Basiliximab

• Prevention of acute organ rejection in patients receiving renal (kidney) transplantation.
• Used as part of an immunosuppressive regimen including corticosteroids and other immunosuppressants.
• Off-label: Occasionally used in heart and liver transplantation to prevent rejection.

• Route: Intravenous infusion.
• Adult dose for renal transplant: 20 mg IV within 2 hours prior to transplantation, followed by a second 20 mg dose 4 days after transplantation.
• Pediatrics: Safety and efficacy not well established; use with caution.
• Elderly: No specific dose adjustment recommended; monitor closely.
• Renal or hepatic impairment: No dose adjustment necessary.
• Administration: Infuse over 20–30 minutes; do not administer as a bolus.

Basiliximab is a chimeric monoclonal antibody that binds specifically to the alpha subunit (CD25) of the interleukin-2 receptor on activated T lymphocytes. By blocking IL-2 binding, it inhibits T-cell proliferation and activation, reducing the immune response that causes acute organ rejection.

• Absorption: Administered intravenously, ensuring complete bioavailability.
• Distribution: Primarily stays within the vascular space; volume of distribution approximately 0.15 L/kg.
• Metabolism: Catabolized by proteolytic enzymes into small peptides and amino acids.
• Elimination: Half-life about 7 days after repeated dosing; clearance decreases with repeated doses due to receptor saturation.
• Onset: Rapid receptor binding following infusion.
• Duration: Effects persist approximately 4 to 6 weeks post-administration.

• Pregnancy: Category C. Animal studies show potential fetal risks; no adequate human studies. Use only if benefits justify risks.
• Lactation: Unknown if excreted in breast milk; caution advised.

• Immunosuppressant
• Monoclonal antibody
• IL-2 receptor antagonist

• Known hypersensitivity to basiliximab or its components.
• History of severe allergic reactions to monoclonal antibodies.

• Increased susceptibility to infections and malignancies due to immunosuppression.
• Monitor for hypersensitivity reactions during and after infusion.
• Use caution in patients with active infections or pre-existing malignancies.
• Not indicated for treatment of acute rejection.

• Common: Peripheral edema, hypertension, nausea, vomiting, diarrhea, tremor, fever.
• Serious/Rare: Anaphylaxis, increased infection risk, post-transplant lymphoproliferative disorder (PTLD), cardiovascular events.

• No known direct drug interactions.
• Concomitant immunosuppressants may increase risk of infections; monitor accordingly.
• Not metabolized by CYP450 enzymes; no CYP450-related interactions.

• Basiliximab remains a recommended induction agent for renal transplantation in patients at low to moderate immunologic risk.
• Enhanced monitoring protocols for infections and malignancies have been emphasized in recent guidelines.
• No significant changes in dosing or approved indications by regulatory authorities.

• Store refrigerated at 2°C to 8°C (36°F to 46°F).
• Protect from light and do not freeze.
• Keep in original carton until use.
• Single-use vial; discard unused portion.