(FDA approved in bold)

• Prophylaxis of organ rejection in patients with allogenic 1 kidney, liver, and heart transplants
• Rheumatoid arthritis
• Psoriasis
• Myasthenia gravis (MG)
• Leukemias refractory to routine treatment
• Aplastic anemia
• Ulcerative colitis

• Specifically and reversibly inhibits T-lymphocytes, especially T-helper cells. Also inhibits lymphokine production and release, including interleukin-2

• Most patients with MG improve 1–2 months after starting treatment, but maximum improvement takes 6 or more months

• Decrease dose of corticosteroids. Gradually reduce to the minimum dose needed to maintain clinical improvement

• Consider alternative disease-modifying therapy or thymectomy

• Often used with corticosteroids (prednisone), especially in the initial stages of treatment

• Obtain baseline CBC, magnesium, potassium, uric acid, lipids, blood urea nitrogen, and creatinine. Measure trough levels 1 month after starting determine dosing. Measure creatinine every 2–4 weeks for the first few months, then monthly, and then every 2–3 months when stable or when new medications are added. Measure CBC, uric acid, potassium and lipids every 2 weeks for the first 3 months, then monthly. Monitor blood pressure frequently (at least monthly)