Belimumab Treatment: Dosage, Side Effects, and Uses for Lupus

Summary of Key Points

Belimumab is a prescription medication used to treat autoimmune conditions such as systemic lupus erythematosus (SLE) and lupus nephritis. It works by targeting specific proteins in the immune system to reduce inflammation and prevent flare-ups. Belimumab is typically administered either by injection or infusion. Always consult a healthcare provider before starting or adjusting your treatment. You can schedule a telemedicine appointment with one of our providers today for personalized advice.

Names of Medication

US Brand Name: Benlysta

Generic Name: Belimumab

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name will be listed in parentheses.

Pharmacologic Category

Monoclonal Antibody

B-lymphocyte Stimulator (BLyS)-specific Inhibitor

Belimumab Dosage

Belimumab is used to treat various autoimmune diseases. The dosage depends on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also consult one of our telemedicine providers for personalized guidance.

Systemic Lupus Erythematosus (SLE)

For adults with systemic lupus erythematosus, the recommended dose is 10 mg/kg administered by intravenous (IV) infusion over one hour every 2 weeks for the first 3 doses, followed by every 4 weeks thereafter.

Lupus Nephritis

For adults with lupus nephritis, the dose is 10 mg/kg by IV infusion over one hour every 2 weeks for the first 3 doses, then every 4 weeks thereafter. Alternatively, a subcutaneous injection of 200 mg once weekly may be used.

Rheumatoid Arthritis

Although not FDA-approved for rheumatoid arthritis, Belimumab is sometimes used off-label. Consult your doctor for specific dosing recommendations.

Sjögren’s Syndrome

Belimumab is not FDA-approved for Sjögren’s syndrome but may be used off-label. Speak with your healthcare provider for more information on dosing.

Dermatomyositis and Polymyositis

Belimumab is not FDA-approved for dermatomyositis or polymyositis but may be used off-label. Consult your doctor for specific dosing recommendations.

Vasculitis

Belimumab is not FDA-approved for vasculitis but may be used off-label. Please speak with your healthcare provider for more information.

Systemic Sclerosis

Belimumab is not FDA-approved for systemic sclerosis but may be used off-label. Consult your healthcare provider for more information.

Mixed Connective Tissue Disease

Belimumab is not FDA-approved for mixed connective tissue disease but may be used off-label. Speak with your doctor for more information on dosing.

Antiphospholipid Syndrome

Belimumab is not FDA-approved for antiphospholipid syndrome but may be used off-label. Consult your healthcare provider for specific dosing recommendations.

Dosage Forms and Strengths

Intravenous (IV) Infusion: 120 mg, 400 mg vials

Subcutaneous Injection: 200 mg in a prefilled syringe or autoinjector

Belimumab Administration Instructions

Belimumab can be administered as an intravenous infusion or subcutaneous injection. If receiving the IV form, it will be administered by a healthcare professional in a clinic or hospital. The subcutaneous injection can be given at home after proper training. Always follow your healthcare provider’s instructions for administration and contact them if you have any questions or concerns. You can also reach out to one of our telemedicine providers for assistance.

Contraindications for Belimumab

A contraindication is a specific condition where a medication should not be used because it may cause harm. It’s important to know if you have any contraindications before starting Belimumab.

Contraindications for Belimumab

Severe active infections: Belimumab can weaken your immune system, making it harder for your body to fight infections. If you have a serious infection, taking Belimumab could worsen it.

Hypersensitivity to Belimumab: If you have had an allergic reaction to Belimumab in the past, you should not take it again. Allergic reactions can be severe and life-threatening.

Live vaccines: You should not receive live vaccines while taking Belimumab, as the medication may reduce the vaccine’s effectiveness or increase your risk of contracting the infection the vaccine is designed to prevent.

HIV, Hepatitis B or C: If you have a history of these viral infections, Belimumab may increase the risk of reactivating these viruses, leading to serious health complications.

If you have any of these conditions, discuss them with your healthcare provider before starting Belimumab. Our telemedicine providers are available to help you assess whether this medication is safe for you.

Drug-to-Drug Interactions

Belimumab may interact with other medications, potentially affecting its efficacy or increasing the risk of side effects. Be sure to inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal products.

Medications that may interact with Belimumab

Rituximab (Rituxan): Using Rituximab with Belimumab can increase the risk of infections and further weaken your immune system.

Abatacept (Orencia): Combining these medications may heighten the risk of serious infections.

TNF inhibitors: Drugs like Adalimumab (Humira), Etanercept (Enbrel), and Infliximab (Remicade) can increase the risk of infections when taken with Belimumab.

Live vaccines: As mentioned earlier, live vaccines such as the MMR (measles, mumps, rubella) vaccine or the yellow fever vaccine should be avoided while on Belimumab.

