Belatacept

Belatacept Brand Name– NULOJIX

What is Belatacept

Belatacept is a selective T-cell costimulation blocker indicated for rejection prophylaxis in adults receiving a kidney transplant.

Belatacept is used in combination with basiliximab induction, mycophenolate mofetil, and corticosteroids and is only indicated for use in Epstein-Barr virus (EBV) seropositive patients.

Belatacept is contraindicated for use by patients who are EBV seronegative or with unknown serostatus because of the risk of post-transplant lymphoproliferative disorder.

Belatacept was FDA approved in June 2011.

Indications

  • kidney transplant rejection prophylaxis

For kidney transplant rejection prophylaxis in combination with basiliximab induction, mycophenolate mofetil, and corticosteroids

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. alopecia
  4. anaphylactoid reactions
  5. anemia
  6. antibody formation
  7. anxiety
  8. arthralgia
  9. atrial fibrillation
  10. back pain
  11. BK virus-associated nephropathy
  12. constipation
  13. cough
  14. diabetes mellitus
  15. diarrhea
  16. dizziness
  17. dyspnea
  18. dysuria
  19. fever
  20. Guillain-Barre syndrome
  21. headache
  22. hematuria
  23. hypercholesterolemia
  24. hyperglycemia
  25. hyperhidrosis
  26. hyperkalemia
  27. hypertension
  28. hyperuricemia
  29. hypocalcemia
  30. hypokalemia
  31. hypomagnesemia
  32. hypophosphatemia
  33. hypotension
  34. immunosuppression
  35. infection
  36. influenza
  37. insomnia
  38. leukoencephalopathy
  39. leukopenia
  40. lymphocele
  41. musculoskeletal pain
  42. nausea
  43. neutropenia
  44. new primary malignancy
  45. peripheral edema
  46. pharyngitis
  47. post-transplant lymphoproliferative disorder (PTLD)
  48. proteinuria
  49. renal failure (unspecified)
  50. renal tubular necrosis
  51. stomatitis
  52. thrombosis
  53. tremor
  54. urinary incontinence
  55. vomiting
  56. wound dehiscence

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • breast-feeding
  • children
  • diabetes mellitus
  • immunosuppression
  • infants
  • infection
  • liver transplant
  • mortality
  • neonates
  • new primary malignancy
  • post-transplant lymphoproliferative disorder (PTLD)
  • pregnancy
  • progressive multifocal leukoencephalopathy
  • requires a specialized care setting
  • requires an experienced clinician
  • sunlight (UV) exposure
  • thromboembolic disease
  • tuberculosis
  • vaccination

Interactions

  • Antithymocyte Globulin
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Influenza Virus Vaccine
  • Intranasal Influenza Vaccine
  • Live Vaccines
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Typhoid Vaccine
  • Varicella-Zoster Virus Vaccine, Live
  • Yellow Fever Vaccine, Live
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