Nulojix Side Effects

Generic name: belatacept

Medically reviewed by Drugs.com. Last updated on Jun 21, 2023.

Note: This document contains side effect information about belatacept. Some dosage forms listed on this page may not apply to the brand name Nulojix.

Applies to belatacept: intravenous powder for solution.

Warning

Intravenous route (Powder for Solution)

Increased risk for developing posttransplant lymphoproliferative disorder (PTLD), predominantly involving the CNS. Recipients without immunity to Epstein-Barr virus (EBV) are at a particularly increased risk; therefore, use in EBV-seropositive patients only. Do not use belatacept in transplant recipients who are EBV seronegative or with unknown EBV serostatus. Only physicians experienced in immunosuppressive therapy and management of kidney transplant patients should prescribe belatacept. Patients receiving the drug should be managed in facilities equipped and staffed with adequate laboratory and supportive medical resources. Increased susceptibility to infection and the possible development of malignancies may result from immunosuppression. Use in liver transplant patients is not recommended due to an increased risk of graft loss and death.

Serious side effects of Nulojix

Along with its needed effects, belatacept (the active ingredient contained in Nulojix) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking belatacept:

More common

Abdominal or stomach pain
agitation
black, tarry stools
bladder pain
bloating or swelling of the face, arms, hands, lower legs, or feet
bloody or cloudy urine
blurred vision
bone pain
burning while urinating
chest pain
chills
coma
confusion
convulsions
cough or hoarseness
decreased frequency or amount of urine
decreased urine output
depression
difficult or labored breathing
difficult, burning, or painful urination
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
drowsiness
dry mouth
fainting
fast or irregular heartbeat
fever
frequent urge to urinate
headache
hostility
inability to move the arms and legs
increased blood pressure
increased thirst
irritability
itching in other skin areas
lethargy
loss of appetite
loss of bladder control
lower back or side pain
mood or mental changes
muscle pain or cramps
muscle spasms (tetany) or twitching
nausea or vomiting
nervousness
numbness or tingling in the hands, feet, or lips
pale skin
pounding in the ears
rapid weight gain
scaling
shortness of breath
slow or fast heartbeat
sore throat
sores, ulcers, or white spots on the lips or in the mouth
stupor
sudden decrease in the amount of urine
sudden numbness and weakness in the arms and legs
sweating
swelling of the face, ankles, or hands
swollen glands
tightness in the chest
trembling
troubled breathing
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight gain or loss
weakness or heaviness of the legs
weight gain
wheezing

Less common

Back pain
coughing or spitting up blood
drowsiness
joint pain, stiffness, or swelling
loss of appetite
night sweats
persistent non-healing sore
pink growth reddish patch or irritated area
shiny bump
sudden high fever or low-grade fever for months
swelling of the feet or lower legs
weight gain
white, yellow, or waxy scar-like area

Other side effects of Nulojix

Some side effects of belatacept may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Abdominal or stomach cramps
blemishes on the skin
body aches or pain
collection of blood under the skin
cough producing mucus
deep, dark purple bruise
diarrhea
difficulty having a bowel movement (stool)
difficulty with moving
dry mouth
ear congestion
flushed, dry skin
fruit-like breath odor
hair loss or thinning of the hair
increased hunger
increased sweating
increased urination
itching, pain, redness, or swelling
loss of consciousness
loss of voice
muscle cramps in the hands, arms, feet, legs, or face
muscle or bone pain
muscle pain or stiffness
numbness and tingling around the mouth, fingertips, or feet
pain in the joints
pimples
shakiness in the legs, arms, hands, or feet
shortness of breath
sleeplessness
sneezing
swelling or inflammation of the mouth
tightness in the chest
tremor
trouble sleeping
unable to sleep
unexplained weight loss

For Healthcare Professionals

Applies to belatacept: intravenous powder for injection.

Immunologic

Very common (10% or more): Infections (82%), serious infections (36%), herpes infection (14%), cytomegalovirus (12%)

Common (1% to 10%): Blood immunoglobulin G decreased, blood immunoglobulin M decreased, sepsis, influenza, herpes zoster, herpes simplex, BK virus infection, candidiasis, cellulitis, wound infection, localized infection, fungal infection

Uncommon (0.1% to 1%): Hypogammaglobinemia, progressive multifocal leukoencephalopathy, cerebral fungal infection, cytomegalovirus (CMV) colitis, polyomavirus-associated nephropathy, genital herpes, staphylococcal infection, endocarditis, tuberculosis (TB), bronchiectasis, strongyloidiasis, blastocystis infection, giardiasis, lymphangitis, Guillain-Barre syndrome, polyoma virus^[Ref]

Cardiovascular

Very common (10% or more): Hypertension (32%), hypotension (18%)

Common (1% to 10%): Tachycardia, bradycardia, atrial fibrillation, cardiac failure, angina pectoris, left ventricular hypertrophy, shock, infarction, hematoma, lymphocele, angiopathy, arterial fibrosis

Uncommon (0.1% to 1%): Acute coronary syndrome, atrioventricular block second degree, aortic valve disease, arrhythmia supraventricular, venous thrombosis, arterial thrombosis, thrombophlebitis, arterial stenosis, intermittent claudication, flushing^[Ref]

Dermatologic

Common (1% to 10%): Onychomycosis, acne, pruritus, alopecia, skin lesion, rash, night sweats, hyperhidrosis

Uncommon (0.1% to 1%): Psoriasis, hair growth abnormal, onychoclasis, penile ulceration, swelling face, trichorrhexis, alopecia^[Ref]

Gastrointestinal

Very common (10% or more): Diarrhea (39%), constipation (33%), nausea (24%), vomiting (22%), abdominal pain (19%)

