Patients on immunosuppressive therapy have an increased risk of infections. Since infections have a potential to trigger acute porphyric attacks vigilance is motivated regarding signs or symptoms of infection and/or possible symptoms of a porphyric attack. Side effects like diarrhoea, nausea, vomiting and abdominal pain may potentially be porphyrinogenic through reduction in carbohydrate intake.

Infections are common in patients using immunosuppressants and since infections might trigger an acute porphyric attack, vigilance regarding signs and symptoms of an infection and/ or a porphyric attack is recommended. Common adverse reactions of belatacept that can be confused with an acute porphyric attack are abdominal pain, nausea, vomiting, constipation and diarrhoea. These side effects may potentially be porphyrinogenic if leading to a decrease in carbohydrate intake.

Belatacept is a protein with no CYP metabolism. No pharmacokinetic porphyrinogenic effects are suspected.

Belatacept is a soluble fusion protein.

Belatacept is indicated for prophylaxis of graft rejection in adults receiving a renal transplant.

The cytochrome P450 enzyme system or uridine diphosphate-glucuronosyltransferases are not expected to be involved with the metabolism of belatacept. Because the drug is a protein, belatacept is degraded into smaller peptides and amino acids by proteolytic enzymes (DrugBank)