Home Drug Guide Elotuzumab

Drug Guide

Generic Name

Elotuzumab

Brand Names Empliciti

Classification

Therapeutic: Antineoplastic agent, Immunostimulant

Pharmacological: Monoclonal antibody

FDA Approved Indications

  • Treatment of multiple myeloma in combination with pomalidomide and dexamethasone, in patients who have received at least one prior therapy

Mechanism of Action

Elotuzumab is a humanized IgG1 monoclonal antibody that targets SLAMF7 (signaling lymphocytic activation molecule F7) on myeloma cells and natural killer (NK) cells, enhancing NK cell-mediated cytotoxicity against myeloma cells.

Dosage and Administration

Adult: 10 mg/kg IV weekly for 2 weeks, then every 2 weeks, in combination with pomalidomide and dexamethasone, as per specific treatment protocols.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustment required, but monitor closely due to comorbidities.

Renal Impairment: No adjustment necessary.

Hepatic Impairment: No adjustment necessary.

Pharmacokinetics

Absorption: Administered intravenously; absorption not applicable.

Distribution: Distributed mainly in vascular and extracellular spaces.

Metabolism: Metabolized by proteolytic catabolism into small peptides and amino acids.

Excretion: Excreted via proteolytic pathways; not renal.

Half Life: Approximately 16 days.

Contraindications

  • Hypersensitivity to elotuzumab or its components.

Precautions

  • Pre-medicate to reduce risk of infusion reactions; monitor for infections; avoid live vaccines during treatment. Caution in patients with pre-existing lung disease due to risk of pneumonitis.

Adverse Reactions - Common

  • Fatigue (Common)
  • Fever (Common)
  • Infusion reactions (fever, chills, flushing) (Common)

Adverse Reactions - Serious

  • Pneumonitis (Uncommon)
  • Infections (bacterial, viral, fungal) (Uncommon)
  • Hypersensitivity reactions, including anaphylaxis (Rare)

Drug-Drug Interactions

  • Immunosuppressants, other monoclonal antibodies

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for infusion reactions, signs of infection, pulmonary symptoms.

Diagnoses:

  • Risk for infection
  • Impaired ventilation related to pulmonary reactions.

Implementation: Administer as an IV infusion with premedication (antihistamines, antipyretics, corticosteroids). Observe during and after infusion for reactions.

Evaluation: Assess patient response, monitor for adverse effects, ensure early detection of reactions.

Patient/Family Teaching

  • Report any signs of infection, difficulty breathing, or allergic reactions immediately.
  • Inform about potential infusion reactions and importance of premedication.
  • Maintain scheduled follow-up appointments.

Special Considerations

Black Box Warnings:

  • Infusion reactions, including severe and life-threatening reactions.
  • Malignancies and progressive multifocal leukoencephalopathy (PML) risk not established.

Genetic Factors: None specific.

Lab Test Interference: None reported.

Overdose Management

Signs/Symptoms: Severe infusion reactions, hypotension, hypoxia.

Treatment: Stop infusion immediately, provide supportive care, manage airway and hemodynamic stability, administer antihistamines or corticosteroids as needed.

Storage and Handling

Storage: Store vials refrigerated at 2°C to 8°C (36°F to 46°F). Protect from light.

Stability: Stable until the expiration date when stored properly. Use immediately after preparation if not diluted for infusion.

🛡️ 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.