Bone marrow transplant (BMT) medicines

This page explains about how to give your child bone marrow transplant (BMT) medicines.

• Keep all medicines in a safe place where children cannot reach them.
• Store all medicines in a cool, dry place out of direct sunlight and away from heat sources. Some medicines need to be stored in a refrigerator – the label will tell you if this is the case.
• Different strengths of medicines are available so always check the strength before giving to your child.
• Medicines should only be removed from their packaging or bottle at the time of giving a dose to reduce the risk of contamination or breakdown. In particular, the following medicines can be less effective or potentially harmful if prepared some time in advance of a dose:
  • Nifedipine breaks down under light making the medicine less effective.
  • Ciclosporin sticks to the sides of the syringe so that less than the recommended dose could be given.
  • Mycophenolate mofetil (MMF) is considered cytotoxic so special handling precautions are required as detailed in our separate information sheet.
  • Ciprofloxacin can settle at the bottom of the container so that less than the recommended dose could be given.
• We do not know for sure whether tablets crushed and dispersed in water (off label use) remain stable and effective after any length of time. Therefore we recommend that each dose is prepared at the time of giving and any remaining solution is poured into the sink and flushed with plenty of water. A fresh tablet should also be used for each dose.
• Ensure that your child drinks plenty of fluids especially when taking aciclovir or ciclosporin as they can affect the kidneys.
• When medication is given three or four times a day (nifedipine, aciclovir or mycophenolate mofetil) there should be six to eight hours between each dose. However, the evening dose may be brought forward up to two hours to avoid waking your child during the night. 

Please note that your child may not be taking all of the above medications or maybe on other medication not listed above. Use this information only for the medicines that are prescribed for your child. If you have any questions or concerns regarding any medication not listed above or any other queries, please ring the contact numbers of this information sheet and ask to speak to your doctor, nurse or pharmacist.