Basiliximab
Basiliximab (Simulect)
Basiliximab
( bah-zih- LIX-ih-mab)
Pregnancy Category: B Simulect (Rx)

Classification: Drug to prevent rejection of kidney transplants

Action/Kinetics: An interleukin-2 (IL-2) receptor antagonist which is a monoclonal antibody produced by recombinant DNA technology. Acts as immunosuppressant by binding to and blocking the IL-2 receptor þ-chain which is selectively expressed on the surface of activated T-lymphocytes. This competitively inhibits IL-2-mediated activation of lymphocytes which is a critical pathway in the cellular immune response involved in allograft rejection. To be effective, serum levels must exceed 0.2 mcg/mL. At the recommended dosing regimen, the mean duration of basiliximab saturation of IL-2Rþ was 36 days. t 1/2, terminal, adults and adolescents: 7.2 days; t 1/2, terminal, children: 11.5 days.

Uses: Prophylaxis of acute organ rejection in renal transplantation. Used as part of an immunosuppresive regimen that includes cyclosporine and corticosteroids.

Contraindications: Lactation.

Special Concerns: Increased risk for developing opportunistic infections and lymphoproliferative disorders.

Side Effects: The incidence of side effects following basiliximab is no greater than placebo groups; however, 99% of clients in both groups reported side effects. Those with an incidence of 3% or greater are listed. GI: Constipation, N&V;, diarrhea, abdominal pain, dyspepsia, moniliasis, enlarged abdomen, flatulence, GI disorder, gastroenteritis, GI hemorrhage, gum hyperplasia, melena, esophagitis, ulcerative stomatitis. CNS: Headache, tremor, dizziness, insomnia, hypoesthesia, neuropathy, paresthesia, agitation, anxiety, depression. CV: Angina pectoris, cardiac failure, chest pain, abnormal heart sounds, aggravated hypertension, hypotension, arrhythmia, atrial fibrillation, tachycardia, vascular disorder. GU: Dysuria, UTI, impotence, genital edema, bladder disorder, hematuria, frequent micturition, oliguria, abnormal renal function, renal tubular necrosis, ureteral disorder, urinary retention. Respiratory: Dyspnea, URTI, coughing, rhinitis, pharyngitis, bronchitis, bronchospasm, abnormal chest sounds, pneumonia, pulmonary disorder, pulmonary edema, sinusitis. Dermatologic: Surgical wound complications, acne, cysts, herpes simplex, herpes zoster, hypertrichosis, pruritus, rash, skin disorder, skin ulceration. Musculoskeletal: Leg pain, back pain, arthralgia, arthropathy, bone fracture, cramps, hernia, myalgia. Hematologic: Hematoma, anemia, hemorrhage purpura, thrombocytopenia, thrombosis, polycythemia. Metabolic: Acidosis, weight increase, dehydration, diabetes mellitus, fluid overload. Ophthalmic: Cataract, conjunctivitis, abnormal vision. Miscellaneous: Pain, peripheral edema, fever, viral infection, leg edema, asthenia, accidental trauma, chest pain, increased drug level, face edema, fatigue, infection, malaise, generalized edema, rigors, sepsis.

Laboratory Test Alterations: NPN, glucocorticoids. Albuminuria, hyperkalemia, hypokalemia, hyperglycemia, hypoglycemia, hyperuricemia, hypophosphatemia, hypocalcemia, hypercalcemia, hyperlipemia, hypercholesterolemia, hypoproteinemia, hypomagnesemia.

Drug Interactions: Do not give echinacea with basiliximab.

How Supplied: Powder for injection: 20 mg

Dosage
?IV, central or peripheral Prevent kidney transplant rejection.
Adults: Two 20-mg doses; give the first 20 mg within 2 hr prior to transplant surgery and the second 20 mg dose 4 days after transplantation. Children, 2 to 15 years: Two doses of 12 mg/m ² each, up to a maximum of 20 mg each. Space the doses as in adults.