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1. Foods to Avoid: Kiwi fruit, pineapple, grapefruit, pomelo (other citrus fruits may be consumed in small amounts but must be separated from immunosuppressant intake by at least 2 hours), papaya, shiitake mushrooms, white fungus, black fungus, red dates, royal jelly, soy milk, soy isoflavones, miso, curry, onion, mulberries, aloe vera, ginger, Hypericum perforatum (St. John’s Wort), and raw fish.
   Rationale: These foods may interfere with the efficacy of immunosuppressive agents.
2. Multivitamins: Do not take multivitamins concurrently with calcineurin inhibitors (CNIs). Maintain at least a 2-hour interval between them.
3. Water Intake: Prefer filtered water for daily consumption.
4. Public Exposure: Wear a face mask when attending public venues..
5. Infection Prevention: Avoid contact with individuals with colds or other communicable diseases.
6. Hand Hygiene: Wash hands thoroughly before eating.
7. Personal Habits: Correct unconscious habits such as touching the face, rubbing the eyes, picking the nose, or inserting fingers into the ears.
8. Shared Meals: Use chopsticks and spoons when dining with others.
9. Strict Prohibitions: Smoking, raising pets (or close contact with animals), consumption of traditional Chinese medicine, folk remedies, or herbal tonics are strictly forbidden.
10. Travel Restrictions: Avoid overseas travel within the first 3 months post-transplant. For any necessary travel, consult your primary transplant physician in advance.
11. Lifestyle and Gratitude: Engage in charitable activities. Consider the date of your kidney transplant as your “second birthday.” On this day, it is encouraged to perform good deeds in remembrance and gratitude toward your donor.

Note: When seeking medical care in specialties other than transplant nephrology, please proactively inform the physician that you are a transplant recipient. Physicians should exercise caution in prescribing medications with potential drug–drug interactions as listed below. If the use of such medications is deemed necessary, please consult your transplant physician regarding appropriate adjustments.

Medications That Increase CNI (Calcineurin Inhibitor) Levels:

• Calcium Channel Blockers (CCB): Diltiazem, Verapamil, Felodipine
• Antiarrhythmic Drug: Amiodarone
• Antibiotics:
  • Antifungals: Ketoconazole, Fluconazole, Itraconazole, Voriconazole, Posaconazole, Isavuconazole, Metronidazole
  • Macrolides: Erythromycin, Clarithromycin, Azithromycin
• Anti-TB: Isoniazid
• Proton Pump Inhibitors (PPI): Omeprazole, Esomeprazole (may mildly increase CNI levels; pantoprazole and rabeprazole have minimal effects)
• Anti-HIV Medications: Saquinavir, Indinavir, Nelfinavir, Ritonavir
• Traditional Chinese Medicine: Citrus reticulata (Hua Ju Hong)

Medications/Foods That Decrease CNI Levels:

• Anticonvulsants: Carbamazepine, Phenobarbital, Phenytoin, Fosphenytoin
• Anti-TB Drugs: Rifampin, Rifabutin, Rifapentine
• Chinese Herbal Medicines:
  St. John’s Wort, Immature bitter orange (Zhi Shi), Kudzu root (Ge Gen), Pagoda tree flower (Huai Mi), Rhubarb, Scutellaria (Huang Qin), Phellodendron (Huang Bai), Japanese knotweed (Hu Zhang), Ginseng, American ginseng, Cordyceps, Licorice, Peony-Licorice Decoction, San Huang Xie Xin Tang, Huang Lian Jie Du Tang, Ge Gen Qin Lian Tang
• Other Foods/Herbs: Ginger, onion, mulberries, soy milk, miso, grapefruit, aloe vera, ginkgo, milk thistle, rue, oak extract, resveratrol, curcumin