Abatacept

Brand names Orencia

Medication error Look-alike, sound-alike drug names.

potential
USP reports that Orencia may be confused with Oracea.(1)

Contraindications Warnings: Concomitant use with tumor necrosis factor (TNF) antagonists or other biologic
and warnings rheumatoid arthritis therapy is not recommended.(2)
Hypersensitivity reactions may occur.
Discontinue use if serious infection occurs.
Screen for tuberculosis prior to starting therapy.
Live vaccines should not be given during or until 3 months after abatacept discontinuation.
Children’s vaccination status should be current prior to beginning therapy.

Infusion-related An acute hypersensitivity reaction occurred in one of 190 pediatric patients treated with
cautions abatacept.(2) Appropriate medical care should be available in the event this occurs.

Dosage Juvenile idiopathic arthritis • 6 years(2,3)

<75 kg: 10 mg/kg repeated at 2 and 4 weeks after initial infusion and q 4 wk thereafter.
75–100 kg: 750 mg.
>100 kg: 1000 mg.
Other uses: One child with juvenile idiopathic arthritis-associated uveitis responded to
treatment with abatacept after iniximab was discontinued due to adverse effects and
etanercept and rituximab failed to elicit an improvement.(4) Seven children with juvenile
idiopathic arthritis-associated uveitis refractory or intolerant to immunosuppressive and
anti-TNF alpha agents demonstrated sustained improvement with abatacept therapy.(5)

Dosage adjustment None recommended.

in organ dysfunction

Maximum dosage 1000 mg.

Additives Maltose. (See Laboratory Interference in the Comments section.)

Suitable diluents SW to reconstitute. NS to dilute.(2)

Maximum 10 mg/mL.(2)
concentration

2

 Abatacept
Preparation and Preparation: Reconstitute by adding 10 mL SW with the silicone-free, disposable syringe
delivery provided. Gently rotate the vial to dissolve. Do not shake. The vial should be vented to
dissipate any foam that is present.(2)
The reconstituted dose must be diluted in 100 mL of NS prior to infusion. Remove the
volume of the dose from the 10-mL bag of NS and then using the silicone-free syringe
slowly inject the dose into 100-mL NS. Gently mix.(2)
Delivery system issues: Infuse through a sterile, nonpyrogenic 0.2- to 1.2-micron, low
protein-binding lter.
Stability: The vial contains no preservatives and once reconstituted must be used within
24 hours.(2)

IV push Not indicated.

Intermittent infusion Over 30 minutes.(2)

Continuous infusion Not indicated.

Other routes of SC dosage available as a single-dose, prelled glass syringe as 125 mg in 1 mL. This
administration solution does not contain maltose.

Comments Adverse events: Serious infections have been reported in individuals receiving TNF-alpha
blocker therapy and abatacept concurrently.(2)
Laboratory interference: Because of the maltose additive in the IV preparation, a falsely
elevated blood glucose measurement may occur with some types of glucose monitors.(2)
Juvenile idiopathic arthritis, juvenile rheumatoid arthritis, and juvenile chronic arthritis
may be used interchangeably.