Info

Adverse Reactions

• Nausea and vomiting • Infection with herpes simplex

• Chest pain virus, cytomegalovirus,

• Diarrhea Staphylococcus epidermidis,

• Tremor Pneumocystis carinii, Legionella,

• Wheezing Cryptococcus, Serratia, and

• Headache gram-negative bacteria

• Hypersensitivity reactions • Posttransplant lympho-

proliferative disorders

Drug Interactions

• Indomethacin alone and in conjunction with muromonab-CD3 has been associated with CNS effects

• Corticosteroids alone and in conjunction with muromonab-CD3 have been associated with psychosis and infection

• Azathioprine alone and in conjunction with muromonab-CD3 has been associated with infection and malignancies

• Cyclosporine-A alone and in conjunction with muromonab-CD3 has been associated with seizures, encephalopathy, infection, malignancies, and thrombotic events

Formulation

• 5 mL ampule containing 5 mg

Dosage

• 5 mg/d IV for 10 to 14 days

Editors' Notes:

Muromonab-CD3 is used infrequently to treat or prevent rejection in the present era. It has significant toxicity due to the cytokine defense syndrome (CDS).

Evidence suggests that giving 250 mg of methylprednisolone 6 hours prior and 1 hour prior to administration of muromonab-CD3 can decrease the incidence of cytokine release syndrome (CRS). Pentoxifylline has not been shown to attenuate CRS. Indomethacin, however, can be effective.

If CD3 levels remain high during therapy with muromonab-CD3, the dose may be increased or one may switch to an alternate antilymphocyte preparation.

Adjunctive prophylaxis with ganciclovir in CMV-positive patients or in recipients of CMV-positive organs may be effective in reducing risk of CMV infection.

0 0

Post a comment