Nurses Compass
Drug Guide
Brodalumab
Classification
Therapeutic: Immunosuppressant; Monoclonal antibody for psoriasis
Pharmacological: Interleukin-17 receptor A antagonist
FDA Approved Indications
- Plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
Mechanism of Action
Brodalumab binds to and inhibits interleukin-17 receptor A, blocking the activity of interleukin-17A and related cytokines, thereby reducing inflammation and psoriatic plaque formation.
Dosage and Administration
Adult: Subcutaneous injection of 210 mg at Weeks 0, 1, 2, then every 2 weeks thereafter.
Pediatric: Not approved for pediatric use.
Geriatric: No specific dosage adjustment suggested, but caution in elderly patients due to potential infections.
Renal Impairment: No specific adjustment necessary.
Hepatic Impairment: No specific adjustment necessary.
Pharmacokinetics
Absorption: Subcutaneous bioavailability approximately 30%.
Distribution: Generally limited to the vascular and interstitial spaces.
Metabolism: Degraded by proteolytic enzymes into small peptides and amino acids.
Excretion: Eliminated primarily through catabolic pathways.
Half Life: Approximately 16 to 19 days.
Contraindications
- Hypersensitivity to brodalumab or any of its components.
Precautions
- Risk of serious infections, including fungal, bacterial, and viral infections; screening for tuberculosis prior to initiation.
- Monitoring for hypersensitivity reactions.
- Not recommended during active infections or for patients with a history of inflammatory bowel disease.
Adverse Reactions - Common
- Injection site reactions (Common)
- Upper respiratory tract infections (Common)
- Headache (Common)
Adverse Reactions - Serious
- Suicidal ideation and behavior (Reported post-marketing, black box warning)
- Inflammatory bowel disease exacerbation (Reported)
Drug-Drug Interactions
- Immunosuppressants
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of infection, hypersensitivity, and mood changes.
Diagnoses:
- Risk for infection,
- Risk for adverse immune response
Implementation: Administer as prescribed via subcutaneous injection; educate patients on recognizing signs of infection.
Evaluation: Assess for improvement in psoriatic lesions and adverse effects.
Patient/Family Teaching
- Report any signs of infection, mood changes, or allergic reactions promptly.
- Do not initiate during active infections.
- Maintain regular follow-up visits and laboratory testing as advised.
Special Considerations
Black Box Warnings:
- Serious infections, including fungal, bacterial, and viral infections, with some cases of opportunistic infections and demyelinating diseases.
- Suicidal ideation and behavior
Genetic Factors: None specified.
Lab Test Interference: May affect certain immune function tests.
Overdose Management
Signs/Symptoms: Potential increased risk of infections and hypersensitivity reactions.
Treatment: Supportive care; no specific antidote.
Storage and Handling
Storage: Refrigerate at 2°C to 8°C (36°F to 46°F).
Stability: Stable until the expiration date printed on the vial if stored properly.