Only physicians experienced in immunosuppression therapy and management of organ transplantation patients should prescribe basiliximab. The physician responsible for basiliximab administration should have complete information requisite for the follow-up of the patient. Patients receiving the drug should be managed in facilities equipped with adequate laboratory and supportive medical resources.
Note: Patients previously administered basiliximab should only be re-exposed to a subsequent course of therapy with extreme caution.
Renal transplantation (prophylaxis of acute rejection): IV: 20 mg within 2 hours prior to transplant surgery, followed by a second 20 mg dose 4 days after transplantation (in combination with other immunosuppressants). The second dose should be withheld if complications occur (including severe hypersensitivity reactions or graft loss). Timing of basiliximab dosing may vary based on clinical and institutional factors; refer to institutional protocol for specific information.
Graft-versus-host disease, acute (aGVHD), refractory (treatment) (off-label use): IV: 20 mg on days 1 and 4; may repeat for recurrent acute GVHD (Schmidt-Hieber 2005). Additional data may be necessary to further define the role of basiliximab in this condition.
Heart transplantation (prophylaxis of acute rejection) (off-label use): IV: 20 mg on the day of transplant, followed by a second 20 mg dose on day 4 post-transplantation (in combination with other immunosuppressants) (Mehra 2005). The first dose is usually administered immediately prior to transplant or within the first hours postoperatively.
Liver transplantation (prophylaxis of acute rejection) (off-label use): IV: 20 mg on the day of transplant (day 0), followed by a second 20 mg dose on day 4 post-transplantation (in combination with other immunosuppressants) (Neuhaus 2002; Trunecka 2015). In clinical trials, the first dose was administered during the procedure once hemostasis was achieved or immediately post-transplant, or within 6 hours of organ reperfusion.
Lung transplantation (prophylaxis of acute rejection) (off-label use): IV: 20 mg prior to transplantation, followed by a second 20 mg dose 4 days after transplantation (in combination with other immunosuppressants) (Clinckart 2009; Swarup 2011). Additional trials may be necessary to further define the role of basiliximab in this condition.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
(For additional information see "Basiliximab: Pediatric drug information")
Note: Patients previously administered basiliximab should only be re-exposed to a subsequent course of therapy with extreme caution due to increased risk of hypersensitivity reactions. Hold second or subsequent dose(s) if severe hypersensitivity reactions or graft failure occurs.
Heart transplantation: Limited data available (ISHLT [Velleca 2023]):
Infants, Children, and Adolescents:
Patient weight <35 kg:
Initial dose: IV: 10 mg administered immediately before cardiopulmonary bypass started is recommended, or may administer within 6 hours of organ perfusion (Ford 2005); reported timing of doses is variable; however, superior outcomes have been reported with pretransplant basiliximab administration (Grundy 2009).
Second dose: IV: 10 mg administered 4 days after transplantation (Ford 2005).
Patient weight ≥35 kg:
Initial dose: IV: 20 mg administered immediately before cardiopulmonary bypass started is recommended, or may administer within 6 hours of organ perfusion (Ford 2005); reported timing of doses is variable; however, superior outcomes have been reported with pretransplant basiliximab administration (Grundy 2009).
Second dose: IV: 20 mg administered 4 days after transplantation (Ford 2005).
Liver transplantation: Limited data available:
Infants, Children, and Adolescents:
Patient weight <35 kg:
Initial dose: IV: 10 mg administered within 6 hours of organ perfusion (Cintorino 2006; Newland 2019; Spada 2006).
Second dose: IV: 10 mg administered 4 days after transplantation (Cintorino 2006; Newland 2019; Spada 2006).
Third dose (optional): IV: 10 mg has been repeated on postoperative days 8 to 10 if ascites fluid loss exceeds 70 mL/kg (Cintorino 2006; Spada 2006).
Patient weight ≥35 kg:
Initial dose: IV: 20 mg administered within 6 hours of organ perfusion (Cintorino 2006; Newland 2019; Spada 2006).
Second dose: IV: 20 mg administered 4 days after transplantation (Cintorino 2006; Newland 2019; Spada 2006).
Third dose (optional): IV: 20 mg has been repeated on postoperative days 8 to 10 if ascites fluid loss exceeds 70 mL/kg or if total ascites volume ≥5 L (Cintorino 2006; Spada 2006).
