Muromonab cd3

Definition
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Immunosuppressant.

Pharmacodynamics (Effect)
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Monoclonal antibody against the T3 antigen of human T cells.

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Indication
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Prophylaxis of rejection reactions after heart, liver or kidney transplantation; for the treatment of autoimmune diseases currently in clinical trials.

Dosage and method of use
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5 mg/day i.v., 1-4 hours before first administration 8 mg/kg bw methylprednisolone i.v. (to avoid allergic reactions).

Undesirable effects
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See Table 1.

Interactions
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See Table 2.

Contraindication
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Pregnancy, lactation, hypersensitivity to mouse products (anti-mouse antibodies > 1:1000), water retention, heart failure, seizures in the medical history.

Preparations
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Orthoclone OKT 3

Tables
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Major side effects of Muromonab CD3

Airways	Dyspnoea, bronchospasm, flu-like symptoms Respiratory arrest Hyperventilation Pulmonary oedema, pneumonia, pneumonitis
Blood, lymph	aplastic anemia Blood coagulation disorders Eosinophilia leukocytosis, leukopenia, pancytopenia Splenomegaly, lymphadenopathy, lymphomas
GIT	Abdominal pain, gastrointestinal disturbances Transaminase increase hepatitis, hepatomegaly
Urinary tract	Anuria, Oliguria Glomerulonephritis Urea and creatinine increase
Skin	herpes simplex Pruritus, erythema, exanthema, urticaria, Quincke's edema, anaphylactic reactions spinocellular carcinomas
Cardiovascular	Hypertension, tachycardia Angina pectoris, cardiac arrhythmia, myocardial infarction temporal arteritis Thrombosis Subarachnoid hemorrhage
Nervous System	Headaches Rigor, Tremor loss of consciousness, delirium, hallucinations encephalopathy, brain edema Seizures aseptic meningitis Tetraplegia
Sensory Organs	double images, blurred vision, reduced vision to blindness conjunctivitis, photophobia Rotational vertigo hearing loss, tinnitus, otitis media
Support apparatus	Arthralgia, Myalgia Muscle twitching
System reactions	30-60 min. after administration: fever, chills

Significant interactions of Muromonab CD3

Azathioprine	Encephalopathy, infections, carcinogenicity ↑
Ciclosporin A	Encephalopathy, infections, carcinogenicity ↑
Glucocorticoids	Encephalopathy, infections, carcinogenicity ↑
Indomethacin	Encephalopathy