Nurses Compass
Drug Guide
Elotuzumab
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/ADrug-Herb Interactions
N/ANursing 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.