Page 29 - RxExam's Naplex Theory Book Part 2

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Dose Special Notes

Belatacept 2). Belatacept (Nulojix) is indicated for prophylaxis of organ rejection
(Injection) in adult patients receiving a kidney transplant. It is to be used in
combination with basiliximab induction, mycophenolate mofetil, and
corticosteroids.

3). The prescribed dose of Belatacept (Nulojix) must be evenly divisible
by 12.5 mg in order for the dose to be prepared accurately using the
reconstituted solution and the silicone-free disposable syringe
provided. Evenly divisible increments are 0, 12.5, 25, 37.5, 50, 62.5,
75, 87.5, and 100.
For example: A patient weighs 64 kg. The dose is 10 mg per kg.
Calculated Dose: 64 kg × 10 mg per kg = 640 mg
The closest doses evenly divisible by 12.5 mg below and above 640 mg
are 637.5 mg and 650 mg. The nearest dose to 640 mg is 637.5 mg.
Therefore, the actual prescribed dose for the patient should be 637.5 mg.

4). Due to an increased risk of post-transplant lymphoproliferative
disorder (PTLD) predominantly involving the central nervous system
(CNS), progressive multifocal leukoencephalopathy (PML), and serious
CNS infections, administration of higher than the recommended doses
or more frequent dosing of Belatacept (Nulojix) is not recommended.

5). The risk of post-transplant lymphoproliferative disorder PTLD is
higher in Epstein-Barr Virus (EBV) sero-negative patients compared to
Epstein-Barr Virus (EBV) sero-positive patients. EBV sero-positive
patients are defined as having evidence of acquired immunity shown
by the presence of IgG antibodies to viral capsid antigen (VCA) and
EBV nuclear antigen (EBNA). Epstein-Barr virus serology should be
ascertained before starting administration of Belatacept (Nulojix), and
only patients who are EBV sero-positive should receive Belatacept
(Nulojix). Transplant recipients who are EBV sero-negative, or with
unknown sero-status, should NOT receive Belatacept (Nulojix).

6. CNS infections, infusion site reactions, PTLD, PML, proteinuria,
hypertension, dyslipidemia, nausea and vomiting are reported side
effects of Belatacept (Nulojix).

Muromonab 1. Renal, cardiac 1). Muromonab-CD3 (Orthoclone OKT3) is a murine monoclonal
Cd3 and hepatic antibody to the CD3 antigen of human T cells which functions as an
(Injection) transplants: immunosuppressant.
5 mg per day in a
single (bolus) IV 2). Muromonab-CD3 (Orthoclone OKT3) is indicated for the treatment
injection in less of:
than one minute a). Acute allograft rejection in renal transplant patients.
for 10 to 14 days. b). Steroid-resistant acute allograft rejection in cardiac and hepatic
transplant patients.

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