Renal transplantation:
Children and Adolescents:
Patient weight <35 kg:
Initial dose: IV: 10 mg administered within 2 hours prior to renal transplant surgery.
Second dose: IV: 10 mg administered 4 days after transplantation.
Patient weight ≥35 kg:
Initial dose: IV: 20 mg administered within 2 hours prior to renal transplant surgery.
Second dose: IV: 20 mg administered 4 days after transplantation.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in manufacturer's labeling.
There are no dosage adjustments provided in manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported with combination therapy.
>10%:
Cardiovascular: Hypertension (exacerbation of hypertension: 3% to 10%), peripheral edema (leg edema: 3% to 10%)
Dermatologic: Acne vulgaris
Endocrine & metabolic: Hypercholesterolemia, hyperglycemia, hyperkalemia, hyperuricemia, hypokalemia, hypophosphatemia
Gastrointestinal: Abdominal pain, constipation, diarrhea, dyspepsia, nausea, vomiting
Genitourinary: Urinary tract infection
Hematologic & oncologic: Anemia
Infection: Cytomegalovirus disease (11%), viral infection
Nervous system: Headache, insomnia, pain, tremor
Respiratory: Dyspnea, upper respiratory infection
Miscellaneous: Fever
1% to 10%:
Cardiovascular: Abnormal heart sounds (3% to 10%), angina pectoris (3% to 10%), atrial fibrillation (3% to 10%), cardiac arrhythmia (3% to 10%), chest pain (3% to 10%), dependent edema (3% to 10%), edema (3% to 10%), heart failure (3% to 10%), hypotension (3% to 10%), tachycardia (3% to 10%), thrombosis (3% to 10%), vascular disease (3% to 10%)
Dermatologic: Dermal ulcer (3% to 10%), hypertrichosis (3% to 10%), pruritus (3% to 10%), skin rash (3% to 10%)
Endocrine & metabolic: Acidosis (3% to 10%), albuminuria (3% to 10%), dehydration (3% to 10%), diabetes mellitus (3% to 10%), hypercalcemia (3% to 10%), hyperlipidemia (3% to 10%), hypertriglyceridemia (3% to 10%), hypervolemia (3% to 10%), hypocalcemia (3% to 10%), hypoglycemia (3% to 10%), hypomagnesemia (3% to 10%), increased nonprotein nitrogen (3% to 10%), increased serum glucocorticoids (3% to 10%), weight gain (3% to 10%)
Gastrointestinal: Aphthous stomatitis (3% to 10%), enlargement of abdomen (3% to 10%), esophagitis (3% to 10%), flatulence (3% to 10%), gastroenteritis (3% to 10%), gastrointestinal candidiasis (3% to 10%), gastrointestinal hemorrhage (3% to 10%), gingival hyperplasia (3% to 10%), hernia of abdominal cavity (3% to 10%), melena (3% to 10%)
Genitourinary: Bladder dysfunction (3% to 10%), dysuria (3% to 10%), erectile dysfunction (3% to 10%), genital edema (male) (3% to 10%), hematuria (3% to 10%), oliguria (3% to 10%), ureteral disease (3% to 10%), urinary frequency (3% to 10%), urinary retention (3% to 10%)
Hematologic & oncologic: Hematoma (3% to 10%), hemorrhage (3% to 10%), hypoproteinemia (3% to 10%), leukopenia (3% to 10%), polycythemia (3% to 10%), purpuric disease (3% to 10%), thrombocytopenia (3% to 10%)
Hypersensitivity: Facial edema (3% to 10%)
Immunologic: Antibody development (1%)
Infection: Infection (including herpes simplex infection, herpes zoster infection) (3% to 10%), sepsis (3% to 10%)
Nervous system: Agitation (3% to 10%), anxiety (3% to 10%), asthenia (3% to 10%), depression (3% to 10%), dizziness (3% to 10%), fatigue (3% to 10%), hypoesthesia (3% to 10%), malaise (3% to 10%), neuropathy (3% to 10%), paresthesia (3% to 10%), rigors (3% to 10%)
Neuromuscular & skeletal: Arthralgia (3% to 10%), arthropathy (3% to 10%), back pain (3% to 10%), bone fracture (3% to 10%), lower leg pain (3% to 10%), muscle cramps (3% to 10%), myalgia (3% to 10%)
Ophthalmic: Cataract (3% to 10%), conjunctivitis (3% to 10%), visual disturbance (3% to 10%)
Renal: Kidney impairment (including renal tubular necrosis) (3% to 10%)
