• Premedication is not required.
• Cortisone doses should be consistent with clinical trials experience. Cortisone doses were tapered to between 10–20 mg/day by first 6 wk after transplant, then remained at 10 mg (5–10 mg) per day for first 6 mo after transplant.
• Treat patient for latent tuberculosis prior to therapy.
• Prophylaxis for Pneumocystis jiroveci infection is recommended after transplant.

IV Administration:

• Intermittent Infusion: Calculate number of vials required for total infusion dose. Reconstitution: Reconstitute contents of each vial with 10.5 mL of sterile water for injection, 0.9% NaCl or D5W using the silicone-free disposable syringe provided and an 18–21 gauge needle for a concentration of 25 mg/mL. Direct stream of diluent to wall of vial. Rotate and invert vial gently; do not shake to avoid foaming. Solution is clear to slightly opalescent and colorless to pale yellow; do not use if opaque particles, discoloration, or other particles are present. Calculate total volume needed for infusion dose. Diluent: Dilute further with 0.9% NaCl or D5W if reconstituted with sterile water for injection, 0.9% NaCl if reconstituted with 0.9% NaCl, or with D5W if reconstituted with D5W.Concentration: 2 mg/mL. Withdraw amount of diluent from infusion container equal to volume of infusion dose. Using same silicone-free disposable syringe used for reconstitution, withdraw required amount of belatacept solution from vial, inject into infusion container, and rotate gently to mix. Typical infusion volume is 100 mL, but may range from 50–250 mL. Transfer from vial to infusion container immediately; infusion must be completed within 24 hr of reconstitution. May be refrigerated and protected from light for 24 hr. Do not administer solutions that are discolored or contain particulate matter. Discard unused solution in vials.
• Rate: Infuse over 30 min using a nonpyrogenic, low-protein-binding filter with 0.2–1.2 micron pore size.
• Y-Site Incompatibility: Do not mix or infuse in same line with other agents.