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belatacept (Intravenous route)

bel-AT-a-sept

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 .

Commonly used brand name(s)

In the U.S.

  • Nulojix

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Immunological Agent

Uses For belatacept

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.

Slideshow: 2014 Update - First Time Brand-to-Generic Switches

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.

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

Before Using belatacept

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 belatacept, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to belatacept 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.

Pediatric

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.

Geriatric

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

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal 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.

Interactions with 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.

Interactions with Food/Tobacco/Alcohol

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 belatacept. 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 belatacept.

Proper Use of belatacept

A nurse or other trained health professional will give you belatacept in a hospital. belatacept 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.

belatacept 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 belatacept

It is very important that your doctor check your progress at regular visits to make sure that belatacept 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 belatacept.

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

Using belatacept 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.

belatacept 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.

belatacept may increase your risk of developing infections. Avoid being near people who are sick or have infections while you are using belatacept. Wash your hands often. Tell your doctor if you have any kind of infection before you start using belatacept. 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 belatacept. Tell your doctor if you or anyone in your home has ever had a positive reaction to a tuberculosis skin test.

belatacept 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.

belatacept Side Effects

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.

See also: Side effects (in more detail)

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