergy / Antihistamines
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Loratadine (Claritin)
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Fexofenadine (Allegra)
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Cetirizine (Zyrtec)
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Non-drowsy, generally safe for seasonal allergies.
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3. Cough & Cold (Use Caution)
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Guaifenesin (Mucinex) – for chest congestion (okay in most cases).
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Dextromethorphan (Delsym, Robitussin DM) – for dry cough (caution: check with doctor).
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Saline nasal spray – safe for nasal congestion.
4. Heartburn / Acid Reflux
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Calcium carbonate (Tums) – occasional use.
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Famotidine (Pepcid AC) – OK, but always check for interactions.
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Avoid cimetidine (Tagamet) – interacts with immunosuppressants.
5. Constipation
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Psyllium (Metamucil)
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Polyethylene glycol (MiraLAX)
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Docusate sodium (Colace)
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Often needed due to constipation from medications like opioids or calcium channel blockers.
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6. Diarrhea
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Loperamide (Imodium) – use only under guidance and for mild, short-term diarrhea.
7. Vitamins
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Vitamin D / Calcium – common after transplant.
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Multivitamins without herbal additives – but consult your transplant team.
❌ OTC Medications to AVOID Without Explicit Approval
1. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
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Ibuprofen (Advil, Motrin)
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Naproxen (Aleve)
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Can harm kidneys, raise blood pressure, and interact with transplant meds.
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2. Decongestants
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Pseudoephedrine (Sudafed)
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Phenylephrine (Sudafed PE)
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Can raise blood pressure and heart rate.
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3. Herbal Supplements
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St. John’s Wort, Echinacea, Ginseng, Ginkgo biloba, etc.
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Can interfere with immunosuppressant levels.
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