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palivizumab (Synagis)

Indications: - treatment of respiratory syncytial virus (RSV) - prevention of respiratory syncytial virus during RSV season [2] - preterm infants - *<29 weeks' gestation - *preterm infants with chronic lung disease of prematurity - *<32 weeks' gestation requiring >21% oxygen therapy during the first 28 days of life - may prevent recurrent wheezing in preterm infants with a family history of allergy at 6 years of age [5] - *infants with hemodynamically significant congenital heart disease - *infants with congenital anomalies or neuromuscular disorders - *during the second year of life only for preterm infants who require continued medical support for chronic lung disease [2] Contraindications: - Down syndrome - immunocompromised children - routine prophylaxis for cystic fibrosis* [2] - prophylaxis for healthcare workers [3] - not recommended in the U.S. for most infants born after 29 weeks' gestation [5] - not indicated in adults [6] * indication base on severity of chronic lung disease during the 1st 2 years of life Dosage: - monthly doses of 50 mg IM during RSV season - maximum of 5 doses - discontinue monthly prophylaxis if a breakthrough RSV infection occurs [2] Mechanism of action: - recombinant monoclonal antibody against RSV

Interactions

drug adverse effects of pharmaceutical monoclonal antibodies

Related

respiratory syncytial virus (RSV)

General

pharmaceutical monoclonal antibody

References

  1. Nuijten MJ, Wittenberg W, Lebmeier M. Cost Effectiveness of Palivizumab for Respiratory Syncytial Virus Prophylaxis in High-Risk Children: A UK Analysis. Pharmacoeconomics. 2007;25(1):55-71. PMID: 17192118
  2. Committee on Infectious Diseases and Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 2014 Aug 1; 134:415 PMID: 25070315 http://pediatrics.aappublications.org/content/134/2/415
  3. Anello J, Feinberg B, Heinegg J, Lindsey R, Wojdylo C, Wong O. Medcsape Oncology. August 2014 Recommendations for Respiratory Syncytial Virus (RSV) from the American Academy of Pediatrics. http://reference.medscape.com/features/slideshow/guidelines-review/august2014
  4. Ralston SL et al Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis Pediatrics. October 27, 2014 PMID: 25349312 http://pediatrics.aappublications.org/content/early/2014/10/21/peds.2014-2742.full.pdf+html
  5. Orciari Herman A, Sofair A, Chavey WE Palivizumab Prophylaxis in Preterm Infants Tied to Less Wheezing Later. Physician's First Watch, Feb 3, 2017 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org - Mochizuki H, Kusuda S, Okada K et al Palivizumab Prophylaxis in Preterm Infants and Subsequent Recurrent Wheezing: 6 Year Follow Up Study. Am J Resp Crit Care Med Feb 2, 2017 PMID: 24127479 Free full text http://www.atsjournals.org/doi/abs/10.1164/rccm.201609-1812OC
  6. Medscape: palivizumab (Rx) https://reference.medscape.com/drug/synagis-palivizumab-343140