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Indications and Dosage
Subcutaneous
Treatment and prophylaxis of haemorrhagic episodes in patients with haemophilia A Adult: Initially, 3 mg/kg once weekly for 4 weeks. Maintenance: Either 1.5 mg/kg once weekly or 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks.
Child: Same as adult dose. |
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Special Precautions
Patient with risk of thrombotic microangiopathy and thromboembolism e.g. thrombocytopenia, microangiopathic haemolytic anaemia and acute kidney injury, without severe deficiencies in ADAMTS13. Children. Pregnancy and lactation.
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Adverse Reactions
Significant: Thrombotic microangiopathy.
Gastrointestinal disorders: Diarrhoea. General disorders and administration site conditions: Inj site reactions, pyrexia. Infections and infestations: Cavernous sinus thrombosis. Musculoskeletal and connective tissue disorders: Arthralgia, myalgia. Nervous system disorders: Headache. Skin and subcutaneous tissue disorders: Skin necrosis. Vascular disorders: Thrombophlebitis superficial. |
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Monitoring Parameters
Monitor coagulation parameters using single factor assays utilizing chromogenic or immune-based methods. Asses for thrombotic microangiopathy and thrombotic events if activated prothrombin complex concentrate (aPCC) is administered concomitantly.
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Drug Interactions
May increase risk of thrombotic microangiopathy with activated prothrombin complex concentrate (aPCC). May enhanced adverse effect of belimumab.
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Lab Interference
May interfere with coagulation tests e.g. activated clotting time (ACT), aPTT, and all assay based on aPTT e.g. Bethesda assays (clotting-based) for FVIII inhibitor titers, one-stage aPTT-based single-factor assays, aPTT-based activated protein C resistance (APC-R).
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Action
Description: Emicizumab is a humanized monoclonal modified IgG4 antibody that links activated factor IX and factor X to restore the function of missing activated factor VIII that is needed for effective haemostasis.
Pharmacokinetics: Absorption: Bioavailability: 80.4-93.1%. Distribution: Volume of distribution: 10.4 L. Excretion: Elimination half-life: Approx 26.9 ± 9.1 days. |
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Storage
Store between 2-8°C. Protect from light. Do not freeze.
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MIMS Class
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ATC Classification
B02BX06 - emicizumab ; Belongs to the class of other systemic hemostatics. Used in the treatment of hemorrhage.
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References
Anon. Emicizumab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 19/06/2019. Buckingham R (ed). Emicizumab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/06/2019. Hemlibra Injection, Solution (Genentech, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 19/06/2019. Joint Formulary Committee. Emicizumab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/06/2019.
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