daprodustat Jesduvroq Pharmaceutical company: GlaxoSmithKline Pharmacologic classification: Hypoxia-inducible factor prolyl hydroxylase inhibitor Therapeutic classification: Hematopoietic |
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AVAILABLE FORMS Tablets: 1 mg; 2 mg; 4 mg; 6 mg; 8 mg INDICATIONS AND DOSAGES Anemia due to chronic kidney disease in patients who have been receiving dialysis for at least 4 months Adults not being treated with an erythropoiesis stimulating agent (ESA): If the pretreatment hemoglobin is less than 9 g/dL, give 4 mg PO once daily; if the pretreatment hemoglobin is 9 to 10 g/dL, give 2 mg PO once daily; if the pretreatment hemoglobin is greater than 10 to 11 g/dL, give 1 mg PO once daily. Adults being switched from an ESA: For patients switching from epoetin alfa, darbepoetin alfa, or ethoxy PEG-epoetin beta, refer to the manufacturer's instructions for daprodustat dosing instructions based on current ESA drug and dosage. Adjust-a-dose: Increase or decrease dose by one dose level at a time. Dose levels are 1 mg, 2 mg, 4 mg, 6 mg, 8 mg, 12 mg, 16 mg, and 24 mg. Decrease dose if hemoglobin increases rapidly by more than 1 g/dL over 2 weeks or 2 g/dL over 4 weeks, or if hemoglobin exceeds 11 g/dL. Don't increase the dose more frequently than every 4 weeks. If hemoglobin exceeds 12 g/dL, interrupt treatment. Restart at one dose level lower when hemoglobin drops to within the target range. Maximum dose is 24 mg once daily. Reduce daprodustat starting dose by half in patients on clopidogrel or a moderate CYP2C8 inhibitor, or with moderate hepatic impairment (Child-Pugh class B), except in patients whose starting dose is already 1 mg. Discontinue therapy if a clinically meaningful hemoglobin increase isn't achieved by 24 weeks. CONTRAINDICATIONS AND CAUTIONS
PREGNANCY-LACTATION-REPRODUCTION
INTERACTIONS Drug-drug. CYP2C8 inducers (rifampin): May decrease daprodustat level and decrease its efficacy. Monitor hemoglobin and adjust daprodustat dose when initiating or discontinuing CYP2C8 inducers. Moderate CYP2C8 inhibitors (clopidogrel): May increase daprodustat level. Reduce daprodustat starting dose when initiating treatment unless starting dose is already 1 mg. Monitor hemoglobin and adjust daprodustat dose when initiating or stopping CYP2C8 inhibitors. Strong CYP2C8 inhibitors (gemfibrozil): May increase level of daprodustat. Concomitant use in contraindicated. Drug-lifestyle. Tobacco smoking, alcohol use: May increase risk of gastric or esophageal erosions. Discourage use together. ADVERSE REACTIONS CNS: stroke, dizziness. CV: thrombotic vascular events (MI, deep vein thrombosis, pulmonary embolism, vascular access thrombosis), heart failure, hypertension. GI: GI erosion, abdominal pain. Other: hypersensitivity.
Reactions in bold italics are life-threatening.
Released: May 2023
Nursing Drug Handbook © 2023 Wolters Kluwer |
lecanemab-irmb Leqembi Pharmaceutical company: Eisai Inc. and Biogen Pharmacologic classification: Amyloid beta-directed antibody Therapeutic classification: Anti-Alzheimer drug |
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AVAILABLE FORMS Injection: 200 mg/2 mL; 500 mg/5 mL single-use vials INDICATIONS AND DOSAGES Mild cognitive impairment or mild dementia stage of Alzheimer disease Adults: 10 mg/kg administered IV infusion over approximately one hour once every two weeks. Adjust-a-dose: See the manufacturer's instructions for dose reductions in the settings of amyloid-related imaging abnormalities-edema (ARIA-E) and -hemosiderin deposition (ARIA-H) based on symptom severity and magnetic resonance imaging findings. CONTRAINDICATIONS AND CAUTIONS
PREGNANCY-LACTATION-REPRODUCTION
INTERACTIONS Drug-drug. Antithrombotics, thrombolytic agents, antiplatelets, anticoagulants: May increase risk of bleeding; use together cautiously. Consider withholding lecanemab-irmb temporarily if anticoagulant must be used for 4 weeks or less. ADVERSE REACTIONS CNS: headache, ARIA-E. CV: atrial fibrillation. EENT: cough. GI: diarrhea. Hematologic: lymphopenia. Other: infusion-related reactions.
Reactions in bold italics are life-threatening.
Released: May 2023
Nursing Drug Handbook © 2023 Wolters Kluwer |