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Overview: Nulojix is used to prevent organ rejection after a kidney transplant. It works by making your immune system less active so that it is less likely to attack a transplanted organ. The most common side effects are anemia, diarrhea, kidney or bladder infection, fluid retention, and constipation. Tell your health care provider right away if you have pain near your new kidney, changes in your urine, a fever, trouble breathing, unusual changes in mood or behavior, or skin changes. Nulojix is usually given as an infusion into a vein (IV) by a health care provider in a hospital or clinic.

Uses

What is Nulojix used for?

Nulojix (belatacept) is commonly used to prevent organ rejection after a kidney transplant. Organ rejection can happen if your immune system sees the donated organ as different or foreign and starts attacking it. 

Nulojix may also be used for other conditions as determined by your health care provider.

How does Nulojix work (mechanism of action)?

Nulojix works by blocking signals that normally activate immune cells called T cells. This makes the immune system less active, which helps prevent it from attacking a transplanted organ.

How is Nulojix supplied (dosage forms)?

Brands and other names

  • Nulojix

Dosage forms and strengths

Nulojix is available in an injectable form that is given by a health care provider.

How should I store Nulojix?

Nulojix is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Nulojix?

The most common side effects of Nulojix are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Low levels of red blood cells (anemia)
  • Diarrhea or constipation
  • Kidney or bladder infection
  • Swelling in your hands, legs, ankles, or feet
  • High blood pressure
  • Fever
  • Problems with your new kidney not working the way it should
  • Cough
  • Nausea or vomiting
  • Headache
  • High or low potassium level
  • Low white blood cell levels (leukopenia)

There may be other side effects of Nulojix that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Nulojix?

While less common, the most serious side effects of Nulojix are described below, along with what to do if they happen.

Severe Allergic Reactions. Nulojix may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Cancer. Nulojix may increase the risk of cancer, including cancers of the blood or skin. The risk of a type of blood cancer, called post-transplant lymphoproliferative disorder (PTLD), may be higher in people who have or have not had certain viral infections or have had certain treatments after their organ transplant. Tell your health care provider right away if you have any skin changes or any of the following symptoms of PTLD.

  • Unusual changes in mood or behavior
  • Confusion or memory problems
  • Trouble walking, talking, or seeing
  • Weakness or reduced strength on one side of your body

Progressive Multifocal Leukoencephalopathy (PML). People using Nulojix may develop a rare brain disease called PML. It is caused by a virus called the JC virus. PML is very serious and can lead to death. Call your health care provider right away if you have any of the following symptoms of PML.

  • Clumsiness or loss of coordination
  • Difficulty walking or speaking
  • Facial drooping
  • Vision problems
  • Thinking, memory, or personality changes
  • Weakness on one side of your body that gets worse
  • Seizures

Serious Infections. Nulojix can increase your risk of infections, including serious and rare infections. Sometimes, these infections can be deadly. Before you start treatment with Nulojix, tell your health care provider if you have ever had tuberculosis (TB) or any other serious infections. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Fever, chills, sweats, or muscle aches
  • Burning or stinging when you pee
  • Cough or coughing up blood
  • Shortness of breath
  • Diarrhea or stomach pain
  • Weight loss

 

Warnings & Precautions

Who should not use Nulojix?

Allergies to Ingredients. People who are allergic to any of the following should not use Nulojix.

  • Belatacept
  • Nulojix
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Nulojix.

Epstein-Barr Virus (EBV). Nulojix should only be used by people who have been exposed to the Epstein-Barr virus (EBV). It should not be used by people who have never been exposed to EBV or if it is unknown if they have been exposed. People who are not immune to EBV are at a higher risk of a serious condition called post-transplant lymphoproliferative disorder (see the Side Effects section for more details). Before starting Nulojix, your health care provider will test your blood to see if you have been exposed to EBV in the past. 

What should I know about Nulojix before using it?

Nulojix is usually given as an infusion into a vein (IV) by a health care provider in a hospital or clinic.

Your health care provider will do tests before you start Nulojix to make sure it is safe for you. Keep all lab appointments to check your blood and pee (urine) while you are using Nulojix. This helps your health care provider watch for side effects and make sure that Nulojix is working for you.

Nulojix may increase the risk of skin cancer. If possible, avoid direct sunlight and sunlamps. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin. Tell your health care provider right away if you have any new moles or skin changes.

Nulojix lowers the activity of your immune system and raises the risk of infection. Your health care provider will likely prescribe other medicines to help prevent infections and recommend ways to protect your health after a transplant. It is important to follow all of your health care provider’s directions.

What should I tell my health care provider before using Nulojix?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Nulojix is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Nulojix may interact with other medicines and supplements. Before using Nulojix, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Vaccines. Talk to your health care provider about any vaccines that you may need. You should not receive certain vaccines right before or while using Nulojix. Tell your health care provider about any vaccines you have recently received or have scheduled.

Pregnancy. It is not known if or how Nulojix could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. If you or your partner becomes pregnant while using Nulojix, tell your health care provider right away. You can also register for the Transplant Pregnancy Registry International by calling 877-955-6877 or at www.transplantpregnancyregistry.org. This registry collects safety information about the use of Nulojix during pregnancy. 

Breastfeeding. It is not known if Nulojix passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop Nulojix.

Liver Transplant. Nulojix is not recommended for people who have had a liver transplant. Tell your health care provider if you have ever had a liver transplant.

How can I get more information about Nulojix?

For more information about Nulojix, you can visit the drugmaker’s website at www.nulojix.bmscustomerconnect.com or call them at 800-321-1335.

Interactions

Does Nulojix interact with foods or drinks?

There are no known interactions between Nulojix and foods or drinks.

It is unknown if drinking alcohol will affect Nulojix.

Does Nulojix interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are taking or have recently taken any other medicine that suppresses your immune system (an immunosuppressant), including cyclosporine (Gengraf, Neoral, Sandimmune, and others).

This may not be a complete list of medicines that can interact with Nulojix. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Nulojix?

If you or someone else has used too much Nulojix, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Nulojix?

Nulojix is usually given by a health care provider at a clinic or hospital. Your health care provider will make sure you are receiving Nulojix as scheduled. It is important to keep all of your health care appointments. If you miss an appointment to get your Nulojix dose, call to make another appointment as soon as possible.