Kerala State Drug Formulary.pdf

Immunosuppressant Drugs
270
Dose: Adults – 1 g IV twice a day for upto 4 days starting
within 24 hours of transplant and then shift to oral
maintenance therapy.
Adults – 1 g orally twice a day starting within 72 hours
of transplant.
Cost : Tab 500mg (10) Rs 880/-
GLUCOCORTICOIDS
They are widely used as immunosuppressants in many immune
mediated primary and secondary glomerular diseases and in renal
transplantation. It inhibits interleukin-1(IL-1), T-helper cell activation,
antibody production and also has antiinflammatory properties.
Prednisolone
Prednisolone is the preferred corticosteroid for oral
immunosuppression, because of its lesser suppressive effect on the
hypothalamopituitary axis.
I: Nephrotic syndrome produced by minimal change
disease and membraneous nephropathy, lupus
nephritis, other autoimmune disorders, vasculitis and
renal transplantation.
Dose : Nephrotic syndrome In adults: Img/kg/day or 2mg/
kg/alternate day is recommended. In children 2mg/
kg or 40mg/mg daily for 4 to 8 weeks, followed by
alternate day therapy for a similar duration.
Maintenance therapy in low dose of 0.1 to 0.2 mg on
alternate days indicated in membranous nephropathy
and steroid dependent minimal change disease for a
period of 6 months.
Lupus nephritis: 2 mg/kg bw for 4 — 8 weeks followed
by 0.2 mg/kg maintenance 3 to 5 years.
Renal transplant:1 mg/ kg to start, taper to 0.1 mg/kg
by 3 - 6 months and continue lifelong. Usually combined
with azathioprine and cyclosporine.
Methyl Prednisolone
Intravenous infusion of methyl prednisolone in high doses of upto 1
g daily for 3 - 5 days is called steroid pulse therapy and is used for early
response in severely ill patients.