Immunosuppressive drugs, also known as anti-rejection drugs, are employed to prevent autoimmune diseases, such as arthritis, myasthenia gravis, lupus, Crohn’s disease, and glomerulonephritis, and to control organ transplant rejections. The Discovery of new immune suppressant drugs in the past decade has been phenomenal. Tacrolimus, mycophenolate mofetil, cyclosporine, sirolimus, azathioprine, methotrexate, leflunomide, glucocorticoids, etc., are used either as monotherapy or combined for immunosuppressive action in patients. Learn immunosuppressive drugs’ uses, risks, mechanism of action, and side effects.
What are immunosuppressants?
Anti-rejection or immunosuppressants keep your immune system working as it should. Your immune system fights infection that targets intruders like bacteria, viruses, and malignant cells. But sometimes, it attacks healthy cells and tissues. These immune suppressants can slow or completely stop this response. In some cases, Immune suppressants weaken your immune system, increasing your risk of developing bacteria, viral, and fungal infections.
What are the uses of Immunosuppressants?
Immune suppressants are prescription treatments for autoimmune diseases. People who get organ transplants or stem cell transplants (bone marrow transplants) receive immunosuppressants on prescription, so their immune system does not attack the transplanted organ or stem cells. These medicines reduce symptoms and even put some autoimmune conditions into remission (where there are no signs of the disease). Immunosuppressants may be given if you have alopecia areata, lupus, Crohn’s disease, ulcerative colitis, psoriasis, rheumatoid arthritis, and multiple sclerosis.
When can you use immunosuppressants?
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- Autoimmune diseases – If you get an autoimmune disease, your immune system stops protecting your body from invaders and begins to attack healthy tissues and cells. An immunosuppressant medication holds back your immune system and helps to prevent further cell damage and inflammation. These pharmaceutical agents minimize symptoms.
- Organ transplants – If you need an organ transplant, immune suppressants help lower the risk that your body will reject the received organ. Organ rejection occurs when your immune system is aware of the transplanted organ and that it is new to the body. It will treat it like an intruder that should be eliminated from the body. Immunosuppressants protect newly transplanted organs by keeping your immune system’s response damaged.
- Stem cell transplants – Sometimes, people with blood cancers, disorders, or bone marrow problems have allogeneic stem cell transplants. The transplant procedure involves a donor who donates stem cells to a receiver, replacing unhealthy stem cells so the body can build a new immune system. Healthcare specialists treat many conditions with stem cell transplants, including:
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- Blood disorders, including thalassemia, sickle cell disease
- Blood cancers such as multiple myeloma, lymphoma
- Bone marrow problems like aplastic anemia
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This new immune system may see your body as foreign and attack your healthy organs and tissues. This is called graft-versus-host disease (GvHD). You may be prescribed different oral and intravenous immune suppressants for several weeks or months during and after a stem cell transplant. You may need to take these immunosuppressants for years until the immune system settles.
What medications are involved?
Steroids – Corticosteroids include hydrocortisone, cortisone, and prednisone. They effectively treat rashes, asthma, inflammatory bowel syndrome, and other conditions. When prescribed in certain doses, they help reduce inflammation caused by asthma, arthritis, and skin rashes and ultimately ease symptoms. They are also effective at preventing organ rejection in transplant recipients. These corticosteroids suppress the immune system and help control conditions in which the immune system mistakenly attacks its own tissues.
Prednisone – Prednisone is a mainstay of treatment for most immune-mediated diseases. It works by blocking the wide range of immune responses. The use of prednisone is related to a wide variety of side effects. The most reported side effects are more annoying than dangerous.
Other immune suppressive medicines
Other medicines are often used alongside steroids. They work to change the immune system in different ways and sometimes allow the lowest dose of the steroid to be used. This is especially applicable if the side effects of steroids become too severe.
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- Cyclosporine – It acts rapidly and doesn’t suppress cell production in the marrow. We often measure the medicine’s concentration in the bloodstream to ensure the correct dose.
- Azathioprine – This medicine is initially given once daily, but the dose can be adjusted every other day or a few times a week. It takes several weeks to begin working and reduce the production of bone marrow cells.
- Methotrexate – It is prescribed for the treatment of rheumatoid arthritis. It is usually given once or twice a week and takes a few weeks to show improvement.
- Leflunomide – It starts working in a few weeks and has few adverse effects. Initially, it is generally given once a day.
- Mycophenolate (Mycofit 500 mg) – This medication is given once or twice a day to start and begins to work in days.
- Tacrolimus (Pangraf 1 mg) – Take pangram 1 mg at the same time each day. If you choose to take pangram with food, you should always take it with food. One can take it at the same time each day, twelve hours apart.
- Sirolimus (Rapacan 1mg) – If you are taking cyclosporine, take sirolimus for four hours after your cyclosporine dose. Sirolimus is a drug with rapid absorption of 1 to 2 hours. This means it may start to work after it gets completely absorbed in the body.
How do immunosuppressants work?
Immune suppressant drugs are a class of drugs that hold back or decrease the intensity of the immune response in the body. These medicines make the body less likely to resist a transplanted organ. In organ transplantation, immunosuppressants are required to activate early-stage immunosuppression, manage late-stage immunosuppression, or maintain organ rejection. The Discovery of novel agents and improvements in immunosuppression regimens after transplantation are significant factors that led to this progress.
However, these medications also increase the risk of infection, cancer, and certain types of cancers and specific adverse effects specific to each agent in patients, particularly in pregnant ladies and fertility issues.
What are immune suppressant’s side effects?
These anti-rejection drugs are potentially powerful drugs that can cause many adverse effects such as diabetes, acne, fatigue, headaches, mouth sores, hair loss or growth, high blood pressure, tremors, headaches, fatigue, weight gain, tremors, nausea, vomiting, and stomach upset.
Summary
When your immune system attacks your body, immune suppressant drugs manage it. These drugs effectively treat autoimmune diseases. If you have a donated stem cell or an organ, anti-rejection drugs help prevent your body from rejecting your new stem cells and organ. These drugs can successfully treat autoimmune diseases and offer many life-saving benefits. But there are potential risks and complications. Be careful of the side effects of immunosuppressive drugs. Let your healthcare specialist know if your side effects are more severe than expected.