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Transplant Meds

Solid Organ Transplant

DrugClass/MOAMajor ADRPremdicatePlace in TherapyD/IOther
Tacrolimus CNI Nephrotoxicity Hepatotoxicity Neurotoxicity Tremor Alopecia Hyperglycemia No. Maintenance. Cornerstone to immunosuppression regimen CYP3A4 Highly lipophilic; does not require bile for absorption Monitor trough levels (CNI): African Americans typically require larger doses; redistributes to erythrocytes
Sirolimus mTOR-I Angioedema, proteinuria, oral ulcers, micoryctic anemia, impaired wound healing, graft thrombus: (greatest risk in first 30 days of transplant) Heart Transplant: delay initiation until 3-6 months’ post-transplant No. Maintenance Can replace CNI or Anti-metabolite Nephrotoxicity Cancer Intolerance to another agent CYP3A4 No IV formulation Nephrotoxicity when used in combo with CNI, so need to lower CNI target troughs when combine CNI with mTOR inhibitor
Everolimus mTOR-I Angioedema, proteinuria, oral ulcers, micoryctic anemia, impaired wound healing, graft thrombus: (greatest risk in first 30 days of transplant) Heart Transplant: delay initiation until 3-6 months’ post-transplant No. Maintenance Can replace CNI or Anti-metabolite Nephrotoxicity Cancer Intolerance to another agent CYP3A4 No IV formulation Cannot crush tablets
Azathioprine Antimetabolite Bone marrow suppression, pancreatitis, alopecia, photosensitivity, monitor WBC No. Maintenance. Commonly used with CNI llopurinol (decrease azathioprine to 1/4th original dose); Febuxostat IV:PO conversion: 1 mg IV: 1 mg PO
Belatacept Co-Stimulation Blocker PTLD, C/I in EBV, PML, CNS infection No . Maintenance Commonly used with CNI N/A N/A
Mycophenolate Anitmetabolite Bone marrow suppression N/D Teratogenic- REMS No. Maintenance Commonly used with CNI Bile Acid Resins Cellcept 500 mg = Myfortic 360 mg; cannot crush
Anti-thymocyte globulin Antibody depleting T and B cells Low lymphocytes Cytokine release syndrome Yes. Acetaminophen, Diphenhydramine, Steroids Induction None IV infusion, held for low cell counts, use a filter, central IV line, round the dose to vial size
Alemtuzumab Antibody (against CD52) depleting T and B cells , Steroids hemolytic anemia, hyperthyroidism Yes. Acetaminophen, Diphenhydramine Induction None Single Dose IV
Basiliximab IL2RA Hypersensitivity No. Induction None None
Corticosteroids Corticosteroids Hyperglycemia, Osteoporosis, Buffalo hump, moon face etc. No. Induction/ Maintenance/ Rejection None May give pre- or intra-operative Kidney/pancreas transplant: may withdraw steroids after pre-op dose; Other organs: typically withdraw steroids months/years after transplant
Cyclosporine CNI Nephrotoxicity Hepatotoxicity Tremor Hirsutism, Gingival hyperplasia Hypertension Hyperlipidemia No. Maintenance. Cornerstone to immunosuppression regimen CYP3A4 and P-GP Avoid ACE-I and ARBs Sandimmune is NOT interchangeable with Neoral or Gengraf (Neoral, Gengraf preferred) Monitor: Trough concentrations
Created by: Bmiller01
 

 



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