Home Drug Guide Alemtuzumab

Drug Guide

Generic Name

Alemtuzumab

Brand Names Campath, Lemtrada

Classification

Therapeutic: Antineoplastic and Immunomodulator

Pharmacological: Monoclonal antibody (anti-CD52)

FDA Approved Indications

  • Treatment of B-cell chronic lymphocytic leukemia (CLL)
  • Relapsing multiple sclerosis (Lemtrada)

Mechanism of Action

Alemtuzumab is a monoclonal antibody that targets CD52, a protein conducted on the surface of mature lymphocytes, leading to antibody-dependent cell-mediated cytolysis and significant lymphocyte depletion, modulating immune responses.

Dosage and Administration

Adult: For CLL: 30 mg intravenously 3 times a week for 3 weeks, with prophylactic corticosteroids and antimicrobials. For MS: 12 mg IV daily for 5 consecutive days, repeated after 12 months.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; monitor renal and hepatic function.

Renal Impairment: Adjust dosage based on renal function; close monitoring recommended.

Hepatic Impairment: No specific adjustment; monitor liver function during therapy.

Pharmacokinetics

Absorption: Administered intravenously; rapid distribution.

Distribution: Widely distributed; crosses blood-brain barrier in limited amounts.

Metabolism: Metabolized to peptides and amino acids by proteolytic degradation.

Excretion: Primarily via cellular catabolism; not renal elimination.

Half Life: Approximately 3 weeks.

Contraindications

  • Hypersensitivity to alemtuzumab or its components.
  • Active infections.

Precautions

  • Monitor for infusion reactions, infections, autoimmune conditions, and secondary malignancies. Use with caution in patients with pre-existing autoimmune diseases or active infections.

Adverse Reactions - Common

  • Infusion reactions (fever, chills, rash) (Common)
  • Infections, including opportunistic infections (Common)
  • Lymphopenia (Common)

Adverse Reactions - Serious

  • Autoimmune disorders (e.g., immune thrombocytopenic purpura, thyroid disorders) (Serious but less common)
  • Secondary malignancies, including melanoma and other skin cancers (Less common)

Drug-Drug Interactions

  • Immunosuppressants, vaccines, other biologics

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor complete blood counts, liver and renal function, signs of infusion reactions, and infections.

Diagnoses:

  • Risk for infection
  • Impaired immune response
  • Risk for autoimmune response

Implementation: Pre-medicate with antihistamines, corticosteroids, and acetaminophen to reduce infusion reactions. Ensure strict aseptic technique during administration.

Evaluation: Assess for infusion reactions, infection signs, autoimmune symptoms, and laboratory abnormalities regularly.

Patient/Family Teaching

  • Report signs of infection, autoimmune symptoms, or unusual bleeding.
  • Follow infection prevention measures.
  • Attend regular blood tests and follow-up visits.

Special Considerations

Black Box Warnings:

  • Risk of serious autoimmune conditions, including immune thrombocytopenic purpura and thyroid disorders.
  • Risk of malignancies.

Genetic Factors: No specific genetic testing recommended.

Lab Test Interference: May alter lymphocyte counts; interpret with caution during and after therapy.

Overdose Management

Signs/Symptoms: Severe immunosuppression, infections, infusion reactions.

Treatment: Supportive care; corticosteroids or antihistamines for infusion reactions; antimicrobial therapy as needed; no specific antidote.

Storage and Handling

Storage: Store vials refrigerated at 2°C to 8°C.

Stability: Stable until the expiration date stated on package.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.