Abatacept Dosage

Medically reviewed by Drugs.com. Last updated on Mar 4, 2024.

Applies to the following strengths: 250 mg; 125 mg/mL; 50 mg/0.4 mL; 87.5 mg/0.7 mL

Usual Adult Dose for Rheumatoid Arthritis

IV Dosing Regimen:

Weight less than 60 kg: 500 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter
Weight 60 to 100 kg: 750 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter
Weight more than 100 kg: 1000 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter

Subcutaneous Dosing Regimen:

Optional IV loading dose:
Weight less than 60 kg: 500 mg IV once
Weight 60 to 100 kg: 750 mg IV once
Weight more than 100 kg: 1000 mg IV once
Subcutaneous injection: 125 mg subcutaneously once a week

Comments:

This drug may be used as monotherapy or concomitantly with disease-modifying antirheumatic drugs (DMARDs) other than Janus kinase (JAK) inhibitors or biologic disease-modifying antirheumatic drugs (bDMARDS), such as tumor necrosis factor (TNF) antagonists.
The IV infusion should be administered over 30 minutes.
Before the first subcutaneous dose, an optional loading dose may be administered as a single IV infusion; if an IV loading dose is used, the first subcutaneous injection should be administered within 1 day of the infusion.
For patients switching from IV therapy to subcutaneous administration, the first subcutaneous dose should be administered instead of the next scheduled IV dose.

Use: For the treatment of patients with moderately to severely active rheumatoid arthritis

Usual Adult Dose for Psoriatic Arthritis

IV Dosing Regimen:

Weight less than 60 kg: 500 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter
Weight 60 to 100 kg: 750 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter
Weight more than 100 kg: 1000 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter

Subcutaneous Dosing Regimen: 125 mg subcutaneously once a week

Comments:

This drug may be used with or without nonbiologic DMARDs.
The IV infusion should be administered over 30 minutes.
For patients switching from IV therapy to subcutaneous administration, the first subcutaneous dose should be administered instead of the next scheduled IV dose.

Use: For the treatment of patients with active psoriatic arthritis

Usual Adult Dose for Graft Versus Host Disease - Prophylaxis

10 mg/kg IV on the day before transplantation (Day -1), then 10 mg/kg IV on Days 5, 14, and 28 after transplantation
Maximum dose: 1000 mg/dose

Comments:

Before administering this drug, recommended antiviral prophylaxis for Epstein-Barr virus (EBV) reactivation should be administered and continued for 6 months after hematopoietic stem cell transplantation (HSCT); additionally, prophylactic antivirals for CMV infection/reactivation should be considered during therapy and for 6 months after HSCT.
The IV infusion should be administered over 60 minutes.

Use: In combination with a calcineurin inhibitor and methotrexate, for the prophylaxis of acute graft versus host disease (aGVHD) in patients undergoing HSCT from a matched or 1 allele-mismatched unrelated-donor

Usual Pediatric Dose for Juvenile Idiopathic Arthritis

IV Dosing Regimen:
6 years and older:

Weight less than 75 kg: 10 mg/kg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter
Weight 75 to 100 kg: 750 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter
Weight more than 100 kg: 1000 mg IV initially, at 2 and 4 weeks, and every 4 weeks thereafter

Maximum dose: 1000 mg/dose

Subcutaneous Dosing Regimen:
2 years and older:

Weight 10 to less than 25 kg: 50 mg subcutaneously once a week
Weight 25 to less than 50 kg: 87.5 mg subcutaneously once a week
Weight at least 50 kg: 125 mg subcutaneously once a week

Comments:

This drug may be used as monotherapy or concomitantly with methotrexate.
The IV infusion should be administered over 30 minutes.
Subcutaneous administration: Patients may self-inject or the patient's caregiver may administer this drug if both the health care practitioner and parent/legal guardian decides it is appropriate; the ability of pediatric patients to self-inject with the autoinjector has not been tested.

