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Muromonab-CD3 (trade name Orthoclone OKT3,) is an immunosuppressant drug given to reduce acute rejection in patients with organ transplants. It is a monoclonal antibody targeted at the CD3 receptor a membrane protein on the surface of T cells. It was the first monoclonal antibody to be approved for clinical use in humans.

Adverse effects

Especially during the first infusion, the binding of muromonab-CD3 to CD3 can activate T cells to release cytokines like tumor necrosis factor and interferon gamma. This cytokine release syndrome, or CRS, includes side effects like skin reactions, fatigue, fever, chills, myalgia, headaches, nausea and diarrhea and could lead to life-threatening conditions like apnoea, cardiac arrest, and flash pulmonary edema. To minimize the risk of CRS and to offset some of the minor side effects patient experience, glucocorticoids (such as methylprednisolone), acetaminophen, and diphenhydramine are given before the infusion.

Other adverse effects include leucopenia, as well as an increased risk for severe infections and malignancies typical of immunosuppressive therapies. Neurological side effects like aseptic meningitis and encephalopathy have been observed [as a consequence of the fact the immune system has been suppressed].

Repeated application can result in tachyphylaxis (reduced effectiveness) due to the formation of anti-mouse antibodies in the patient, which accelerates elimination of the drug. It can also lead to an anaphylactic reaction against the mouse protein which may be difficult to distinguish from a CRS.

On Jan, 28, 2016: 491 people reported to have side effects when taking Orthoclone okt3. Among them, 3 people (0.61%) have Hallucination.

On Jan, 28, 2016: 491 people reported to have side effects when taking Orthoclone okt3. Among them, 5 people (1.02%) have Death.