Respiratory: Abnormal breath sounds (3% to 10%), bronchitis (3% to 10%), bronchospasm (3% to 10%), cough (3% to 10%), pharyngitis (3% to 10%), pneumonia (3% to 10%), pulmonary edema (3% to 10%), rhinitis (3% to 10%), sinusitis (3% to 10%)
Miscellaneous: Cyst (3% to 10%)
Postmarketing:
Cardiovascular: Capillary leak syndrome
Hypersensitivity: Cytokine release syndrome, hypersensitivity reaction (including anaphylaxis, severe hypersensitivity reaction)
Known hypersensitivity to basiliximab or any component of the formulation
Concerns related to adverse effects:
• Anaphylactoid/hypersensitivity reactions: Severe hypersensitivity reactions, occurring within 24 hours, have been reported. Reactions, including anaphylaxis, have occurred both with the initial exposure and/or following re-exposure after several months; use caution during re-exposure to a subsequent course of therapy in a patient who has previously received basiliximab. Patients in whom concomitant immunosuppression was prematurely discontinued due to abandoned transplantation or early graft loss are at increased risk for developing a severe hypersensitivity reaction upon re-exposure. Discontinue permanently if a severe reaction occurs. Medications for the treatment of hypersensitivity reactions should be available for immediate use.
• Diabetes: In renal transplant recipients receiving basiliximab plus prednisone, cyclosporine, and mycophenolate, new-onset diabetes, glucose intolerance, and impaired fasting glucose were observed at rates significantly higher than observed in patients receiving prednisone, cyclosporine, and mycophenolate without basiliximab (Aasebo 2010).
• Human antimurine antibodies (HAMA): Treatment may result in the development of HAMA; however, limited evidence suggests the use of murine anti-lymphocytic antibody products is not precluded.
• Lymphoproliferative disorders: The incidence of lymphoproliferative disorders may be increased by immunosuppressive therapy.
• Opportunistic infections: The incidence of opportunistic infections may be increased by immunosuppressive therapy.
Other warnings/precautions:
• Appropriate use: To be used as a component of an immunosuppressive regimen that may include a calcineurin inhibitor, adjunctive agent (eg, mycophenolate mofetil, everolimus), and corticosteroids.
• Experienced physician: [US Boxed Warning]: Should be administered under the supervision of a physician experienced in immunosuppression therapy and organ transplant management.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Intravenous [preservative free]:
Simulect: 10 mg (1 ea); 20 mg (1 ea)
No
Solution (reconstituted) (Simulect Intravenous)
10 mg (per each): $4,006.52
20 mg (per each): $5,258.56
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Intravenous:
Simulect: 20 mg (1 ea)
IV: For intravenous administration only. Infuse as a bolus or IV infusion over 20 to 30 minutes (bolus dosing is associated with nausea, vomiting, and local pain at the injection site); may be administered through either a peripheral or central line. For the treatment of acute GVHD (off-label use), the dose was administered over 30 minutes (Schmidt-Hieber 2005).
IV: For IV administration only through central or peripheral access. Administer only after confirmation that patient will receive graft and immunosuppression. Reconstituted basiliximab solution may be administered undiluted as a bolus injection or further diluted and infused over 20 to 30 minutes. Bolus injection is associated with nausea, vomiting, and local pain at the injection site.
Renal transplant (prophylaxis of acute rejection): Prophylaxis of acute organ rejection in renal transplantation in combination with cyclosporine (modified) and corticosteroids.
Acute graft-versus-host disease, refractory (treatment); Heart transplant (prophylaxis of acute rejection); Liver transplant (prophylaxis of acute rejection); Lung transplant (prophylaxis of acute rejection)
Basiliximab may be confused with bezlotoxumab.
