Home Drug Guide Brentuximab Vedotin

Drug Guide

Generic Name

Brentuximab Vedotin

Brand Names Adcetris

Classification

Therapeutic: Antineoplastic Agent

Pharmacological: Antibody-Drug Conjugate

FDA Approved Indications

  • Hodgkin lymphoma (relapsed or refractory)
  • Systemic anaplastic large cell lymphoma (relapsed or refractory)

Mechanism of Action

Brentuximab vedotin is an antibody-drug conjugate that targets CD30-positive cells. The conjugate binds to CD30, is internalized, and subsequently releases monomethyl auristatin E (MMAE), which inhibits microtubule formation, leading to cell cycle arrest and apoptosis.

Dosage and Administration

Adult: 3.6 mg/kg IV infusion over 30 minutes every 3 weeks, up to 16 cycles

Pediatric: Safety and effectiveness not established in pediatric patients

Geriatric: Use with caution; no specific dosage adjustment recommended but consider age-related comorbidities

Renal Impairment: Use with caution; no specific dose adjustment recommended, monitor renal function

Hepatic Impairment: Use with caution; no specific dose adjustment recommended, monitor hepatic function

Pharmacokinetics

Absorption: Administered intravenously; bioavailability not applicable

Distribution: Wide distribution, including to tissues and lymph nodes

Metabolism: Metabolized primarily in the liver to active and inactive metabolites

Excretion: Eliminated via feces and urine

Half Life: Approximately 4 to 6 days

Contraindications

  • Hypersensitivity to brentuximab vedotin or its components

Precautions

  • Progressive multifocal leukoencephalopathy (PML), monitor neurological status
  • Peripheral neuropathy, avoid use if severe
  • Infusion reactions, administer with monitoring
  • Bacterial, viral, and fungal infections, monitor and manage appropriately

Adverse Reactions - Common

  • Fatigue (Common)
  • Nausea (Common)
  • Fever (Common)
  • Neutropenia (Common)
  • Peripheral sensory neuropathy (Common)

Adverse Reactions - Serious

  • PML (Progressive multifocal leukoencephalopathy) (Rare)
  • Serious infections (sepsis, pneumonia) (Less common)
  • Perforation or fistula (Uncommon)
  • Stevens-Johnson syndrome/toxic epidermal necrolysis (Rare)

Drug-Drug Interactions

  • Bone marrow suppressants, increase risk of severe cytopenias

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for infusion reactions, peripheral neuropathy, signs of infections, complete blood counts regularly

Diagnoses:

  • Risk for infection
  • Risk for peripheral neurotoxicity
  • Risk for bleeding or thrombocytopenia

Implementation: Pre-medicate with antihistamines or steroids if indicated, monitor patient during and post-infusion, handle with care due to cytotoxicity

Evaluation: Assess for adverse reactions, effectiveness in tumor reduction, monitor blood counts

Patient/Family Teaching

  • Inform about signs of infection, peripheral neuropathy, or infusion reactions
  • Advise on avoiding live vaccines during treatment
  • Report any unexplained fever, nerve changes, or severe reactions immediately

Special Considerations

Black Box Warnings:

  • Progressive multifocal leukoencephalopathy (PML)

Genetic Factors: N/A

Lab Test Interference: May cause false elevations in serum transaminases and bilirubin due to hepatic metabolism

Overdose Management

Signs/Symptoms: Severe cytopenias, neurotoxicity, infusion reactions

Treatment: Supportive care, interruption or discontinuation of therapy, symptomatic management, no specific antidote

Storage and Handling

Storage: Store refrigerated at 2°C to 8°C (36°F to 46°F); do not freeze

Stability: Stable for 24 hours at room temperature after reconstitution, discard unused portions

🛡️ 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.