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      Drugs & Diseases

      muromonab CD3 (Discontinued)

      Brand and Other Names:Orthoclone OKT3
      • Print

      Dosing & Uses

      AdultPediatric

      Dosage Forms & Strengths

      injectable solution

      • 1mg/mL

      Acute Allograft Rejection or Acute Graft-Vs-Host Disease Treatment

      5 mg IVP qDay x 10-14 days

      Cardiac or Hepatic Allograft Rejection, Steroid Resistant

      5 mg IVP qDay x 10-14 days

      Dosage Forms & Strengths

      injectable solution

      • 1mg/mL

      Acute Allograft Rejection or Acute Graft-Vs-Host Disease Treatment

      <30 kg: 2.5 mg IVP qDay x 10-14 days

      >30 kg: 5 mg IVP qDay x 10-14 days; may titrate daily by 2.5 mg to achieve CD3+ cells < 25/mm³ and serum muromonab-CD3 > 800 ng/mL

      Next:

      Interactions

      Interaction Checker

      and muromonab CD3

      No Results

         activity indicator 
        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

              Minor

                All Interactions Sort By:
                 activity indicator 

                Contraindicated (0)

                  Serious - Use Alternative (71)

                  • adalimumab

                    adalimumab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • adenovirus types 4 and 7 live, oral

                    muromonab CD3 decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.

                  • alefacept

                    alefacept and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • anakinra

                    anakinra and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • anthrax vaccine

                    muromonab CD3 decreases effects of anthrax vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • antithymocyte globulin equine

                    antithymocyte globulin equine and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • antithymocyte globulin rabbit

                    antithymocyte globulin rabbit and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • axicabtagene ciloleucel

                    muromonab CD3, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • azathioprine

                    azathioprine and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • basiliximab

                    basiliximab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • BCG vaccine live

                    muromonab CD3 decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • brexucabtagene autoleucel

                    muromonab CD3, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • canakinumab

                    canakinumab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • ciltacabtagene autoleucel

                    muromonab CD3, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • cyclosporine

                    cyclosporine and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • diphtheria & tetanus toxoids

                    muromonab CD3 decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • diphtheria & tetanus toxoids/ acellular pertussis vaccine

                    muromonab CD3 decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine

                    muromonab CD3 decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • etanercept

                    etanercept and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • etrasimod

                    etrasimod, muromonab CD3. Either increases effects of the other by Mechanism: aldehyde dehydrogenase inhibition. Avoid or Use Alternate Drug. Risk of additive immune system effects with etrasimod has not been studied in combination with antineoplastic, immune-modulating, or noncorticosteroid immunosuppressive therapies. Avoid coadministration during and in the weeks following administration of etrasimod.

                  • everolimus

                    everolimus and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • glatiramer

                    glatiramer and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • golimumab

                    golimumab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • hepatitis A vaccine inactivated

                    muromonab CD3 decreases effects of hepatitis A vaccine inactivated by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • hepatitis a/b vaccine

                    muromonab CD3 decreases effects of hepatitis a/b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • hepatitis a/typhoid vaccine

                    muromonab CD3 decreases effects of hepatitis a/typhoid vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • hepatitis b vaccine

                    muromonab CD3 decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • human papillomavirus vaccine, nonavalent

                    muromonab CD3 decreases effects of human papillomavirus vaccine, nonavalent by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.

                  • human papillomavirus vaccine, quadrivalent

                    muromonab CD3 decreases effects of human papillomavirus vaccine, quadrivalent by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.

                  • hydroxychloroquine sulfate

                    hydroxychloroquine sulfate and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • idecabtagene vicleucel

                    muromonab CD3, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • infliximab

                    infliximab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • influenza virus vaccine quadrivalent

                    muromonab CD3 decreases effects of influenza virus vaccine quadrivalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • influenza virus vaccine quadrivalent, adjuvanted

                    muromonab CD3 decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

                  • influenza virus vaccine quadrivalent, cell-cultured

                    muromonab CD3 decreases effects of influenza virus vaccine quadrivalent, cell-cultured by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • influenza virus vaccine quadrivalent, intranasal

                    muromonab CD3 decreases effects of influenza virus vaccine quadrivalent, intranasal by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • influenza virus vaccine trivalent

                    muromonab CD3 decreases effects of influenza virus vaccine trivalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • influenza virus vaccine trivalent, adjuvanted

                    muromonab CD3 decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

                  • Japanese encephalitis virus vaccine

                    muromonab CD3 decreases effects of Japanese encephalitis virus vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • leflunomide

                    leflunomide and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • lisocabtagene maraleucel

                    muromonab CD3, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • measles (rubeola) vaccine

                    muromonab CD3 decreases effects of measles (rubeola) vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • measles mumps and rubella vaccine, live

                    muromonab CD3 decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • measles, mumps, rubella and varicella vaccine, live

                    muromonab CD3 decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • meningococcal A C Y and W-135 polysaccharide vaccine combined

                    muromonab CD3 decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • mycophenolate

                    muromonab CD3 and mycophenolate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • pneumococcal vaccine 13-valent

                    muromonab CD3 decreases effects of pneumococcal vaccine 13-valent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • pneumococcal vaccine heptavalent

                    muromonab CD3 decreases effects of pneumococcal vaccine heptavalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • pneumococcal vaccine polyvalent

                    muromonab CD3 decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • rabies vaccine

                    muromonab CD3 decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.

