264
P A R T 3
Drugs acting on the immune system
TABLE 17.2
DRUGS IN FOCUS Antianginal agents
Drug name
Dosage/route
Usual indications
T- and B-cell suppressors
abatacept (Orencia)
<60 kg: 500 mg IV repeated at 2 and 4 weeks,
then every 4 weeks
60–100 kg: 750 mg IV, repeated at 2 and
4 weeks, then every 4 weeks
>100 kg: 1 g IV, repeated at 2 and 4 weeks,
then every 4 weeks
Reduction of the signs and symptoms and
slowing structural damage in adults with
rheumatoid arthritis who have inadequate
response to other drugs
azathioprine (Imuran)
Adult: 3–5 mg/kg day PO for prevention of
rejection; maintenance: 1–3 mg/kg per day
PO
Rheumatoid arthritis: 1–2.5 mg/kg per day PO;
reduce dose with renal impairment
Paediatric: 3–5 mg/kg per day IV or PO to
prevent rejection; maintenance: 1–3 mg/kg
per day PO
Prevention of rejection in renal
homotransplants; treatment of
rheumatoid arthritis
cyclosporin
(Sandimmun)
15 mg/kg PO as a single oral dose 4–12 hours
before transplantation, then 5–10 mg/kg per
day PO
Paediatric: larger doses may be needed to
achieve therapeutic levels
Suppression of rejection in a variety of
transplant situations
(Neoral)
9–15 mg/kg PO as a single oral dose
4–12 hours before transplantation, then
5–10 mg/kg per day PO—titrate down
Rheumatoid arthritis: 2.5 mg/kg per day PO
in two divided doses
Psoriasis: 2.5 mg/kg PO b.d.
Treatment of rheumatoid arthritis, psoriasis
glatiramer acetate
(Copaxone)
20 mg/d SC
Reduction of the number of relapses in
multiple sclerosis in adults
mycophenolate (CellCept)
1–1.5 g PO b.d.; may be started IV during
transplantation, with switch to oral route as
soon as possible
Prevention of rejection after renal, hepatic,
or heart transplantation in adults; not for
use in pregnancy
pimecrolimus (Elidel)
Applied to effected site b.d.
Treatment of atopic dermatitis
sirolimus (Rapamune)
6 mg PO as soon after transplant as possible;
then 2 mg/day PO
Children <13 years: 3 mg/m
2
PO loading dose,
then 1 mg/m
2
per day PO
Prevention of rejection after renal
transplantation
Interleukin-receptor antagonist
anakinra (Kineret)
100 mg/day SC
Prevention of rejection after renal or liver
transplantation; reduction of the signs
and symptoms and slowing structural
damage in adults with rheumatoid
arthritis who have inadequate response
to other drugs
Monoclonal antibodies
adalimumab (Humira)
40 mg SC every other week; if also taking
methotrexate, may require 40 mg SC once
a week
Reduction of signs and symptoms and
inhibition of structural damage in
adults who have moderate to severe
rheumatoid arthritis and who have not
responded to other drugs
basiliximab (Simulect)
20 mg IV twice—first dose within 24 hours of
transplantation, then at 4 days
Prevention of renal transplant rejection
certolizumab pegol
(Cimzia)
400 mg subcutaneously, repeated at weeks 2
and 4, then every 4 weeks
Reduction of the signs and symptoms of
Crohn’s disease in adults with moderate
to severe disease not controlled by
standard therapy
