| Renal transplant rejection

Astagraf XL vs Nulojix

Side-by-side clinical, coverage, and cost comparison for renal transplant rejection.

Deep comparison between: Astagraf Xl vs Nulojix with Prescriber.AI

AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.

Safety signalsNulojix has a higher rate of injection site reactions vs Astagraf Xl based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Nulojix but not Astagraf Xl, including UnitedHealthcare

Category

Astagraf Xl

Nulojix

At A Glance

RouteOral

FrequencyDaily

ClassCalcineurin inhibitor

RouteIV infusion

FrequencyEvery 4 weeks

ClassSelective T cell costimulation blocker

Indications

Renal transplant rejection

Renal transplant rejection

Dosing

Renal transplant rejection - adult (with basiliximab induction) 0.15 to 0.2 mg/kg once daily prior to reperfusion or within 48 hours of completion of transplant, with MMF and steroids; taken orally every morning on an empty stomach.

Renal transplant rejection - adult (without basiliximab induction) Pre-operative: 0.1 mg/kg within 12 hours prior to reperfusion; post-operative: 0.2 mg/kg once daily at least 4 hours after pre-operative dose and within 12 hours after reperfusion, with MMF and steroids.

Renal transplant rejection - pediatric (with basiliximab induction) 0.3 mg/kg once daily administered within 24 hours following reperfusion, with MMF and steroids.

Renal transplant rejection Initial phase: 10 mg/kg IV on Day 1, Day 5, and end of Weeks 2, 4, 8, and 12; maintenance phase starting Week 16: 5 mg/kg IV every 4 weeks (+/- 3 days), administered over 30 minutes.

Contraindications

Known hypersensitivity to tacrolimus

EBV seronegative or unknown EBV serostatus, due to risk of post-transplant lymphoproliferative disorder (PTLD) predominantly involving the CNS

Drug Interactions

1432View drug interactions

264View drug interactions

Adverse Reactions

Most common (>=30%) Diarrhea, constipation, nausea, peripheral edema, tremor, anemia

Serious Lymphoma and other malignancies, serious infections, new onset diabetes after transplant, nephrotoxicity, neurotoxicity, hyperkalemia, hypertension, QT prolongation, pure red cell aplasia, thrombotic microangiopathy including hemolytic uremic syndrome and thrombotic thrombocytopenic purpura

Postmarketing Agranulocytosis, pancytopenia, cardiac arrest, myocardial infarction, Torsades de pointes, Stevens-Johnson syndrome, toxic epidermal necrolysis, progressive multifocal leukoencephalopathy, posterior reversible encephalopathy syndrome, hepatic failure, graft versus host disease

Most common (>=20%) Anemia, diarrhea, urinary tract infection, peripheral edema, constipation, hypertension, pyrexia, graft dysfunction, cough, nausea, vomiting, headache, hypokalemia, hyperkalemia, leukopenia

Serious PTLD predominantly involving the CNS, serious infections including JC virus-associated PML and polyoma virus nephropathy

Postmarketing Anaphylaxis, venous thrombosis of the renal allograft

Pharmacology

Calcineurin inhibitor; tacrolimus binds the intracellular protein FKBP-12 to form a complex that inhibits calcineurin phosphatase activity, blocking dephosphorylation and translocation of NF-AT and NF-kB and thereby suppressing T-lymphocyte activation, proliferation, and T-helper-cell-dependent B-cell responses.

Selective T cell costimulation blocker; belatacept is a soluble CTLA4-Ig fusion protein that binds CD80 and CD86 on antigen-presenting cells, blocking CD28-mediated T lymphocyte costimulation and inhibiting T cell proliferation and cytokine production that mediate immunologic rejection.

View Full FDA Information

View full FDA information

Enter your patient's insuranceCheck specific coverage details for your patient.

Most Common Insurance

Anthem BCBS

Astagraf Xl