Use: For the treatment of patients with moderately to severely active polyarticular juvenile idiopathic arthritis

Usual Pediatric Dose for Psoriatic Arthritis

2 years and older:

Weight 10 to less than 25 kg: 50 mg subcutaneously once a week
Weight 25 to less than 50 kg: 87.5 mg subcutaneously once a week
Weight at least 50 kg: 125 mg subcutaneously once a week

Comments:

This drug may be used as monotherapy or concomitantly with methotrexate.
IV administration is not approved for pediatric patients with psoriatic arthritis.
Patients may self-inject or the patient's caregiver may administer this drug if both the health care practitioner and parent/legal guardian decides it is appropriate; the ability of pediatric patients to self-inject with the autoinjector has not been tested.

Use: For the treatment of patients with active psoriatic arthritis

Usual Pediatric Dose for Graft Versus Host Disease - Prophylaxis

2 to less than 6 years: 15 mg/kg IV on the day before transplantation (Day -1), then 12 mg/kg IV on Days 5, 14, and 28 after transplantation
6 years and older: 10 mg/kg IV on the day before transplantation (Day -1), then 10 mg/kg IV on Days 5, 14, and 28 after transplantation
Maximum dose: 1000 mg/dose

Comments:

Before administering this drug, recommended antiviral prophylaxis for EBV reactivation should be administered and continued for 6 months after HSCT; additionally, prophylactic antivirals for CMV infection/reactivation should be considered during therapy and for 6 months after HSCT.
The IV infusion should be administered over 60 minutes.

Use: In combination with a calcineurin inhibitor and methotrexate, for the prophylaxis of aGVHD in patients undergoing HSCT from a matched or 1 allele-mismatched unrelated-donor

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS: None

IV administration:

Polyarticular juvenile idiopathic arthritis: Safety and efficacy have not been established in patients younger than 6 years.
Psoriatic arthritis: Safety and efficacy have not been established in patients younger than 18 years.

Subcutaneous administration: Safety and efficacy have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
IV Infusion:

Use an infusion set and a sterile, nonpyrogenic, low-protein-binding filter (pore size of 0.2 to 1.2 microns).
For rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, and adults with psoriatic arthritis, administer the entire diluted solution over 30 minutes.
For prophylaxis of aGVHD, administer the entire diluted solution over 60 minutes.
Infusion of the diluted solution must be completed within 24 hours of reconstitution of the vials.
Do not infuse concomitantly in the same IV line with other agents.

Subcutaneous Administration:

The prefilled syringes and ClickJect autoinjectors are for subcutaneous use only under the guidance of a health care practitioner; do not use for IV infusion.
Rotate injection sites and avoid injections into areas where the skin is tender, bruised, red, or hard.

Storage requirements:

Refrigerate at 2C to 8C (36F to 46F); protect from light by storing in original package until time of use.
IV infusion: May store diluted solution at room temperature or refrigerate at 2C to 8C (36F to 46F) up to 24 hours before use; discard diluted solution if not administered within 24 hours.
Subcutaneous injection: Do not freeze.

Reconstitution/preparation techniques:

For IV infusion: This drug must be reconstituted (using only the provided silicone-free disposable syringe) and further diluted prior to administration.
The manufacturer product information should be consulted.

IV compatibility:

Compatible: Sterile Water for Injection, USP; 0.9% Sodium Chloride Injection, USP
There have been no physical or biochemical compatibility studies to evaluate coadministration of this drug with other agents.

General:

Limitations of Use: The concomitant use of this drug with other potent immunosuppressants (e.g., bDMARDS, JAK inhibitors) is not recommended.

Monitoring:

Infections/Infestations: For signs of infection (when transitioning from TNF antagonist therapy to this drug); for EBV reactivation; for CMV infection/reactivation (for 6 months posttransplant)
Respiratory: For worsening respiratory status in patients with COPD

Patient advice:

Read the US FDA-approved patient labeling (Patient Information and Instructions for Use).
Notify health care professional immediately if symptoms of an allergic reaction occur on the day of administration or the day after administration.
Patients treated with the IV formulation who are using glucose dehydrogenase pyrroloquinoline quinone (GDH-PQQ)-based monitoring systems for glucose: Consider using other methods for glucose monitoring (e.g., those based on glucose dehydrogenase nicotine adenine dinucleotide [GDH-NAD], glucose oxidase, or glucose hexokinase test methods) or you may get falsely elevated blood glucose readings on the day this drug is infused.