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Immunosuppressants

Immunosuppressants are drugs used to reduce the activity of the body's immune system.

Immunosuppressants
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Immunosuppressants reduce the level of activity of the body's immune system. The immune system works to protect the body against infection and helps to destroy diseased cells. However, in certain conditions, known as autoimmune disorders, the immune system acts against the body's healthy tissues, and immunosuppressant drugs may be required to protect them from permanent damage. Immunosuppressants are also given just before transplant surgery and afterwards for life to prevent the immune system from attacking and rejecting the new organ. The drugs are also used to treat some cancers.

People who are taking immunosuppressant drugs are at increased risk of infection because the drugs reduce the body's ability to fight disease.

Common drugs

Corticosteroids: Prednisolone Cytotoxic immunosuppressants: Azathioprine, Cyclophosphamide, Methotrexate
Other immunosuppressants: Ciclosporin, Tacrolimus

What are the types of immunosuppressants?

The main types of drug used to suppress the activity of the immune system are corticosteroids and cytotoxic immunosuppressants. Other immunosuppressants that are commonly used include ciclosporin and tacrolimus.

Corticosteroids

You may be given oral corticosteroid drugs if you have an autoimmune disorder such as systemic lupus erythematosus. Corticosteroids weaken the immune system by affecting the activity of white blood cells, which are an essential component of the immune response.

Prolonged use of oral corticosteroids may cause acne, the development of a moon-shaped face, and weight gain. The drugs also increase the risk of developing osteoporosis, high blood pressure (see Hypertension), and diabetes mellitus, and may make some otherwise minor infections, such as chickenpox, life-threatening. You should not stop taking corticosteroids suddenly. Your pharmacist or doctor will issue a card giving details of your treatment, which you should carry at all times to inform health professionals in case of a medical emergency.

Cytotoxic immunosuppressants

If corticosteroids are ineffective, autoimmune disorders, such as rheumatoid arthritis, may be treated with cytotoxic immunosuppressants. This type of drug may also be used with corticosteroids so that the corticosteroid dose can be reduced. Some cytotoxic immunosuppressants are used to treat cancers, such as leukaemia, and to prevent the rejection of tissue grafts or organ transplants. The drugs suppress the immune system by stopping the growth of new white blood cells in the bone marrow.

Cytotoxic immunosuppressant drugs can cause side effects including nausea, vomiting, diarrhoea, hair loss, and sterility. They may also cause easy bruising and abnormal bleeding, such as nosebleeds. You will need regular blood tests to monitor the drug's effects.

Other immunosuppressants

Ciclosporin and tacrolimus are drugs that may be given to prevent the rejection of a transplanted organ. Ciclosporin may also be used to treat autoimmune disorders, such as rheumatoid arthritis, when other drugs are ineffective. The drugs work in similar ways by blocking the action of white blood cells that are involved in the immune response.

Ciclosporin and tacrolimus are often given as intravenous infusions before a transplant operation and are taken orally afterwards. These drugs may cause side effects such as tiredness, gastrointestinal upsets, and excessive hair growth. They can also cause high blood pressure and kidney damage, and regular blood tests are needed to check kidney function.

Warning

When taking immunosuppressant drugs, it is important that you report any signs of infection, such as a sore throat or fever, or any unusual bruising or bleeding to your doctor immediately.

Posted 09.09.2010

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