Overview of Immunosuppressant Drugs

    Immunosuppressant drugs are a class of drugs that suppress or reduce the strength of the body’s immune system. They are also called anti-rejection drugs. One of the primary uses of immunosuppressant drugs is to lower the body’s ability to reject a transplanted organ, such as a liver, heart or kidney.

    What Do the Drugs Treat?

    Almost everyone who receives an organ transplant has to take immunosuppressant drugs. The body recognizes a transplanted organ as a foreign mass. This triggers a response by the body’s immune system to attack it.

    By weakening the immune system, immunosuppressant drugs decrease the body’s reaction to the foreign organ. The drugs allow the transplanted organ to remain healthy and free from damage.

    Immunosuppressant drugs also are used to treat autoimmune diseases such as lupus. An autoimmune disorder is a disease process in which the body attacks its own tissue. Lupus results from just such a misdirected activity of the body’s own immune system. By suppressing this reaction, immunosuppressant drugs can help control the impact of the disease on the body.

    Other diseases treated with immunosuppressant drugs include:

    • psoriasis
    • rheumatoid arthritis
    • Crohn’s disease, a chronic inflammation of the digestive tract
    • multiple sclerosis
    • alopecia areata (patchy hair loss)

    What Drugs Are Used?

    Immunosuppressant drugs can be classified into four categories:

    • azathioprine (Imuran)
    • cyclosporine (Neoral, Sandimmune, SangCya)
    • monoclonal antibodies, which include: basiliximab (Simulect), daclizumab (Zenapax), and muromonab (Orthoclone OKT3)
    • corticosteroids such as prednisone (Deltasone, Orasone)

    Most patients are prescribed drugs from more than one category.

    How Are the Drugs Administered?

    All immunosuppressant drugs are only available with a prescription from a physician. They can be administered as tablets, capsules, liquids, and injections. A physician determines the best course of treatment using a combination of drugs. The goal of immunosuppressant therapy is to find the course that will prevent rejection and have the least harmful side effects.

    A person taking immunosuppressant drugs must take them exactly as prescribed every day. Even the slightest change from the medication regimen can trigger an organ rejection. After missing a dose, it’s important to contact a physician immediately.

    The immunosuppressant drugs in a patient’s regimen are adjusted and may eventually be reduced. As the risk of organ rejection lessens over time, the need for these medications may decrease. However, most people who have had a transplant will have to take at least one immunosuppressant drug for their lifetime.

    Regular blood tests are used to monitor the effectiveness of the drugs and the need for adjustments.

    What Are the Risks?

    When immunosuppressant drugs weaken the immune system, the body becomes less resistant to infection. Any infections that develop will be more difficult to treat because of this. These drugs also increase the likelihood of uncontrolled bleeding due to injury or infection.

    People taking immunosuppressant drugs should be careful to avoid catching an infection. Precautions include:

    • frequent hand washing
    • avoiding sports in which injuries occur
    • extra care when using sharp objects such as knives or razors
    • avoiding close contact with people who have infections or colds

    A physician should be notified immediately when the following symptoms occur:

    Immunosuppressant drugs can cause adverse reactions and birth defects. Physicians should be made aware of the following conditions before immunosuppressant drugs are prescribed:

    • allergies
    • pregnancy
    • lactation
    • shingles or chickenpox
    • kidney or liver disease
    • intestinal problems

    What Are the Side Effects?

    The most significant side effect of immunosuppressant drugs is an increased risk of infection. The drugs can also put you at a higher risk for cancer because the immune system also protects you from this disease.

    Other, less serious side effects can include loss of appetite, nausea, vomiting, increased hair growth, and hand trembling. These effects typically subside as the body adjusts to the immunosuppressant drugs.

    The following side effects indicate the need for immediate attention:

    • a feeling of being unusually tired or weak
    • fever or chills
    • frequent urination

    Immunosuppressant drugs can interact with many other medications. This can cause dangerous effects in which the immunosuppressants may lose or even increase their effect. The primary caregiver should be made aware of any prescription or over-the-counter medications their patients are taking while on immunosuppressant therapy.