lanadelumab

General

Pronunciation:
lan-a-del-ue-mab

Trade Name(s)

• Takhzyro

Ther. Class.

antiangioedema agents

Pharm. Class.

kallikrein inhibitors

monoclonal antibodies

Indications

Prevention of hereditary angioedema attacks.

Action

Acts as a selective, reversible inhibitor of kallikrein, thereby inhibiting its action in initiating bradykinin production, part of the cascade of events in hereditary angioedema.

Therapeutic Effect(s):

Reduction in number of hereditary angioedema attacks.

Pharmacokinetics

Absorption: Well absorbed following SUBQ administration.

Distribution: Well distributed to tissues.

Metabolism and Excretion: Unknown.

Half-life: 14–15 days.

TIME/ACTION PROFILE (plasma concentrations)

Contraindication/Precautions

Contraindicated in:

• OB:   Pregnancy.

Use Cautiously in:

• Lactation:  Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
• Pedi:   Children <2 yr (safety and effectiveness not established).

Adverse Reactions/Side Effects

Derm: rash

GI: diarrhea, ↑ liver enzymes

Local: injection site reactions

Neuro: headache, dizziness

Resp: upper respiratory infection

MS: myalgia

Misc: HYPERSENSITIVITY REACTIONS (including anaphylaxis)

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

None reported.

Route/Dosage

SUBQ (Adults and Children ≥12 yr): 300 mg every 2 wk. If patient has been free of attacks for >6 mo, can adjust regimen to 300 mg every 4 wk.

SUBQ (Children 6–<12 yr): 150 mg every 2 wk. If patient has been free of attacks for >6 mo, can adjust regimen to 150 mg every 4 wk.

SUBQ (Children 2–<6 yr): 150 mg every 4 wk.

Availability

Solution for injection (prefilled syringes): 150 mg/mL

Assessment

• Assess for signs (facial, laryngeal, or abdominal swelling; dyspnea; pain; nausea; vomiting; cramps; diarrhea) and frequency of hereditary angioedema attacks.
• Monitor for signs and symptoms of hypersensitivity reactions (rash, urticaria, pruritus, flushing, dizziness, vomiting, abdominal pain) and angioedema (swelling of throat, lips, tongue, or face; dyspnea; wheezing; hoarseness) during or after injection. Discontinue immediately and provide supportive care.

Implementation

• SUBQ Remove prefilled syringe from refrigerator 15 min before injecting to allow to warm to room temperature. Do not shake prefilled syringe. Inject dose slowly into abdomen, thigh, or upper arm over 10–60 sec. Discard unused portion of prefilled syringe.

Patient/Family Teaching

• Explain the purpose and side effects of lanadelumab to patient. Do not stop receiving drug without consulting health care professional. May be administered by patient or caregiver to adults and children ≥12 yr; should be administered by health care professional or caregiver in children 2–<12 yr. Instruct patient or caregiver in correct technique for injection, storage, and place to discard syringes and needles. Advise patient to read  Patient Information  before starting and with each Rx refill in case of changes.
• Advise patient to notify health care professional immediately if signs and symptoms of hypersensitivity reaction occur (rash, hives, itchiness, flushing, dizziness, vomiting, abdominal pain). If angioedema occurs (swelling of throat, lips, tongue, or face; trouble breathing; wheezing; hoarseness), notify health care professional and call 911 immediately.
• May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
• Rep:  Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Decrease in frequency, intensity, and duration of symptoms of hereditary angioedema attacks.