@twocatmama, I want to share this because I think it will go well with what @luckonetj has to add.
Transplant Medications 101: Q&A
https://connect.mayoclinic.org/page/transplant/newsfeed-post/transplant-medications-101-qa/

@twocatmama I can tell you about my transplant medications, but there are others. Initially, I was on tacrolimus (Prograf) and CellCept. They discontinued the CellCept after a short time and then I was just on tacrolimus, two times a day. That was affecting my kidneys so they changed me to sirolimus which helped with my kidneys. I still have to drink about 80 - 100 ounces of water/fluid a day to keep my kidneys flushed. So far, so good.
The biggest effect I have had from the immunosuppressants is diarrhea. It started right after I went on them. After struggling with it for a long time (about two years) I discovered that my problem was from lactose intolerance. I feel fairly certain that the lactose intolerance was triggered by the immunosuppressants though, due to the timing.
With both tacrolimus and sirolimus they tell you to take it either with food or without food, but to be consistent. It finally dawned on me that since it was obviously affected by food that maybe if I took it without food I could take fewer pills. I was being tested frequently and let my transplant center know that I wanted to do that so they tested me weekly for a short time to determine what the correct dosage of sirolimus would be when taking it without food. I went down from 4 mg once a day to 2.5 mg once a day.
When you are on immunosuppressants there are certain food restrictions. You cannot have any grapefruit, pomegranate, and one type of orange -- I think it's Seville. Of course after transplant alcohol is prohibited also. There are many herbs that are not allowed also, the ones that are bark or root I think, and absolutely no echinacea or anything that is supposed to contribute to immunity since the immunosuppressants are decreasing that so that your body does not reject your liver.
I've tried to cover everything here but I may have missed something. Please feel free to ask any other questions that will help you or your family member.
JK