Immunosuppressants have one risk in common—people taking these therapies have a greater risk of infections. Often, this risk will increase if a person is taking a higher dose of their treatment. In some cases, this might result in a minor infection. However, sometimes serious and even life-threatening infections may happen. Taking an immunosuppressant might make you more likely to get sick from a common illness, like a cold.
For example, you might be more likely to get an unusual pneumonia resulting from a fungal infection. Not all immunosuppressive therapies affect the immune system in the same way. Some affect the immune system more strongly than others, which may put you at greater risk of infection. Your immunosuppressant might put you at greater risk of certain types of infections, but not others. For example, you might be at greater risk of bacterial infections but not have much of an increased risk of infections from viruses or parasites.
Your specific risks may vary based on the specific immunosuppressant you are taking, the dosage, and your whole medical situation. Fortunately, there are some steps that can help you lower your risk of infection while taking an immunosuppressant. These tips may also be helpful for people who have reduced ability to fight off infections from another cause , like certain genetic illnesses or HIV. People who are taking immunosuppressive therapies may be more likely to have severe and even life-threatening disease from COVID Such people may need extra precautions, such as the following:.
The Centers for Disease Control and your local health department can continue to provide you with up-to-date guidance. If you are taking an immunosuppressive therapy, it may be worth talking about your current treatment with your doctor. For some immunosuppressive therapies, an increased dose might increase your risk of having severe complications from COVID However, it is not completely straightforward.
Some immunosuppressive therapies are actually being studied as possible treatments for some severe symptoms of COVID such as cytokine storm. However, do not stop taking your immunosuppressive therapies without talking to your doctor.
For many people, this would be a much greater medical risk. Instead, you can have a conversation about whether lowering your current dosage of your immunosuppressant or switching to another treatment might make sense for you.
Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Overview of infections in the immunocompromised host. Microbiol Spectrum. Biologic therapy for autoimmune diseases: an update. BMC Med. Arthritis Rheumatol. Enderby C, Keller CA. An overview of immunosuppression in solid organ transplantation. Am J Manag Care. Davulcu EA, Vural F.
Immunosuppressive agents in hematopoietic stem cell transplantation. Trends in Transplant. Adverse reactions to biologic agents and their medical management. Nat Rev Rheumatol.
Long-term cancer risk of immunosuppressive regimens after kidney transplantation. J Am Soc Nephrol. Infection risk and safety of corticosteroid use. Rheum Dis Clin North Am. Centers for Disease Control and Prevention. Prevention and control—immunocompromised persons. Updated April 3, Updated May 14, Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page.
These choices will be signaled globally to our partners and will not affect browsing data. We and our partners process data to: Actively scan device characteristics for identification. I Accept Show Purposes. Table of Contents View All. However, in the late s, the medication was approved by the FDA for the treatment of arthritis and has been used commonly for this ever since.
Methotrexate works by interfering with the production of folic acid, which is a building block for growing cells in your body. As a result, methotrexate hinders the growth of certain cells, including those of the immune system. This medication is also steroid-sparing, meaning it can be used in conjunction with steroids to lower the dose of steroid therapy and thus also lower the associated side effects.
The medication is usually taken as a tablet in doses of 7. People taking methotrexate usually feel improvements in weeks, but it can take up to 3 months to feel the full benefit of the drug. Be sure to take this medication as directed.
If you miss a dose, you can usually take the medication up to 4 or 5 days after. However, if you miss this window, contact your doctor regarding how you should proceed. Most people taking methotrexate do not experience side effects and many of the more minor side effects will decrease with time.
However, the likelihood of these side effects does increase as your dosage goes up. Many of the side effects of methotrexate involve the fact that the medication works by interfering with the production of folic acid in your body.
Therefore, your doctor will most likely recommend that you take folate supplements, which will prevent many of these side effects, including mouth sores stomatitis. Other side effects may include nausea, vomiting, and an increased risk for abnormal liver function tests. Because of the danger to your liver, you should not drink alcohol while taking methotrexate; drinking while on this medication can cause irreversible damage to your liver. In addition, it is important that people taking methotrexate have normal liver function tests.
Be sure to tell your doctor if you have a history of liver disease. In addition, lung problems, such as a continuing cough or shortness of breath, can occur while taking this medication but are more common in people with preexisting lung conditions.
Talk to you doctor if you experience these symptoms. Some patients experience gradual hair loss alopecia , but hair usually grows back once you stop taking methotrexate. In addition, methotrexate can increase your sensitivity to sunlight. Since many lupus patients already experience sun sensitivity, try to limit sun exposure and be sure to wear sunscreen when going outdoors. If you are pregnant, may become pregnant, or are breastfeeding, you should not take this medication because it can cause serious birth defects and complications during pregnancy.
Women taking this medication should use an effective method of birth control. Speak to your doctor about any pregnancy plans or concerns. As with other drugs that may suppress your immune system, talk to your doctor about any vaccines or surgeries you may have. Do remember, though, that sometimes methotrexate may be used in combination with certain NSAIDs to treat lupus. Your doctor will work with you to determine which treatments will work best to treat your lupus symptoms with the fewest side effects.
Leflunomide is another DMARD used to treat the swelling, pain, and stiffness that many lupus patients feel due to arthritis. It can either be prescribed alone or in combination with other treatments, such as methotrexate; often leflunomide is prescribed for patients who do not respond well to methotrexate. Leflunomide works by blocking the formation of DNA in the cells of your body, including those of the immune system.