Common (1% to 10%): Gastroenteritis, oral candidiasis, dyspepsia, aphthous stomatitis, abdominal hernia, stomatitis

Uncommon (0.1% to 1%): Cholelithiasis, ulcer, GI disorder, pancreatitis, large intestinal ulcer, melena, gastroduodenal ulcer, rectal hemorrhage, small intestinal obstruction, cheilitis, gingival hyperplasia, salivary gland pain, feces discolored^[Ref]

Genitourinary

Very common (10% or more): Urinary tract infection (37%), hematuria (16%), proteinuria (16%), dysuria (11%)

Common (1% to 10%): Hydrocele, glycosuria

Uncommon (0.1% to 1%): Epididymitis, priapism, cervical dysplasia, breast mass, testicular pain, vulval ulceration, atrophic vulvovaginitis, infertility, scrotal edema, urinary incontinence, urinary retention, nocturia, epididymitis, hemorrhagic cystitis, genital herpes^[Ref]

Hematologic

Very common (10% or more): Anemia (45%), leukopenia (20%)

Common (1% to 10%): Thrombocytopenia, neutropenia, leukocytosis, polycythemia, lymphopenia, hematoma

Uncommon (0.1% to 1%): Monocytopenia, pure red cell aplasia, agranulocytosis, hemolysis, hypercoagulation^[Ref]

Metabolic

Very common (10% or more): Hypokalemia (21%), hyperkalemia (20%), hypophosphatemia (19%), dyslipidemia (19%), hyperglycemia (16%), hypercholesterolemia (11%)

Common (1% to 10%): Weight increase, diabetes mellitus, dehydration, weight decrease, acidosis, fluid retention, hypoproteinemia, hypomagnesemia, hyperuricemia

Uncommon (0.1% to 1%): Diabetic ketoacidosis, diabetic foot, alkalosis, decreased appetite, vitamin D deficiency^[Ref]

Musculoskeletal

Very common (10% or more): Arthralgia (17%), back pain (13%)

Common (1% to 10%): Chest pain, musculoskeletal pain

Uncommon (0.1% to 1%): Osteomyelitis

Frequency not reported: Extremity pain, myalgia, muscular weakness, bone pain, joint swelling, intervertebral disc disorder, joint lock, muscle spasms, bone metabolism disorder, osteitis, osteolysis, synovitis, osteoarthritis^[Ref]

Nervous system

Very common (10% or more): Headache

Common (1% to 10%): Tremor, paraesthesia, cerebrovascular accident, dizziness, syncope, lethargy, peripheral neuropathy

Uncommon (0.1% to 1%): Encephalitis, Guillain-Barre syndrome, brain edema, intracranial pressure increased, encephalopathy, convulsion, hemiparesis, demyelination, facial palsy, dysgeusia, cognitive disorder, memory impairment, migraine, burning sensation, diabetic neuropathy, restless leg syndrome^[Ref]

Oncologic

Common (1% to 10%): Squamous cell carcinoma of skin, basal cell carcinoma, skin papilloma

Uncommon (0.1% to 1%): EBV associated lymphoproliferative disorder, lung cancer, rectal cancer, breast cancer, sarcoma, Kaposi's sarcoma, prostate cancer, cervix carcinoma, laryngeal cancer, lymphoma, multiple myeloma, transitional cell carcinoma^[Ref]

Psychiatric

Very common (10% or more): Insomnia (15%), anxiety (10%)

Common (1% to 10%): Depression

Uncommon (0.1% to 1%): Abnormal dreams, mood swings, attention deficit/hyperactivity disorder, libido increased, irritability^[Ref]

Renal

Very common (10% or more): Blood creatinine increased (5%), proteinuria, dysuria, hematuria

Common (1% to 10%): Pyelonephritis, renal tubular necrosis, renal vein thrombosis, renal artery stenosis, glycosuria, hydronephrosis, vesicoureteric reflux, urinary incontinence, urinary retention, nocturia

Uncommon (0.1% to 1%): Renal artery thrombosis, nephritis, nephrosclerosis, renal tubular atrophy, cystitis hemorrhagic, kidney fibrosis^[Ref]

Respiratory

Very common (10% or more): Cough (24%), upper respiratory tract infection (15%), nasopharyngitis (13%), dyspnea (12%), bronchitis (10%)

Common (1% to 10%): Pneumonia, sinusitis, rhinitis, pulmonary edema, wheezing, hypocapnia, orthopnea, epistaxis, oropharyngeal pain

Uncommon (0.1% to 1%): Acute respiratory distress syndrome, pulmonary hypertension, pneumonitis, hemoptysis, bronchopneumopathy, painful respiration, pleural effusion, sleep apnea syndrome, dysphonia, oropharyngeal blistering, bronchiectasis, lymphangitis^[Ref]

Hepatic

Common (1% to 10%): Cytolytic hepatitis, liver function test abnormal

Uncommon (0.1% to 1%): Hepatic cyst, hepatic steatosis, cholelithiasis^[Ref]

Local

Uncommon (0.1% to 1%): Infusion related reaction^[Ref]

Ocular

Common (1% to 10%): Cataract, ocular hyperemia, blurred vision

Uncommon (0.1% to 1%): Retinitis, conjunctivitis, eye inflammation, keratitis, photophobia, eyelid edema^[Ref]

Other

Very common (10% or more): Pyrexia, peripheral edema

Common (1% to 10%): Vertigo, ear pain, tinnitus, fatigue, malaise, impaired healing, C-reactive protein increased, blood parathyroid hormone increased

Uncommon (0.1% to 1%): Hypoacusis, fibrosis, inflammation, feeling hot^[Ref]