Nivolumab


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intravenous
Advanced renal cell carcinoma, Locally advanced non-small cell lung carcinoma, Locally advanced squamous cell carcinoma of the head and neck, Locally advanced urothelial carcinoma, Metastatic melanoma, Metastatic non-small cell lung carcinoma, Metastatic squamous cell carcinoma of the head and neck, Metastatic urothelial carcinoma, Refractory classical Hodgkin lymphoma, Relapsed classical Hodgkin lymphoma
Adult: 3 mg/kg, given via infusion over 60 minutes, every 2 weeks. Continued until disease progression or unacceptable toxicity.

Intravenous
Metastatic colorectal cancer
Adult: 240 mg, given via infusion over 60 minutes, every 2 weeks. Continued until disease progression or unacceptable toxicity.
Child: ≥12 years Same as adult dose.

Intravenous
Hepatocellular carcinoma
Adult: 240 mg, given via infusion over 60 minutes, every 2 weeks. Continued until disease progression or unacceptable toxicity.

Intravenous
Metastatic melanoma
Adult: In combination with ipilimumab: 1 mg/kg, given via infusion over 60 minutes, every 3 weeks for 4 doses, followed by ipilimumab. Thereafter, 3 mg/kg over 60 minutes, every 2 weeks, as monotherapy. Continued until disease progression or unacceptable toxicity.
Hướng dẫn pha thuốc
Dilute vials labelled as containing 10 mg/mL with NaCl 0.9% solution or glucose 5% solution to provide a solution containing approx 1-10 mg/mL. Do not shake.
Thận trọng
Patient with history or concurrent active brain metastases or active auto-immune disease, ocular/uveal melanoma, symptomatic interstitial lung disease, poor prognosis or aggressive disease, and medical conditions requiring systemic immunosuppression. Patient with carcinoma of the nasopharynx or salivary gland when used for the treatment of head and neck cancer. Patient who received hematopoietic stem cell transplant. Moderate to severe hepatic impairment. Children. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Adrenal insufficiency, type 1 diabetes mellitus, diabetic ketoacidosis; elevation of ALT, AST, alkaline phosphatase, bilirubin; hypophysitis, immune-mediated nephritis, and other immune-related adverse reactions (e.g. auto-immune neuropathy, demyelination, uveitis). Rarely, severe infusion-related reactions.
Blood and lymphatic system disorders: Lymphocytopenia, anaemia, leucopenia, thrombocytopenia.
Gastrointestinal disorders: Nausea, constipation, vomiting, abdominal pain, intestinal perforation, stomatitis.
General disorders and administration site conditions: Fatigue, malaise, weakness, febrile reaction.
Investigations: Increased serum amylase, lipase, triglycerides, cholesterol.
Metabolism and nutrition disorders: Peripheral oedema, decreased appetite, hyponatraemia, hyperkalaemia, hypocalcaemia, hypomagnesaemia.
Musculoskeletal and connective tissue disorders: Musculoskeletal pain, back pain, arthralgia, myopathy.
Nervous system disorders: Headache, peripheral neuropathy, neuritis, peripheral nerve palsy.
Renal and urinary disorders: UTI.
Respiratory thoracic and mediastinal disorders: Upper respiratory tract infection.
Skin and subcutaneous tissue disorders: Rash, pruritus, vitiligo, erythema.
Vascular disorders: Hypertension.
Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis, neutropaenia, dyspnoea, renal failure; immune-mediated encephalitis, diarrhea/colitis, hepatitis, hypophysitis, thyroid dysfunction, pneumonia, pneumonitis or interstitial lung disease, pulmonary embolism. Rarely, myotoxicity (e.g. myositis, myocarditis, rhabdomyolysis).
Thông tin tư vấn bệnh nhân
This drug may cause fatigue, if affected, do not drive or operate machinery.
Chỉ số theo dõi
Monitor LFT, serum creatinine, thyroid function at baseline and periodically thereafter; blood glucose. Monitor for signs and symptoms of electrolyte disturbance, dehydration, immune-mediated colitis, hypophysitis, pneumonitis, hepatitis, thyroid disorder, rash, encephalitis, adrenal insufficiency and other immune-related adverse reactions; cardiac and pulmonary adverse reactions, myotoxicity, and infusion reactions during and at least 5 months after discontinuation of therapy.
Tương tác
Potentially Fatal: Decreased therapeutic effect with immunosuppressants.
Tác dụng
Description:
Mechanism of Action: Nivolumab is a human immunoglobulin G4 (IgG4) monoclonal antibody which binds to negative immunoregulatory protein programmed death-1 (PD-1) receptor. This results in the activation of immune response to tumour cells.
Pharmacokinetics:
Distribution: Crosses the placenta.
Metabolism: Catabolised into small peptides and amino acids.
Excretion: Terminal elimination half-life: Approx 25 days.
Bảo quản
Store between 2-8°C. Protect from light. Do not freeze. Reconstituted solution: Stable for 8 hours when stored between 20-25°C and 24 hours between 2-8°C.
Any unused portions should be disposed of in accordance with local requirements.
Phân loại MIMS
Liệu pháp nhắm trúng đích
Phân loại ATC
L01FF01 - nivolumab ; Belongs to the class of PD-1/PDL-1 (Programmed cell death protein 1/death ligand 1) inhibitors. Used in the treatment of cancer.
Tài liệu tham khảo
Anon. Nivolumab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 11/12/2017.

Buckingham R (ed). Nivolumab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/12/2017.

Joint Formulary Committee. Nivolumab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/12/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Nivolumab. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 11/12/2017.

Opdivo Injection (E.R. Squibb & Sons, L.L.C). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 11/12/2017.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Nivolumab từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2024 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Already a member? Sign in
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Already a member? Sign in