                  • rabies vaccine chick embryo cell derived

                    muromonab CD3 decreases effects of rabies vaccine chick embryo cell derived by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • rilonacept

                    muromonab CD3 and rilonacept both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • rotavirus oral vaccine, live

                    muromonab CD3 decreases effects of rotavirus oral vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • rubella vaccine

                    muromonab CD3 decreases effects of rubella vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • sirolimus

                    muromonab CD3 and sirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • smallpox (vaccinia) vaccine, live

                    muromonab CD3 decreases effects of smallpox (vaccinia) vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • tacrolimus

                    muromonab CD3 and tacrolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • temsirolimus

                    muromonab CD3 and temsirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • tetanus toxoid adsorbed or fluid

                    muromonab CD3 decreases effects of tetanus toxoid adsorbed or fluid by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • tick-borne encephalitis vaccine

                    muromonab CD3 decreases effects of tick-borne encephalitis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • tisagenlecleucel

                    muromonab CD3, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • tocilizumab

                    tocilizumab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • tofacitinib

                    muromonab CD3, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • tongkat ali

                    muromonab CD3 and tongkat ali both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • travelers diarrhea and cholera vaccine inactivated

                    muromonab CD3 decreases effects of travelers diarrhea and cholera vaccine inactivated by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • typhoid polysaccharide vaccine

                    muromonab CD3 decreases effects of typhoid polysaccharide vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • typhoid vaccine live

                    muromonab CD3 decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • ustekinumab

                    muromonab CD3 and ustekinumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

                  • varicella virus vaccine live

                    muromonab CD3 decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • yellow fever vaccine

                    muromonab CD3 decreases effects of yellow fever vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  • zoster vaccine live

                    muromonab CD3 decreases effects of zoster vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

                  Monitor Closely (25)

                  • astragalus

                    muromonab CD3 increases and astragalus decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • belatacept

                    belatacept and muromonab CD3 both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.

                  • cholera vaccine

                    muromonab CD3 decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.

                  • dengue vaccine

                    muromonab CD3 decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.

                  • denosumab

                    muromonab CD3, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.

                  • echinacea

                    muromonab CD3 increases and echinacea decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • fingolimod

                    muromonab CD3 increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .

                  • haemophilus influenzae type b vaccine

                    muromonab CD3 decreases effects of haemophilus influenzae type b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .

                  • influenza virus vaccine quadrivalent, recombinant

                    muromonab CD3 decreases effects of influenza virus vaccine quadrivalent, recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immune response to vaccine may be decreased in immunocompromised individuals.

                  • influenza virus vaccine trivalent, recombinant

                    muromonab CD3 decreases effects of influenza virus vaccine trivalent, recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immune response to vaccine may be decreased in immunocompromised individuals.

                  • isavuconazonium sulfate

                    muromonab CD3 and isavuconazonium sulfate both decrease immunosuppressive effects; risk of infection. Use Caution/Monitor.

                  • maitake

                    muromonab CD3 increases and maitake decreases immunosuppressive effects; risk of infection. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • meningococcal group B vaccine

                    muromonab CD3 decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.

                  • mercaptopurine

                    mercaptopurine and muromonab CD3 both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.

                  • methotrexate

                    methotrexate and muromonab CD3 both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Combination may increase risk of myelosuppression.

                  • ocrelizumab

                    muromonab CD3 and ocrelizumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Coadministration of ocrelizumab with immunosuppressants may increase the risk of immunosuppression.

                  • ofatumumab SC

                    ofatumumab SC, muromonab CD3. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.

                  • olaparib

                    muromonab CD3 and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.

                  • ozanimod

                    ozanimod, muromonab CD3. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Coadministration with immunosuppressive therapies may increase the risk of additive immune effects during therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs in order to avoid unintended additive immunosuppressive effects.

                  • poliovirus vaccine inactivated

                    muromonab CD3 decreases effects of poliovirus vaccine inactivated by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .

