muromonab – kdc

CLINICAL USE

Steroid resistant acute transplant rejection Prophylaxis of rejection in sensitised patients

DOSE IN NORMAL RENAL FUNCTION

5 mg daily for 10–14 days (10 days most common)

PHARMACOKINETICS

Molecular weight :50 000 (Heavy chain) + 25 000 (Light chain)

%Protein binding :No data

%Excreted unchanged in urine : No data

Volume of distribution (L/kg) :0.093

half-life – normal/ESRD (hrs) :18–36/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Ciclosporin: increases ciclosporin plasma levelsIndometacin: may increase risk of encephalopathyVolatile anaesthetics/drugs that decrease cardiac contractility: increase risk of developing cardiovascular problems

ADMINISTRATION

Reconstition

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Route

Rate of Administration

FAST over less than 1 minute

Comments

NB Doctor administration recommended

OTHER INFORMATION

Ensure patient is not fluid overloaded prior to administration Possible future scope for dose titration according to CD3 or absolute T-cell countReduce or stop other immunosuppressant therapy during treatment, and resume 3 days prior to cessation of OKT3IV methylprednisolone sodium succinate (8 mg/kg given 1–4 hours prior to the first dose of OKT3) is strongly recommended to decrease the incidence and severity of reactions to the first dose. Paracetamol and antihistamines given concomitantly with OKT3 may also help to reduce some early reactions

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