This medication is in a class the Institute for Safe Medication Practices (ISMP) includes among its list of drug classes that have a heightened risk of causing significant patient harm when used in error.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Abrocitinib: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Antidiabetic Agents: Hyperglycemia-Associated Agents may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy
Antithymocyte Globulin (Equine): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Antithymocyte Globulin (Equine). Specifically, these effects may be unmasked if the dose of immunosuppressive therapy is reduced. Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Antithymocyte Globulin (Equine). Specifically, infections may occur with greater severity and/or atypical presentations. Risk C: Monitor therapy
Baricitinib: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Baricitinib. Risk X: Avoid combination
BCG Products: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of BCG Products. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of BCG Products. Risk X: Avoid combination
Brincidofovir: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Brincidofovir. Risk C: Monitor therapy
Brivudine: May enhance the adverse/toxic effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Chikungunya Vaccine (Live): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Chikungunya Vaccine (Live). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Chikungunya Vaccine (Live). Risk X: Avoid combination
Cladribine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Cladribine. Risk X: Avoid combination
Coccidioides immitis Skin Test: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the diagnostic effect of Coccidioides immitis Skin Test. Management: Consider discontinuing therapeutic immunosuppressants several weeks prior to coccidioides immitis skin antigen testing to increase the likelihood of accurate diagnostic results. Risk D: Consider therapy modification
COVID-19 Vaccine (Adenovirus Vector): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Adenovirus Vector). Management: Administer a 2nd dose using an mRNA COVID-19 vaccine (at least 4 weeks after the primary vaccine dose) and a bivalent booster dose (at least 2 months after the additional mRNA dose or any other boosters). Risk D: Consider therapy modification
COVID-19 Vaccine (Inactivated Virus): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Inactivated Virus). Risk C: Monitor therapy
COVID-19 Vaccine (mRNA): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (mRNA). Management: Give a 3-dose primary series for all patients aged 6 months and older taking immunosuppressive medications or therapies. Booster doses are recommended for certain age groups. See CDC guidance for details. Risk D: Consider therapy modification
COVID-19 Vaccine (Subunit): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Subunit). Risk C: Monitor therapy
COVID-19 Vaccine (Virus-like Particles): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Virus-like Particles). Risk C: Monitor therapy
Dengue Tetravalent Vaccine (Live): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Dengue Tetravalent Vaccine (Live). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Dengue Tetravalent Vaccine (Live). Risk X: Avoid combination
Denosumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Denosumab. Management: Consider the risk of serious infections versus the potential benefits of coadministration of denosumab and immunosuppressants. If combined, monitor for signs/symptoms of serious infections. Risk D: Consider therapy modification
Deucravacitinib: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Efgartigimod Alfa: May diminish the therapeutic effect of Fc Receptor-Binding Agents. Risk C: Monitor therapy
Etrasimod: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Filgotinib: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Inebilizumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Inebilizumab. Risk C: Monitor therapy
Influenza Virus Vaccines: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Influenza Virus Vaccines. Management: Administer influenza vaccines at least 2 weeks prior to initiating immunosuppressants if possible. If vaccination occurs less than 2 weeks prior to or during therapy, revaccinate 2 to 3 months after therapy discontinued if immune competence restored. Risk D: Consider therapy modification
Leflunomide: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Leflunomide. Management: Increase the frequency of chronic monitoring of platelet, white blood cell count, and hemoglobin or hematocrit to monthly, instead of every 6 to 8 weeks, if leflunomide is coadministered with immunosuppressive agents. Risk D: Consider therapy modification
Mumps- Rubella- or Varicella-Containing Live Vaccines: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Mumps- Rubella- or Varicella-Containing Live Vaccines. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Mumps- Rubella- or Varicella-Containing Live Vaccines. Risk X: Avoid combination
Nadofaragene Firadenovec: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Nadofaragene Firadenovec. Specifically, the risk of disseminated adenovirus infection may be increased. Risk X: Avoid combination
Natalizumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Natalizumab. Risk X: Avoid combination
Ocrelizumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ocrelizumab. Risk C: Monitor therapy
Ofatumumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ofatumumab. Risk C: Monitor therapy
Pidotimod: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Pidotimod. Risk C: Monitor therapy