Always consult your healthcare provider before starting or stopping any medications. If you have concerns about drug interactions, our telemedicine providers can review your medication list and provide guidance.

Belimumab in Pregnancy

Is Belimumab Safe During Pregnancy?

There is limited information regarding the safety of Belimumab during pregnancy. While animal studies suggest potential risks, human studies are not yet sufficient to definitively determine whether Belimumab is safe for pregnant women. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of continuing Belimumab with your healthcare provider. They can help you weigh the possible risks to your baby against the benefits of managing your autoimmune condition, such as lupus.

If you are pregnant or considering pregnancy, our telemedicine providers are available to guide you in making an informed decision about your treatment options, including Belimumab.

Belimumab While Breastfeeding

Is Belimumab Safe for Breastfeeding Mothers?

It is currently unknown whether Belimumab passes into breast milk or if it could affect a nursing infant. Due to the lack of conclusive data, healthcare providers generally recommend exercising caution when using Belimumab while breastfeeding. If you are breastfeeding or planning to breastfeed, it is important to discuss the potential risks and benefits with your healthcare provider. They may suggest alternative treatments or advise you to discontinue breastfeeding while taking Belimumab.

If you have concerns about breastfeeding while on Belimumab, our telemedicine providers are available to discuss your options and help you make the best decision for both you and your baby.

Estimated Cost of Belimumab

The cost of Belimumab can vary depending on your location and the pharmacy you use. Without insurance, the estimated cost of a 30-day supply of Belimumab, when using a GoodRx coupon, ranges from approximately $4,000 to $5,000. Be sure to check with your pharmacy for the most accurate pricing, and inquire about any available discounts or assistance programs.

If you need help managing the cost of your Belimumab treatment, our telemedicine providers can assist you in exploring options, including patient assistance programs or alternative treatments.

Possible Alternatives to Belimumab

Depending on your condition, there may be alternative treatments or lifestyle changes that can help manage your symptoms. It’s important to consult your healthcare provider before making any changes to your treatment plan.

Systemic Lupus Erythematosus (SLE)

Hydroxychloroquine (Plaquenil): This medication is commonly used to manage lupus symptoms and may serve as an alternative to Belimumab.

Corticosteroids: These drugs can help reduce inflammation and control lupus flares.

Lifestyle changes: Regular exercise, a balanced diet, and stress management can also help improve lupus symptoms.

Lupus Nephritis

Mycophenolate mofetil (CellCept): This medication is often used to treat kidney inflammation caused by lupus.

Cyclophosphamide (Cytoxan): Another option for treating severe lupus nephritis.

Rheumatoid Arthritis

Methotrexate: A common first-line treatment for rheumatoid arthritis.

Biologics: Medications such as Adalimumab (Humira) or Etanercept (Enbrel) may be alternatives to Belimumab for rheumatoid arthritis.

Sjögren’s Syndrome

Pilocarpine (Salagen): This medication can help increase saliva production in patients with Sjögren’s syndrome.

Artificial tears: Over-the-counter eye drops can help manage dry eyes, a common symptom of Sjögren’s syndrome.

Dermatomyositis and Polymyositis

Corticosteroids: These can help reduce muscle inflammation in patients with dermatomyositis or polymyositis.

Immunosuppressants: Medications such as Methotrexate or Azathioprine may be used to manage these conditions.

Vasculitis

Rituximab (Rituxan): This medication may be used to treat certain types of vasculitis.

Cyclophosphamide (Cytoxan): Another option for severe cases of vasculitis.

Systemic Sclerosis

Immunosuppressants: Medications like Mycophenolate mofetil (CellCept) may be used to control symptoms of systemic sclerosis.

Physical therapy: Regular exercise and therapy can help maintain joint flexibility and mobility in patients with systemic sclerosis.

Mixed Connective Tissue Disease

Corticosteroids: These can help control inflammation in mixed connective tissue disease.

Immunosuppressants: Medications such as Methotrexate or Azathioprine may be used to manage this condition.

Antiphospholipid Syndrome

Blood thinners: Medications like Warfarin (Coumadin) or Heparin may be used to prevent blood clots in patients with antiphospholipid syndrome.

Always consult with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to discuss your options and help you find the best treatment for your condition.

Recent Updates on Belimumab Research

Recent studies continue to explore the effectiveness of Belimumab in treating lupus and other autoimmune diseases. A 2022 study demonstrated that Belimumab, when used in combination with standard therapy, significantly improved outcomes in patients with lupus nephritis. Ongoing research is also investigating the potential of Belimumab in treating other autoimmune conditions, such as Sjögren’s syndrome and rheumatoid arthritis. While these studies are promising, more research is needed to confirm the long-term benefits and safety of Belimumab in these conditions.

If you are interested in learning more about the latest research on Belimumab, our telemedicine providers can help you stay informed and discuss how new findings may impact your treatment plan.

James Kingsley

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