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Belatacept (Intravenous route)

Pronunciation:

bel-AT-a-sept

Brand Names:

  • Nulojix

Dosage Forms:

  • Powder for Solution

Warnings:

Intravenous route(Powder for Solution)

Increased risk for developing posttransplant lymphoproliferative disorder (PTLD), predominantly involving the CNS. Recipients without immunity to Epstein-Barr virus (EBV) are at a particularly increased risk; therefore, use in EBV-seropositive patients only. Do not use belatacept in transplant recipients who are EBV seronegative or with unknown EBV serostatus. Only physicians experienced in immunosuppressive therapy and management of kidney transplant patients should prescribe belatacept. Patients receiving the drug should be managed in facilities equipped and staffed with adequate laboratory and supportive medical resources. Increased susceptibility to infection and the possible development of malignancies may result from immunosuppression. Use in liver transplant patients is not recommended due to an increased risk of graft loss and death .

Classifications:

Therapeutic—

Immunological Agent

Uses of This Medicine:

Belatacept injection belongs to a group of medicines known as immunosuppressive agents. It is used together with other medicines to prevent the body from rejecting a transplanted kidney.

When a patient receives a kidney transplant, the body's white blood cells will try to get rid of (reject) the transplanted kidney. Belatacept works by suppressing the immune system and prevents the white blood cells from trying to get rid of the transplanted organ.

This medicine is to be given only by or under the direct supervision of a doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of belatacept injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of belatacept injection in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Cytomegalovirus (CMV) infection—Use with caution. May increase risk for more serious side effects.
  • Infection (e.g., bacteria, fungus, virus, or protozoa)—May decrease your body's ability to fight infection.
  • Tuberculosis infection—Should be treated before starting therapy with this medicine.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins. The medicine must be injected slowly, so the needle will need to stay in place for at least 30 minutes.

This medicine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. Be sure to keep all appointments.

It is important to tell your doctor if you become pregnant. Your doctor may want you to join a pregnancy registry for patients using this medicine.

Do not receive this medicine if your doctor says you are Epstein-Barr virus (EBV) negative. Your doctor will test you for EBV.

Using this medicine may increase your risk of having serious conditions called post-transplant lymphoproliferative disorder (PTLD) or progressive multifocal leukoencephalopathy. The risk of developing PTLD is higher in patients who are EBV negative, have cytomegalovirus (CMV) infection, or have received treatments for transplant rejections. Check with your doctor right away if you have changes in mood or usual behavior, confusion, problems with thinking, loss of memory, decreased strength on one side of the body, or changes in vision, walking, or talking.

This medicine may increase your risk of getting certain types of cancer, especially of the skin. Talk to your doctor if you have concerns about this risk.

Use sunscreen or sunblock lotions with a sun protection factor (SPF) of at least 15 on a regular basis when you are outdoors. Wear protective clothing and hats, and stay out of direct sunlight between the hours of 10 a.m. and 3 p.m. Avoid sunlamps and tanning beds.

This medicine may increase your risk of developing infections. Avoid being near people who are sick or have infections while you are using this medicine. Wash your hands often. Tell your doctor if you have any kind of infection before you start using this medicine. Also tell your doctor if you have ever had an infection that would not go away or an infection that kept coming back.

You will need to have a skin test for tuberculosis before you start using this medicine. Tell your doctor if you or anyone in your home has ever had a positive reaction to a tuberculosis skin test.

This medicine may increase your risk for developing a rare and serious virus infection called polyoma virus-associated nephropathy (PVAN). PVAN is caused by BK virus. The BK virus may affect how your kidneys work and cause a transplanted kidney to fail. Check with your doctor right away if you are having more than one of these symptoms: bloody urine; a decreased frequency or amount of urine; increased thirst; loss of appetite; lower back or side pain; nausea; swelling of the face, fingers, or lower legs; trouble with breathing; unusual tiredness or weakness; vomiting; or weight gain.

While you are being treated with belatacept, and after you stop using it, it is important to talk to your doctor about the immunizations (vaccines) you should receive. Do not get any vaccine without your doctor's approval. Belatacept may lower your body's resistance and there is a chance you might get the infection the vaccine is meant to prevent. In addition, other persons living in your household should not receive certain vaccines since there is a chance they could pass the infection on to you. Talk to your doctor if you have questions about this.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Abdominal or stomach pain
agitation
black, tarry stools
bladder pain
bloating or swelling of the face, arms, hands, lower legs, or feet
bloody or cloudy urine
blurred vision
bone pain
burning while urinating
chest pain
chills
coma
confusion
convulsions
cough or hoarseness
decreased frequency or amount of urine
decreased urine output
depression
difficult or labored breathing
difficult, burning, or painful urination
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
drowsiness
dry mouth
fainting
fast or irregular heartbeat
fever
frequent urge to urinate
headache
hostility
inability to move the arms and legs
increased blood pressure
increased thirst
irritability
itching in other skin areas
lethargy
loss of appetite
loss of bladder control
lower back or side pain
mood or mental changes
muscle pain or cramps
muscle spasms (tetany) or twitching
nausea or vomiting
nervousness
numbness or tingling in the hands, feet, or lips
pale skin
pounding in the ears
rapid weight gain
scaling
shortness of breath
slow or fast heartbeat
sore throat
sores, ulcers, or white spots on the lips or in the mouth
stupor
sudden decrease in the amount of urine
sudden numbness and weakness in the arms and legs
sweating
swelling of the face, ankles, or hands
swollen glands
tightness in the chest
trembling
troubled breathing
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight gain or loss
weakness or heaviness of the legs
weight gain
wheezing
Less common
Back pain
coughing or spitting up blood
drowsiness
joint pain, stiffness, or swelling
loss of appetite
night sweats
persistent non-healing sore
pink growth reddish patch or irritated area
shiny bump
sudden high fever or low-grade fever for months
swelling of the feet or lower legs
weight gain
white, yellow, or waxy scar-like area

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Abdominal or stomach cramps
blemishes on the skin
body aches or pain
collection of blood under the skin
cough producing mucus
deep, dark purple bruise
diarrhea
difficulty having a bowel movement (stool)
difficulty with moving
dry mouth
ear congestion
flushed, dry skin
fruit-like breath odor
hair loss or thinning of the hair
increased hunger
increased sweating
increased urination
itching, pain, redness, or swelling
loss of consciousness
loss of voice
muscle cramps in the hands, arms, feet, legs, or face
muscle or bone pain
muscle pain or stiffness
numbness and tingling around the mouth, fingertips, or feet
pain in the joints
pimples
shakiness in the legs, arms, hands, or feet
shortness of breath
sleeplessness
sneezing
swelling or inflammation of the mouth
tightness in the chest
tremor
trouble sleeping
unable to sleep
unexplained weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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