                  • ponesimod

                    ponesimod and muromonab CD3 both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

                  • siponimod

                    siponimod and muromonab CD3 both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

                  • sipuleucel-T

                    muromonab CD3 decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

                  • ublituximab

                    ublituximab and muromonab CD3 both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered

                  • zoster vaccine recombinant

                    muromonab CD3 decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

                  Minor (0)

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                    Adverse Effects

                    >10% (Cytokine Release Syndrome 1st 48 Hr)

                    Pyrexia (90%)

                    Chills (59%)

                    Dyspnea (21%)

                    Nausea/Vomiting (19%)

                    Chest pain (14%)

                    Diarrhea (14%)

                    Tremor (13%)

                    Wheezing (13%)

                    Headache (11%)

                    >10% (Overall Incidence)

                    Pyrexia (77%)

                    Chills (43%)

                    Diarrhea (37%)

                    Nausea (32%)

                    Headache (28%)

                    Tachycardia (26%)

                    Hypotension (25%)

                    Vomiting (25%)

                    Hypertension (19%)

                    Dyspnea (16%)

                    Rash (14%)

                    Edema (12%)

                    1-10%

                    Abnl chest sound (10%)

                    Anorexia (10%)

                    Tachycardia (10%)

                    Chest pain (9%)

                    Fatigue (9%)

                    HTN (8%)

                    Arthralgia (7%)

                    Diaphoresis (7%)

                    GI pain (7%)

                    Hyperventilation (7%)

                    Leukopenia (7%)

                    Pruritis (7%)

                    Vasodilation (7%)

                    Abd pain (6%)

                    Confusion (6%)

                    Dizziness (6%)

                    Lethargy (6%)

                    Wheezing (6%)

                    Anemia (2-5%)

                    Arrhythmia (2-5%)

                    Bradycardia (2-5%)

                    Depression (2-5%)

                    Malaise (2-5%)

                    Nervousness (2-5%)

                    Pulmonary edema (2-5%)

                    Somnolence (2-5%)

                    Thrombocytopenia, (2-5%)

                    <1%

                    Anaphylaxis (rare)

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                    Warnings

                    Black Box Warnings

                    Only physicians experienced in immunosuppressive therapy and management of solid organ transplant patients should prescribe

                    Anaphylactic or anaphylactoid reactions may occur following administration of any dose or course

                    Serious and occasionally life-threatening systemic, cardiovascular, and CNS reactions (eg, pulmonary edema, especially in patients with volume overload; shock; cardiovascular collapse; cardiac or respiratory arrest; seizures; coma) have been reported

                    Must be managed in a facility equipped and staffed for cardiopulmonary resuscitation

                    Contraindications

                    Hypersensitivity to any murine-derived products

                    Anti-mouse Ab titers ≥ 1:1000

                    Uncontrolled CHF or fluid overload, uncontrolled HTN, H/O seizures, pregnancy, breastfeeding

                    Cautions

                    Pretreatment with methylprednisone recommended

                    Risk of anaphylaxis, cytokine-release syndrome (CRS: flu-like symptoms or shock), severe pulmonary edema; stabilize any cardiovascular pathologies before administration

                    Anaphylaxis usually appears within 10 min of administration; CRS appears 30-60 min later

                    Risk of seizure; monitor neurologic symptoms carefully during first 24 hr following the first few doses

                    Risk of viral infection, lymphoproliferative neoplasia

                    If temp >100°F, lower by antipyretics before next administration

                    Monitor renal function, LFTs, WBCs, platelets; during treatment, monitor muromonab-CD3 levels & T cell clearance daily

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                    Pregnancy & Lactation

                    Pregnancy Category: C

                    Lactation: not known if excreted in breast milk

                    Pregnancy Categories

                    A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                    B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                    C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                    D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                    X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                    NA: Information not available.

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                    Pharmacology

                    Mechanism of Action

                    Blocks function of CD3 in T lymphocytes (involved in Ag recognition & signal transduction)

                    Pharmacokinetics

                    Onset: Minutes

                    Duration: 1 week

                    Minimum effective serum concentration: 800 ng/mL

                    CD3+ cells return to normal levels within 1 week of discontinuation

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                    Administration

                    IV Administration

                    Give IV push over <1 min undiluted

                    Do not give IM

                    Methylprednisolone sodium succinate 1 mg/kg IV given prior to first muromonab-CD3 administration, & IV hydrocortisone sodium succinate 50-100 mg, given 30 min after administration are strongly recommended to decrease the incidence of reaction to the first dose

                    Filter each dose through a low protein-binding 0.22 micron filter before administration

                    Pt temperature should not exceed 37.8°C (100°F) at time of administration

                    Storage

                    Refrigerate

                    Do not shake or freeze

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                    Images

                    No images available for this drug.
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                    Patient Handout

                    A Patient Handout is not currently available for this monograph.
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                    Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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