azacitidine
Vidaza
Pharmaceutical company: Bristol Myers Squibb
NEW INDICATION & DOSAGE
Newly diagnosed juvenile myelomonocytic leukemia (JMML)
Children age 1 and older weighing 10 kg or more: 75 mg/m2 IV infusion daily for 7 days in a 28-day cycle. Treat for minimum of 3 cycles and maximum of 6 cycles.
Children age 1 month to less than 1 year or weighing less than 10 kg: 2.5 mg/kg IV infusion daily for 7 days in a 28-day cycle. Treat for minimum of 3 cycles and maximum of 6 cycles.
Adjust-a-dose: Treatment delays up to 14 days can be considered for nonhematologic toxicities. Hematologic toxicity will be difficult to differentiate from natural course of JMML; dose reduction for hematologic toxicity isn't recommended during the first 3 cycles. Discontinue therapy if neutrophil count is less than 0.5 x 109/L at the end of cycle 3 or on day 1 of cycles 5 or 6. Refer to the manufacturer's instructions for toxicity-related dose adjustments.
Released: July 2022
Nursing Drug Handbook
© 2022 Wolters Kluwer
dupilumab
Dupixent
Pharmaceutical company: Regeneron Pharmaceuticals
NEW INDICATION & DOSAGE
Eosinophilic esophagitis
Adults and children age 12 and older weighing at least 40 kg: 300 mg subcut once a week.
Released: July 2022
Nursing Drug Handbook
© 2022 Wolters Kluwer
edaravone
Radicava ORS
Pharmaceutical company: Mitsubishi Tanabe Pharma America
NEW FORM
Oral suspension: 105 mg/5 mL.
NEW INDICATION & DOSAGE
Amyotrophic lateral sclerosis
Adults: For initial treatment cycle, 105 mg PO or via nasogastric tube in the morning after overnight fasting for 14 days followed by a 14-day drug-free period. For all subsequent cycles, 105 mg PO or via nasogastric tube daily for 10 out of 14 days, followed by a 14-day drug-free period.
Adjust-a-dose: Patient may be switched from 60 mg IV daily to 105 mg PO solution daily.
Released: July 2022
Nursing Drug Handbook
© 2022 Wolters Kluwer
ravulizumab-cwvz
Ultomiris
Pharmaceutical company: Alexion Pharmaceuticals
INDICATION & DOSAGE
Generalized myasthenia gravis in patients who are anti-acetylcholine receptor antibody-positive
Adults weighing 100 kg or more: 3,000-mg IV infusion loading dose, followed in 2 weeks by maintenance dose of 3,600-mg IV infusion once every 8 weeks.
Adults weighing 60 to less than 100 kg: 2,700-mg IV infusion loading dose, followed in 2 weeks by maintenance dose of 3,300-mg IV infusion once every 8 weeks.
Adults weighing 40 to less than 60 kg: 2,400-mg IV infusion loading dose, followed in 2 weeks by maintenance dose of 3,000-mg IV infusion once every 8 weeks.
Adjust-a-dose (all-indications):Supplemental dosing is required for patients weighing 40 kg or more receiving concomitant plasma exchange (PE), plasmapheresis (PP), or intravenous immunoglobulin (IVIg). Additional dose is given within 4 hours following PE, PP, or IVIg and is based on weight, current dose, and concomitant treatment. Refer to the manufacturer's instructions for ravulizumab-cwvz dosing.
Released: July 2022
Nursing Drug Handbook
© 2022 Wolters Kluwer
remdesivir
Veklury
Pharmaceutical company: Gilead Sciences, Inc.
INDICATION & DOSAGE
Treatment of nonhospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19) at high risk for progression to severe COVID-19, including hospitalization or death
Children age 28 days and older weighing 3 kg to less than 40 kg: Initiate therapy as soon as possible after diagnosis and within 7 days of symptom onset with 5 mg/kg IV infusion on day 1, followed by 2.5 mg/kg IV infusion once daily on days 2 and 3.
Adjust-a-dose: Consider discontinuing the drug if ALT level increases to greater than 10 times the upper limit of normal (ULN). Discontinue if ALT elevation is accompanied by signs or symptoms of liver inflammation.
Treatment of COVID-19 requiring hospitalization
Children age 28 days and older weighing 3 kg to less than 40 kg: Initiate therapy as soon as possible after diagnosis with 5 mg/kg IV infusion on day 1, followed by maintenance dose of 2.5 mg/kg IV infusion once daily on day 2 for 5 days in patients not requiring invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); if no clinical improvement, may extend therapy 5 additional days. Therapy duration for patients requiring invasive mechanical ventilation or ECMO is 10 days.
Adjust-a-dose: Consider discontinuing the drug if ALT level increases to greater than 10 × ULN. Discontinue if ALT elevation is accompanied by signs or symptoms of liver inflammation.
ADMINISTRATION
Alert: Only remdesivir lyophilized powder form is approved for use in children weighing less than 40 kg.
Released: July 2022
Nursing Drug Handbook
© 2022 Wolters Kluwer
upadacitinib
Rinvoq
Pharmaceutical company: AbbVie
INDICATION & DOSAGE
Ankylosing spondylitis in patients who have had an inadequate response or intolerance to one of more tumor necrosis factor blockers
Adults: 15 mg PO once daily.
Adjust-a-dose: If serious infection develops, interrupt the drug until the infection is controlled. Interrupt therapy if absolute neutrophil count (ANC) is less than 1,000 cells/mm3, or absolute lymphocyte count (ALC) is less than 500 cells/mm3, or hemoglobin (Hb) level is less than 8 g/dL. May restart the drug once ANC, ALC, or Hb level returns to above these values. If hepatic transaminase levels rise and drug-induced liver injury is suspected, interrupt therapy.
Released: July 2022
Nursing Drug Handbook
© 2022 Wolters Kluwer
viloxazine
Qelbree
Pharmaceutical company: Supernus Pharmaceuticals
INDICATION & DOSAGE
Attention deficit hyperactivity disorder
Adults: Initially, 200 mg PO once daily. After 1 week, may titrate by 200-mg increments to maximum dose of 600 mg daily, depending on response and tolerability.
Adjust-a-dose: For severe renal impairment (eGFR less than 30 mL/min/1.73 m2), starting dose is 100 mg once daily. May titrate weekly by 50-mg to 100-mg increments once daily to maximum dose of 200 mg once daily.
Released: July 2022
Nursing Drug Handbook
© 2022 Wolters Kluwer