Nurses Compass
Drug Guide
Basiliximab
Classification
Therapeutic: Immunosuppressant
Pharmacological: Chimeric Monoclonal Antibody
FDA Approved Indications
- Prevention of acute organ rejection in kidney transplantation
- Prevention of acute organ rejection in liver transplantation
Mechanism of Action
Basiliximab is a chimeric monoclonal antibody that selectively binds to the alpha-chain (CD25) of the interleukin-2 (IL-2) receptor on activated T-lymphocytes, inhibiting IL-2 mediated T-cell activation and proliferation, thereby suppressing immune response.
Dosage and Administration
Adult: Intravenous initial dose of 20 mg on day 0 and day 4, with additional doses as needed based on immunosuppressive regimen.
Pediatric: Not approved for pediatric use.
Geriatric: No specific dosage adjustment required, but caution advised due to potential comorbidities.
Renal Impairment: No dose adjustment needed.
Hepatic Impairment: No dose adjustment needed.
Pharmacokinetics
Absorption: Administered intravenously; absorption not applicable.
Distribution: Distributes in plasma and extracellular fluid.
Metabolism: Metabolized by proteolytic enzymes into small peptides and amino acids.
Excretion: Excreted primarily via metabolic pathways; not significantly via kidneys.
Half Life: Approximately 7 days.
Contraindications
- Hypersensitivity to basiliximab or any component of the formulation.
Precautions
- Monitor for signs of infection; infection risk increases due to immunosuppression.
- Use with caution in patients with active infections or malignancies.
Adverse Reactions - Common
- Headache (Common)
- UTI (Urinary Tract Infection) (Common)
- Nausea (Common)
Adverse Reactions - Serious
- Anaphylaxis (Rare)
- Serious infection including sepsis (Rare)
- Liver function abnormalities (Rare)
Drug-Drug Interactions
- Other immunosuppressants like calcineurin inhibitors or corticosteroids may increase risk of infection.
- Potential additive immunosuppressive effects with other agents.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of infection, infusion reactions, and allergies.
Diagnoses:
- Risk for Infection due to immunosuppression.
- Risk for Allergic Reaction.
Implementation: Administer as per protocol, monitor vital signs during infusion, prepare resuscitation equipment for possible anaphylaxis.
Evaluation: Assess for effectiveness in preventing organ rejection and monitor for adverse reactions.
Patient/Family Teaching
- Report signs of infection, allergic reactions, or unusual symptoms immediately.
- Keep follow-up appointments for monitoring.
- Understand the importance of adherence to immunosuppressive therapy.
Special Considerations
Black Box Warnings:
- Potential for anaphylaxis during infusion.
Genetic Factors: No specific genetic considerations beyond general immunosuppression.
Lab Test Interference: May cause transient increase in liver enzymes; monitor liver function tests regularly.
Overdose Management
Signs/Symptoms: No specific overdose symptoms are known; signs may include exaggerated immunosuppression or infusion reactions.
Treatment: Supportive care, monitor vital signs, and provide symptomatic treatment as necessary.
Storage and Handling
Storage: Store refrigerated at 2°C to 8°C (36°F to 46°F). Avoid freezing.
Stability: Stable for the period specified on the package; reconstituted solution should be used immediately or stored as per stability data.