lanadelumab
General
Pronunciation:
lan-a-del-ue-mab
Trade Name(s)
- Takhzyro
Ther. Class.
antiangioedema agents
Pharm. Class.
kallikrein inhibitors
monoclonal antibodies
Indications
Prevention of hereditary angioedema (HAE) attacks.
Action
Acts as a selective, reversible inhibitor of kallikrein, thereby inhibiting its action in initiating bradykinin production, part of the cascade of events in HAE.
Therapeutic Effect(s):
Reduction in number of HAE attacks.
Pharmacokinetics
Absorption: Well absorbed following subcutaneous administration.
Distribution: Well distributed to tissues.
Metabolism and Excretion: Unknown.
Half-life: 14–15 days.
TIME/ACTION PROFILE (plasma concentrations)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
Subcut | unknown | 4–5 days | unknown |
Contraindication/Precautions
Contraindicated in:
- OB: Pregnancy (may cause fetal harm, especially during 3rd trimester);
Use Cautiously in:
- Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
- Pedi: Children <12 yr (safety and effectiveness not established).
Adverse Reactions/Side Effects
Derm: rash
GI: diarrhea, ↑ liver enzymes
Local: injection site reactions
Neuro: headache, dizziness
Resp: upper respiratory infection
MS: myalgia
Misc: HYPERSENSITIVITY REACTIONS (including anaphylaxis)
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Interactions
Drug-Drug
None known.
Route/Dosage
Subcut (Adults and Children ≥12 yr): 300 mg every 2 wk. If patient has been free of attacks for >6 mo, can adjust regimen to 300 mg every 4 wk.
Availability
Solution for injection: 150 mg/mL
Assessment
- Assess for signs (facial, laryngeal, or abdominal swelling, dyspnea, pain, nausea, vomiting, cramps, diarrhea) and frequency of HAE.
- Monitor for signs and symptoms of severe hypersensitivity reactions (hives, urticaria, chest tightness, wheezing, hypotension, anaphylaxis) during or after injection.
Potential Diagnoses
- Deficient knowledge, related to medication regimen (Patient/Family/Teaching)
Implementation
- Subcut Remove vial from refrigerator 15 min before injecting to allow to warm to room temperature. Does not require reconstitution or dilution. Solution is clear to slightly opalescent, colorless to slightly yellow; do not administer solutions that are cloudy, discolored, or contain particulate matter. Do not shake vial. Withdraw dose from vial using an 18-gauge needle. Change to 27-gauge, 1/2 inch needle. Inject slowly into abdomen, thigh, or upper arm over 10–60 sec. Inject within 2 hr of preparing dosing syringe; may be refrigerated and used within 8 hr. Discard unused portion of vial.
Patient/Family Teaching
- Instruct patient in correct technique for injection, storage, and place to discard syringes and needles.
- Advise patient to notify health care professional immediately if signs and symptoms of hypersensitivity reaction occur.
- Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Evaluation/Desired Outcomes
Decrease in frequency, intensity, and duration of symptoms of HAE.