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 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 hereditary angioedema.

Therapeutic Effect(s):

Reduction in number of hereditary angioedema attacks.

Pharmacokinetics

Absorption: Well absorbed following SUBQ administration.

Distribution: Well distributed to tissues.

Metabolism and Excretion: Unknown.

Half-life: 14–15 days.

TIME/ACTION PROFILE (plasma concentrations)

Contraindication/Precautions

Contraindicated in:

• OB:   Pregnancy.

Use Cautiously in:

• Lactation:  Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
• Pedi:   Children <2 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 reported.

Route/Dosage

SUBQ (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.

SUBQ (Children 6–<12 yr): 150 mg every 2 wk. If patient has been free of attacks for >6 mo, can adjust regimen to 150 mg every 4 wk.

SUBQ (Children 2–<6 yr): 150 mg every 4 wk.

Availability

Solution for injection (prefilled syringes or vials): 150 mg/mL

Assessment

• Assess for signs (facial, laryngeal, or abdominal swelling, dyspnea, pain, nausea, vomiting, cramps, diarrhea) and frequency of hereditary angioedema attacks.
• Monitor for signs and symptoms of severe hypersensitivity reactions (hives, urticaria, chest tightness, wheezing, hypotension, anaphylaxis) during or after injection.

Implementation

• SUBQ Remove vial or prefilled syringe from refrigerator 15 min before injecting to allow to warm to room temperature. Vials do 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 or prefilled syringe. Withdraw dose from vial using an 18-gauge needle. Change to 27-gauge, ½-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 or prefilled syringe.

Patient/Family Teaching

• May be administered by patient or caregiver in adults and children ≥12 yr; should be administered by health care professional or caregiver in children 2–<12 yr. Instruct patient or caregiver 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.
• Rep:  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 hereditary angioedema attacks.