Home Drug Guide Difelikefalin acetate

Drug Guide

Generic Name

Difelikefalin acetate

Brand Names Korsuva

Classification

Therapeutic: Analgesic, Neurokinin-1 receptor agonist for pruritus

Pharmacological: Kappa-opioid receptor agonist

FDA Approved Indications

  • Treatment of moderate-to-severe pruritus in adult patients with chronic kidney disease on dialysis

Mechanism of Action

Difelikefalin binds selectively to kappa-opioid receptors on peripheral sensory nerves and immune cells, reducing pruritus signals and inflammatory responses associated with chronic kidney disease-related pruritus.

Dosage and Administration

Adult: Start with 0.5 mcg/kg administered intravenously three times per week after dialysis; doses may be adjusted based on response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustments; monitor for increased sensitivity.

Renal Impairment: Use as per dialysis schedule; no dosage adjustment needed for dialysis patients.

Hepatic Impairment: No specific data; caution advised.

Pharmacokinetics

Absorption: Administered intravenously, so absorption is complete.

Distribution: Limited data available; likely distributes to peripheral tissues.

Metabolism: Not extensively metabolized; primarily cleared renally.

Excretion: Excreted unchanged in urine; clearance related to renal function.

Half Life: Approximately 7 hours.

Contraindications

  • Hypersensitivity to difelikefalin or components of the formulation.

Precautions

  • Use cautiously in patients with known sensitivities.
  • Limited data in hepatic impairment; use cautiously.

Adverse Reactions - Common

  • Increased salivation (Unknown)
  • Somnolence (Unknown)
  • Dizziness (Unknown)

Adverse Reactions - Serious

  • Hypersensitivity reactions, including anaphylaxis (Rare)
  • Postural dizziness leading to falls (Uncommon)

Drug-Drug Interactions

  • Limited interaction data available; caution with other CNS depressants.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of hypersensitivity and adverse reactions.

Diagnoses:

  • Risk for falls due to dizziness or hypotension.

Implementation: Administer as per prescribed schedule, monitor patient's response, and watch for side effects.

Evaluation: Assess pruritus severity and monitor for adverse effects.

Patient/Family Teaching

  • Report any allergic reactions immediately.
  • Do not stop therapy without consulting healthcare provider.
  • Be cautious when performing activities that require alertness until response to medication is known.

Special Considerations

Black Box Warnings:

  • None at this time.

Genetic Factors: No special genetic considerations known.

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Potential for exaggerated adverse reactions, sedation, hypotension.

Treatment: Supportive care, monitor vital signs, no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable for the duration of the labeled shelf life when stored properly.

🛡️ 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.