Muromonab CD3 Brand Name– Orthoclone OKT3
What is Muromonab CD3
Muromonab CD3 a parenteral monoclonal antibody of murine origin, is being removed from the market by the manufacturer because of the availability of multiple newer biologic agents; supplies were estimated to be available until May 2011, but any existing inventory may be used up to the expiration date noted on the individual product packaging.
Muromonab CD3 is FDA-approved for the treatment of acute kidney transplant rejection and for the treatment of steroid-resistant acute heart transplant rejection or liver transplant rejection.
Muromonab CD3 has been shown more successful in reversing rejection in patients with cadaveric renal allografts than conventional steroid therapy.
In contrast to polyclonal antibodies such as antithymocyte (ATG), muromonab-CD3 does not contain large amounts of extraneous antibodies.
Because it is monoclonal, muromonab-CD3 has a more consistent and measurable response.
However, a Cochrane analysis of treatments for acute rejection in kidney transplant recipients found no benefit of muromonab-CD3 over ATG in reversing rejection, preventing subsequent rejection, preventing graft loss, or preventing death.
- heart transplant rejection
- kidney transplant rejection
- liver transplant rejection
For treatment of acute kidney transplant rejection and for the treatment of steroid-resistant acute heart transplant rejection or liver transplant rejection
Side Effects
- aseptic meningitis
- cytokine release syndrome
- encephalopathy
- infection
- lymphadenopathy
- new primary malignancy
- pulmonary edema
- seizures
- serious hypersensitivity reactions or anaphylaxis
- wheezing
Monitoring Parameters
- absolute CD3 counts
- CBC
- chest x-ray
- LFTs
- serum alkaline phosphatase
- serum bilirubin (total and direct)
- serum creatinine/BUN
- serum muromonab-CD3 concentrations
Contraindications
- acute bronchospasm
- angina
- angioedema
- breast-feeding
- cardiac disease
- children
- coronary artery disease
- cytokine release syndrome
- fever
- fungal infection
- heart failure
- herpes infection
- human anti-murine antibody (HAMA)
- hypertension
- hypervolemia
- immunosuppression
- infection
- lymphoma
- murine protein hypersensitivity
- myocardial infarction
- neoplastic disease
- pregnancy
- pulmonary edema
- requires a specialized care setting
- requires an experienced clinician
- seizure disorder
- seizures
- serious hypersensitivity reactions or anaphylaxis
- urticaria
- vaccination
- varicella
- viral infection
Interactions
- Abatacept
- Acetaminophen; Aspirin, ASA; Caffeine
- Adalimumab
- Alefacept
- Amlodipine; Celecoxib
- Antithymocyte Globulin
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Azathioprine
- Celecoxib
- Certolizumab pegol
- Cladribine
- Corticosteroids
- Cyclosporine
- Diclofenac
- Diclofenac; Misoprostol
- Echinacea
- Fludarabine
- Flurbiprofen
- Golimumab
- Indomethacin
- Live Vaccines
- Meloxicam
- Mercaptopurine, 6-MP
- Methotrexate
- Penicillamine
- Pentostatin
- Purine analogs
- Rilonacept
- Sipuleucel-T
- Temozolomide
- Thioguanine, 6-TG
- Tocilizumab
- Tolmetin
