Table 2.
Drug | Mechanism of action | Side effects |
---|---|---|
Corticosteroids | Blocks transcription of cytokine genes, IL-1, IL-2, IL-3, IL-5, IL-6, tumor necrosis factor-α, and interferons | Hypertension |
Glucose intolerance | ||
Dyslipidemia | ||
Osteoporosis | ||
Cyclosporin | Inhibits IL-2 production, stimulates TGF-β production | Nephrotoxicity |
Hypertension | ||
Dyslipidemia | ||
Glucose intolerance | ||
Tacrolimus | Inhibits IL-2 production | Nephrotoxicity |
Hypertension | ||
Dyslipidemia | ||
Glucose intolerance | ||
Azathioprine | Inhibits purine synthesis and blocks DNA and RNA synthesis Inhibits CD28 signaling |
Myelosuppression |
Mycohphenolate mofetil | Blocks de novo pathway of purine synthesis (selective for lymphocytes) and blocks glycosylation | Diarrhea and gastrointestinal upset Myelosuppression |
Sirolimus/everolimus | Blocks IL-2-induced cell cycle progression | Hyperlipidemia |
Thrombocytopenia | ||
Impaired wound healing | ||
Oral ulcers | ||
Belatacept | Blocks costimulation by CD28 | PTLD in EBV naïve patients |
Abbreviations: EBV, Epstein–Barr virus; IL, interleukin; PTLD, posttransplant lymphoproliferative disorder; TGF, transforming growth factor.