Pimecrolimus: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Pimecrolimus. Risk X: Avoid combination
Pneumococcal Vaccines: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Pneumococcal Vaccines. Risk C: Monitor therapy
Poliovirus Vaccine (Live/Trivalent/Oral): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Poliovirus Vaccine (Live/Trivalent/Oral). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Poliovirus Vaccine (Live/Trivalent/Oral). Risk X: Avoid combination
Polymethylmethacrylate: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the potential for allergic or hypersensitivity reactions to Polymethylmethacrylate. Management: Use caution when considering use of bovine collagen-containing implants such as the polymethylmethacrylate-based Bellafill brand implant in patients who are receiving immunosuppressants. Consider use of additional skin tests prior to administration. Risk D: Consider therapy modification
Rabies Vaccine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Ritlecitinib: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ritlecitinib. Risk X: Avoid combination
Rozanolixizumab: May diminish the therapeutic effect of Fc Receptor-Binding Agents. Risk C: Monitor therapy
Ruxolitinib (Topical): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ruxolitinib (Topical). Risk X: Avoid combination
Sipuleucel-T: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Sipuleucel-T. Management: Consider reducing the dose or discontinuing the use of immunosuppressants prior to initiating sipuleucel-T therapy. Risk D: Consider therapy modification
Sphingosine 1-Phosphate (S1P) Receptor Modulator: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk C: Monitor therapy
Tacrolimus (Topical): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Tacrolimus (Topical). Risk X: Avoid combination
Talimogene Laherparepvec: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Talimogene Laherparepvec. Specifically, the risk of infection from the live, attenuated herpes simplex virus contained in talimogene laherparepvec may be increased. Risk X: Avoid combination
Tertomotide: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Tertomotide. Risk X: Avoid combination
Tofacitinib: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Tofacitinib. Management: Coadministration of tofacitinib with potent immunosuppressants is not recommended. Use with non-biologic disease-modifying antirheumatic drugs (DMARDs) was permitted in psoriatic arthritis clinical trials. Risk X: Avoid combination
Typhoid Vaccine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Typhoid Vaccine. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Typhoid Vaccine. Risk X: Avoid combination
Ublituximab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ublituximab. Risk C: Monitor therapy
Upadacitinib: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Upadacitinib. Risk X: Avoid combination
Vaccines (Inactivated/Non-Replicating): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Give inactivated vaccines at least 2 weeks prior to initiation of immunosuppressants when possible. Patients vaccinated less than 14 days before initiating or during therapy should be revaccinated at least 2 to 3 months after therapy is complete. Risk D: Consider therapy modification
Vaccines (Live): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Vaccines (Live). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Vaccines (Live). Risk X: Avoid combination
Yellow Fever Vaccine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Yellow Fever Vaccine. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Yellow Fever Vaccine. Risk X: Avoid combination
Females of childbearing potential should use effective contraceptive measures before beginning treatment, during, and for 4 months after completion of basiliximab treatment.
Basiliximab is a monoclonal IgG antibody which targets IL-2 receptors. IgG is known to cross the placenta; IL-2 receptors play an important role in the development of the immune system.
The Transplant Pregnancy Registry International (TPR) is a registry that follows pregnancies that occur in maternal transplant recipients or those fathered by male transplant recipients. The TPR encourages reporting of pregnancies following solid organ transplant by contacting them at 1-877-955-6877 or https://www.transplantpregnancyregistry.org.
It is not known if basiliximab is present in human milk. Because many immunoglobulins are secreted in milk and the potential for serious adverse reactions exists, a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.
Monitor for signs and symptoms of acute rejection; hypersensitivity, infection
Basiliximab is a chimeric (murine/human) immunosuppressant monoclonal antibody which blocks the alpha-chain of the interleukin-2 (IL-2) receptor complex; this receptor is expressed on activated T lymphocytes and is a critical pathway for activating cell-mediated allograft rejection
Duration: Mean: 36 days ± 14 days (determined by IL-2R alpha saturation in patients also on cyclosporine and corticosteroids).
Distribution: Mean: Vd: Children 1 to 11 years: 4.8 ± 2.1 L; Adolescents 12 to 16 years: 7.8 ± 5.1 L; Adults: 8.6 ± 4.1 L.
Half-life elimination: Children 1 to 11 years: 9.5 ± 4.5 days; Adolescents 12 to 16 years: 9.1 ± 3.9 days; Adults: Mean: 7.2 ± 3.2 days.
Excretion: Clearance:
Children 1 to 11 years: 17 ± 6 mL/hour; in pediatric liver transplant recipients, significant basiliximab loss through ascites fluid can increase total body clearance and reduce IL-2R (CD25) saturation duration; dosage adjustments may be necessary (Cintorino 2006; Kovarik 2002; Spada 2006).
Adolescents 12 to 16 years: 31 ±19 mL/hour.
Adults: 41 ± 19 mL/hour.
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