alefacept (Discontinued)

Brand and Other Names:Amevive
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Dosing & Uses

AdultPediatric

Dosing Strengths & Forms

powder for injection

  • 7.5mg/vial
  • 15mg/vial

Psoriasis

Indicated for moderate-to-severe chronic plaque psoriasis

15 mg IM qWeek x 12 weeks

Regimen of 12 weekly injections recommended

Retreatment with additional 12 week course may be initiated, based on normal CD4+ T lymphocyte counts and a minimum 12 week interval

Not recommended

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Interactions

Interaction Checker

and alefacept

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Injection site reactions (16%)

            Lymphopenia (10-50%)

            1-10%

            Malignancies (1.3%)

            Chills (6%)

            Pharyngitis (>2%)

            Dizziness (>2%)

            Nausea (>2%)

            Pruritis (>2%)

            Myalgia (>2%)

            Cough (>2%)

            ALT/AST elevation (1.7%)

            <1%

            Serious infections

            Hypersensitivity reactions

            CAD

            MI

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            Warnings

            Contraindications

            Hypersensitivity

            CD4+ T lymphocyte count below normal

            HIV pts

            Pts at high risk for malignancy

            Lactation

            Cautions

            Monitor CD4+ T lymph counts weekly; withhold dosing if CD4 <250/mcL; discontinue if CD4 <250/mcL for one month

            Pts who become pregnant should enroll in the Biogen Pregnancy Registry (1-866-263-8483)

            May increase risk of malignancies

            Risk of serious infection, anaphylaxis

            15 mg lyophilized powder for IM administration ; 7.5 mg lyophilized powder for IV administration

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excretion in milk unknown/not recommended

            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

            Recombinant dimeric fusion protein: extracellular CD2-binding portion of human leukocyte function antigen-3 (LFA-3) linked to the Fc portion of human IgG1

            Inhibits LFA-3/CD2 interaction, thus inhibits T lymphocyte activation (decreases CD45RO+ T lymphs)

            Absorption

            Bioavailability: 63% (IM)

            Distribution

            Vd: 94 mL/kg (IV)

            Elimination

            Half-Life: 270 hr (IV)

            Clearance: 0.25 mL/kg/hr (IV)

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            Administration

            IV/IM Preparation

            IV: reconsitute 7.5 mg vial with 0.6 mL of the supplied diluent; 0.5 mL will contain 7.5 mg of drug

            IM: reconstitute 15 mg vial with 0.6 mL of supplied diluent; 0.5 mL will contains 15 mg of drug

            Withdraw 0.6 mL of supplied diluent using supplied syringe & needle

            Keep needle pointed at sidewall of vial & slowly inject diluent

            Gently swirl contents during dissolution; do not shake

            Reconstituted solution should be clear & colorless to slightly yellow; inspect solution for particulate matter

            Do not use if discolored, cloudy, or if undissolved material remains

            Do not reconstitute drug with other diluents

            Do not filter reconstituted solution during preparation or administration

            Use immediately or within 4 hr if stored in the vial at 2-8°C (36-46°F)

            IV/IM Administration

            Do not add other medications to solutions containing drug

            IM

            • Withdraw & inject the full 0.5 mL of solution
            • Rotate injection sites
            • Give new injections at least 1 inch from an old site & never into areas where skin is tender, bruised, red, or hard

            IV

            • Prepare 2 syringes with 3 mL NS for pre- & post-administration flush
            • Prime the winged infusion set with 3 mL NS & insert into vein
            • Attach drug-filled syringe to infusion set & administer over no more than 5 sec
            • Flush infusion set with 3 mL NS

            Other Information

            Storage Store between 2-8°C/36-46°F Protect from light

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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.