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eculizumab (Soliris)
Indications:
- paroxysmal nocturnal hemoglobinuria
- hemolytic uremic syndrome (HUS) [1]
- membranoproliferative glomerulonephritis
- Degos-Touraine syndrome
- AChR-Ab + myasthenia gravis
Dosage:
- meningococcal vaccination must be administered to all patients at least 2 weeks prior to the 1st dose of eculizumab*
- infusion 600-900 mg diluted to 5 mg/mL over 35 minutes
- every 7 days during induction phase
- every 14 +/- 2 days during maintenance
- 600 mg weekly for 1st 4 weeks
- 900 mg week 5
- 900 mg every 2 weeks thereafter
300 mg single use vials, 30 ml of 10 mg/mL of sterile solution
* ref [2] case of HUS seemed to have much shorter interval between meningococcal vaccination & first dose of eculizumab
Adverse effects:
- > 10-20%%
- headache
- pyrexia
- nasopharyngitis, upper respiratory infection, cough
- abdominal pain
- nausea/vomiting
- diarrhea
- hypertension
- anemia
- peripheral edema
- urinary tract infections
- increased risk of invasive meningococcal disease
Mechanism of action:
- reduces hemolysis by inhibiting terminal complement activation
- targets complement C5
Interactions
drug adverse effects of pharmaceutical monoclonal antibodies
General
pharmaceutical monoclonal antibody
References
- Deprecated Reference
- Kao AY, Sagar P, Klig JE et al
Case 19-2018: A 15-Year-Old Girl with Acute Kidney Injury.
N Engl J Med 2018; 378:2421-2429. June 21, 2018
PMID: 29924949
https://www.nejm.org/doi/full/10.1056/NEJMcpc1802827
- http://www.soliris.net/
- Prescribing Information
http://www.soliris.net/sites/default/files/assets/soliris_pi.pdf
- Medscape: eculizumab (Rx)
https://reference.medscape.com/drug/soliris-eculizumab-342875