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)

ROUTEONSETPEAKDURATION
Subcutunknown4–5 daysunknown

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

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.

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

Implementation

  • SUBQ 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.