Have you ever heard that our own body's defense system, the system that protects us from disease, sometimes works against us? Or that after someone receives a transplant, like a kidney, their body tries to reject the new organ? Today, we're going to talk about a special class of drugs that doctors prescribe to control the functioning of our immune system in such serious cases.
What are these immunosuppressants?
Simply put, these are drugs that reduce or suppress the activity of your body's immune system. Normally, our immune system is like an army that protects a country. When it sees foreign enemies, such as viruses, bacteria, and cancer cells, this army fights and protects us.
But sometimes, this army makes a mistake and starts attacking our own healthy cells and tissues, thinking, "These are enemies too." At such times, we give these immunosuppressants to calm down the overactive army.
But the most important thing to remember is that because these medications weaken the immune system, the risk of developing infections from viruses and bacteria actually increases.
In what situations are these medications used?
Doctors mainly recommend these medications in two situations.
1. For Autoimmune Diseases
This is the condition where our own immune system attacks us. When this happens, healthy cells in the body are destroyed and inflammation begins to occur. These medications stop the unwanted attack of the immune system and control the symptoms. These medications can even control some diseases completely and put them into remission without any symptoms.
Some of the autoimmune diseases for which this medication is commonly used are:
- Patchy hair loss (Alopecia areata)
- Inflammatory bowel disease, such as Crohn's disease and ulcerative colitis
- Lupus
- Multiple sclerosis (MS)
- Psoriasis and associated arthritis
- Rheumatoid arthritis (RA) , also known as rheumatoid arthritis
2. In Organ and Stem Cell Transplants
Imagine that someone receives a transplant of an organ, such as a kidney, liver, or heart. The body's immune system sees this new organ as a "foreigner." So it thinks it's foreign and attacks it, trying to reject it (organ rejection). To prevent that, that is, to make the body accept the new organ, this (Immunosuppressant) medicine is given.
Similarly, stem cells are transplanted for blood cancers like leukemia and thalassemia. The immune system that develops from these new cells can attack the old body. This is called (Graft-versus-host disease - GvHD) . This medicine is also essential to prevent this condition.
How do I get this medicine and for how long?
These medications can be taken as pills, liquids, injections, or intravenously (IV) . Depending on your condition, you may need to take these medications for several months, a year, or your entire life. Especially if you have had an organ transplant, you may need to continue taking these medications for as long as your doctor tells you to.
What are the most commonly used types of immunosuppressants?
There are many types of these medications. Depending on your condition, your doctor will choose the medication or combination of medications that is most suitable for you.
| Type of medicine | A simple explanation |
|---|---|
| Corticosteroids Ex: Prednisone | These are the most commonly used types. They quickly control immune system function and inflammation. |
| Biologics Ex: Adalimumab, Infliximab | These are produced in the laboratory and target specific parts of the immune system. |
| Calcineurin inhibitors Ex: Tacrolimus, Cyclosporine | It blocks an enzyme that stimulates T-cells (a type of white blood cell) that fight infection. |
| Other different types (IMDH inhibitors, Janus kinase inhibitors, mTOR inhibitors) | These control things like cell growth, inflammatory enzymes, and cell proliferation. |
What are the benefits, side effects, and risks of these medications?
While these medications provide life-saving benefits, they can also cause some side effects and risks.
Possible side effects
These are very strong medications and can cause various side effects. Not everyone will experience all of these.
- Acne formation
- Risk of developing diabetes
- Excessive body fatigue
- Hair loss or unwanted growth
- Headache
- High blood pressure
- Mouth sores
- Osteoporosis
- Tremors
- Weight gain
- Stomach upset, nausea, and vomiting
If you experience more of these side effects than usual, tell your doctor right away. He or she may be able to change the dosage or prescribe a different medication.
Special risks and complications
1. Skipping medication
This is a very serious matter. Do not skip a single dose of this medication for any reason or without your doctor's advice. If someone with an autoimmune disease does this, the disease can suddenly worsen. If someone who has had an organ transplant stops taking the medication, the body will begin to reject the organ.
2. Increased risk of infection
As we discussed earlier, these medications weaken the immune system. This means that your body's defenses are reduced. This makes you (immunocompromised) , meaning your immune system is weakened. This means that you can get serious infections more easily than a normal person. Examples:
- Sepsis (infection of the blood)
- Fungal infections (e.g., thrush)
- Skin infections (Cellulitis)
- Respiratory infections (e.g., colds, pneumonia)
What can I do to stay healthy during treatment?
In this time of deliberately lowered immunity, you need to think about your safety more than ever.
- Wash your hands regularly with soap and water. This is the best way to prevent infections.
- Talk to your doctor about vaccinations. Ask him or her which vaccines you should and should not get.
- Eat nutritious foods. Eat a balanced diet with well-cooked vegetables, fruits, whole grains, and proteins.
- Get enough sleep. Getting good sleep supports the immune system.
- Avoid crowded places and places where sick people are as much as possible.
Do these medications have any effect during pregnancy?
Yes, it definitely can. Anyone taking this medication and planning to have a baby should talk to their doctor beforehand. Some medications can be harmful to the baby in the womb and can cause birth defects. Also, some medications are not suitable during breastfeeding. Therefore, if your doctor wants to, he or she can switch you to a safer medication that is suitable for pregnancy.
Take-Home Message
- Immunosuppressants are a very powerful class of drugs used for serious conditions such as autoimmune diseases and organ transplants.
- Never skip a dose or change the dosage without your doctor's advice.
- Because the risk of infection is increased when taking this medication, it is very important to follow precautions such as frequent hand washing and staying away from sick patients.
- Inform your doctor immediately about any side effects or unusual symptoms you experience.
- If you are expecting a baby, be sure to consult your doctor before planning to become pregnant.
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