Drug reference

Belatacept

Immunosuppressant

Also known as Nulojix

Immunosuppressant

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

AdalimumabSevereDatabaseDDInter
BaricitinibSevereDatabaseDDInter
CertolizumabSevereDatabaseDDInter
CladribineSevereDatabaseDDInter

Mechanism

Belatacept is a fusion protein and a second-generation CTLA4-Ig. It functions as a co-stimulation blocker, preventing the activation of T-cells. This mechanism helps to suppress the immune system, primarily to prevent graft rejection.

Indications

Prophylaxis of graft rejection in adults undergoing renal transplantation who are seropositive for the Epstein-Barr virus (used with interleukin-2 receptor antagonist induction, in combination with corticosteroids and a mycophenolic acid)prevention of renal transplant rejectionprophylaxis of acute organ rejection in patients receiving renal transplantsadult patients receiving a kidney transplant in combination with basiliximab induction, mmf, and corticosteroids

Dosing

Adult: Consult product literature

Pharmacokinetics

Onset

zero-order intravenous infusion

Half-life

about 11 days

Protein binding

linear pharmacokinetics

Contraindications

Increased risk of acute graft rejection with tapering of corticosteroid, particularly in patients with high immunologic risk
Increased risk of infection
Latent and active tuberculosis
Risk factors for post-transplant lymphoproliferative disorder
epstein-barr virus–seronegative patients
administration of higher or more frequent dosing than the recommended doses

Side effects

Common

AcidosisAlopeciaAnaemiaAngina pectorisArrhythmiasArterial fibrosisCataractChest painConstipationCoughCushing’s syndromeDecreased leucocytesDiabetes mellitusDiarrhoeaDizzinessDyslipidaemiaDyspnoeaEar painElectrolyte imbalanceEmbolism and thrombosisEye erythemaFatigueFeverFluid imbalanceGastrointestinal discomfortGastrointestinal disordersHaemorrhageHeadachesHealing impairedHeart failureHepatic disordersHypercapniaHyperglycaemiaHypertensionHypoproteinaemiaHypotensionIncreased risk of infectioninfusion-related reactions (infrequently)

Serious

Acute graft rejection
Post-transplant lymphoproliferative disorder
Serious infections
increased risk of posttransplant lymphoproliferative disorder in epstein-barr virus–seronegative patients
pml
serious cns infections