Disorders of metabolic pathways and mineral homeostasis are common in solid organ transplant recipients. In the early postoperative period, electrolyte abnormalities like hyperkalemia, hypercalcemia, hypomagnesemia, and hypophosphatemia are frequently seen. In the long term, recipients require close monitoring and management of co-morbidities like diabetes, hyperlipidemia, bone disease and gout. Treatment is especially challenging due to potential interactions with the transplant medications and variations in renal and hepatic function. In this chapter we review the therapeutic options available for treating metabolic and electrolyte disorders post-transplant with a particular focus on the potential side effects and drug interactions of commonly used medications.