pegademase (Discontinued)

Brand and Other Names:Adagen

Dosing & Uses

AdultPediatric

Adenosine Deaminase Deficiency

1/22/2019: Discontinuation is due to the permanent shortage of the active ingredient

Based on the demand in mid-January 2019, the inventory is estimated to runout by late-March 2019

Adenosine Deaminase Deficiency

1/22/2019: Discontinuation is due to the permanent shortage of the active ingredient

Based on the demand in mid-January 2019, the inventory is estimated to runout by late-March 2019

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Interactions

Interaction Checker

and pegademase

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (1)

              • pentostatin

                pentostatin decreases effects of pegademase by Other (see comment). Avoid or Use Alternate Drug. Comment: Pentostatin is a potent inhibitor of adenosine deaminase (pegademase).

              Monitor Closely (2)

              • pegloticase

                pegloticase will decrease the level or effect of pegademase by Other (see comment). Use Caution/Monitor. According to the manufacturer, potential for anti-PEG antibody development that may bind to other pegylated drugs; clinical significance unknown

              • pegvaliase

                pegvaliase, pegademase. Other (see comment). Use Caution/Monitor. Comment: The majority of patients treated with pegvaliase develop anti-polyethylene glycol (PEG) IgM and IgG antibodies. Risk of coadministration with different PEGylated products is unknown. There is a case report of anaphylaxis following a medroxyprogesterone acetate injectable suspension that contained PEG 3350. Carefully read all drug labels, including OTC drugs to check contents for PEG. Note: Unable to include an exhaustive product list for this interaction.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Hematologic events: Hemolytic anemia, autoimmune hemolytic anemia, thrombocythemia, thrombocytopenia and autoimmune thrombocytopenia

                Dermatological events: Injection site erythema, urticaria

                Lymphomas

                Headache

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                Warnings

                Contraindications

                Use as a preparatory/support therapy for bone marrow transplantation

                Severe thrombocytopenia

                Cautions

                Use caution in patients with thrombocytopenia; contraindicated in patients with severe thrombocytopenia

                Monitor plasma ADA activity & red blood cell dATP levels

                Development of antibodies reported, which may result in rapid clearance; adjust dose as necessary in patients developing antibodies

                Risk for infection increases in patients that are not able to maintain adequate levels of plasma ADA

                Not a substitute for bone marrow transplant

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: Not known if distributed into breast milk, use caution

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Replaces adenosing deaminase deficiency; the enzyme that catalyzes the deamination of deoxyadenosine and adenosine; this results in combined immunodeficiency disease with profound cellular and humoral immunity

                Pharmacokinetics

                Half-life: 3-6 days

                Peak plasma time: 2-3 days

                Absorption: Rapid

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                Images

                No images available for this drug.
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                Patient Handout

                A Patient Handout is not currently available for this monograph.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.