In hindering the formation of DNA, leflunomide stops the body from producing the overactive immune cells that are responsible for the swelling, stiffness, and pain in your joints. Leflunomide is usually taken in tablets of 10 or 20 milligrams mg once a day. A loading dose is a large dose—about mg—usually given once a week for three weeks in addition to your regular dose.
Alternatively, some doctors may give this loading dose over the first three days. This technique, however, usually increases the chance that the person will develop side effects, including diarrhea.
The good news is that the diarrhea usually goes away once the loading dose is stopped. Leflunomide does have several side effects.
The most common side effect is diarrhea, which affects about 1 in 5 people, but this symptom usually goes away with time. In addition, your doctor can talk with you about taking an anti-diarrheal medication to curb some of this discomfort. Other side effects include nausea, indigestion, rash, or hair loss alopecia , but these effects are less common.
In addition, about 1 in 10 patients taking leflunomide have abnormal liver function tests or decreased blood cell counts, so individuals taking this medication should have liver enzyme and blood count tests done regularly every months.
Because of this risk to your liver, you should not drink alcohol while taking leflunomide, and you should tell your doctor if you have had liver problems in the past. Women who are pregnant, may become pregnant, or are breastfeeding should speak with their doctor before taking leflunomide, since this medication can cause serious birth defects and complications.
In addition, women should use an effective method of birth control while taking leflunomide and continue to do so until two years after leflunomide is stopped, since the medication is known to remain in your body well after you actually stop taking it. Men who want to have children should also talk to their doctor about stopping the medication. Anyone who is on the medication and would like to have children should speak to their doctor about a medication called cholestyramine Questran , which can help eliminate leflunomide from your body.
As with other drugs that suppress your immune system, speak with your doctor about any vaccinations or surgeries you plan to have and any other medications you may be taking, including prescription drugs, over-the-counter medications, vitamins, and supplements.
Medications that can interact with leflunomide include cholestyramine Questran , tolbutamide Orinase , and rifampin Rifadin, Rimactane , so be sure to tell your doctor if you are on these medications. Cytotoxic medications are a class of immunosuppressives that were originally developed and are still used to treat certain types of cancer. The cytotoxic drugs usually prescribed to treat lupus symptoms are classified as alkylating agents and are reserved for patients with more serious forms of lupus that involve organs such as the kidneys, central nervous system, lungs, and blood vessels.
Cytotoxic medications work against the cells of your immune system that make antibodies immunoglobulins. Usually, these molecules help the body to ward of infections and other invaders. However, with lupus, these antibodies actually work against your own body and are produced at a rapid rate. Cytoxic drugs fight the rapidly dividing cells of the immune system, but in doing so, they also work against other rapidly dividing cells in your body, including blood cells, hair cells, and sex cells.
As a result, cytotoxic medications can have serious long term side effects. Even though cytotoxics have proven to improve the symptoms of kidney, nervous system, lung, and blood vessel disease in lupus patients, it is important for you and your doctor to evaluate the costs and benefits of cytotoxic therapy before beginning this treatment. Cytoxan is a cytotoxic medication usually reserved for lupus patients with serious kidney problems who have not responded to other medications.
The dosage of Cytoxan varies from person to person. The IV procedure usually take about 15 to 60 minutes, and a medication may be given before to reduce any nausea you may feel. Doctors usually give Cytoxan once a month for 6 months and then every 2 to 3 months for two years. It may take a few weeks or months for Cytoxan to improve your lupus symptoms.
The side effects of Cytoxan range from mild to severe and may be worse when the medication is taken in tablet form. Side effects include nausea and vomiting, which can sometimes be prevented with an anti-nausea medication such as ondansetron Zofran. Hair loss alopecia can occur, but hair usually grows back when the medication is stopped. Skin rashes can also occur and be difficult to differentiate from lupus symptoms.
Therefore, it is important that you wash your hands regularly, maintain good personal hygiene, and notify your doctor at the first sign of any infection or fever.
Also tell your doctor if you are to have any vaccines or surgeries, since your immune system will be suppressed by Cytoxan. More serious side effects include a reduction in white blood cell count, which usually occurs about days after starting treatment.
Your doctor should perform blood tests at this time to determine whether your dosage should be altered. Immunosuppressants are drugs or medicines that lower the body's ability to reject a transplanted organ. Another term for these drugs is anti-rejection drugs. There are 2 types of immunosuppressants:. Think of a real estate mortgage; the down payment is like the induction drug and the monthly payments are like maintenance drugs.
If the down payment is good enough you can lower the monthly payments, the same as for immunosuppression. When you get a kidney transplant, your body knows that the new kidney is foreign that is, not originally part of your body. Your body will attack the new kidney and try to damage or destroy it. The immunosuppressant drugs suppress your body's ability to do this. The goal is to adjust these drugs to prevent rejection and to minimize any side effects of the drugs.
Almost everyone who has a transplant must take these drugs every day as directed. If your new kidney came from an identical twin, however, you may not have to take them. Even missing a single dose may make it more likely for you to have a rejection. The only time you should skip a dose is if your doctor or other health care team member tells you to do so.
If you are not sure, call your doctor. Also, when you have a clinic visit, you should not take your immunosuppressant medicines until your blood is drawn for lab work. Because of the large number of pills you may need to take each day, forgetting a dose is easy to do.
0コメント