Home Drug Guide Enfuvirtide

Drug Guide

Generic Name

Enfuvirtide

Brand Names Fuzeon

Classification

Therapeutic: Antiretroviral agent for HIV infection

Pharmacological: Fusion inhibitor

FDA Approved Indications

  • Treatment of HIV-1 infection in combination with other antiretroviral agents in treatment-experienced patients

Mechanism of Action

Enfuvirtide is a synthetic peptide that inhibits HIV-1 fusion by binding to the gp41 subunit of the viral envelope glycoprotein, preventing the conformational changes required for viral entry into the host CD4+ T cells.

Dosage and Administration

Adult: 90 mg subcutaneously twice daily; administer on an empty stomach or with food if tolerated

Pediatric: Not approved for pediatric use

Geriatric: No specific dosage adjustment recommended, but caution due to limited data

Renal Impairment: No dose adjustment required

Hepatic Impairment: No specific data; use with caution

Pharmacokinetics

Absorption: Administered subcutaneously, well-absorbed with peak plasma concentrations in 2-4 hours

Distribution: Limited data; binds minimally to plasma proteins

Metabolism: Not metabolized by cytochrome P450 enzymes; degraded by proteolytic enzymes

Excretion: Primarily degraded locally at injection site and via renal proteolytic enzymes

Half Life: 3.8 hours

Contraindications

  • Hypersensitivity to enfuvirtide or any component of the formulation

Precautions

  • Use with caution in patients with active or history of pulmonary diseases, including pneumonia
  • Monitor for immune reconstitution inflammatory syndrome (IRIS)
  • Potential for injection site reactions

Adverse Reactions - Common

  • Injection site reactions (pain, erythema, nodules, pruritus, cysts, inflammation) (Very common)
  • Eosinophilia (Common)

Adverse Reactions - Serious

  • Hypersensitivity reactions, including rash, urticaria, dyspnea (Rare)
  • Pulmonary infections, including pneumonia (Uncommon)

Drug-Drug Interactions

N/A

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for injection site reactions, pulmonary symptoms, and signs of hypersensitivity

Diagnoses:

  • Risk for infection
  • Impaired tissue integrity related to injection site reactions

Implementation: Rotate injection sites; educate on proper injection technique; monitor respiratory status

Evaluation: Assess for reduction in viral load; evaluate for adverse reactions

Patient/Family Teaching

  • Inject medication exactly as prescribed, rotating sites to minimize skin reactions
  • Report any signs of allergic reactions, difficulty breathing, or chest pain
  • Maintain regular follow-up appointments for viral load and CD4 count monitoring
  • Use caution with other injectable medications or substances

Special Considerations

Black Box Warnings:

  • Potential for hypersensitivity reactions which can be severe

Genetic Factors: No pharmacogenetic considerations established

Lab Test Interference: No known interference

Overdose Management

Signs/Symptoms: Localized injection site reactions or hypersensitivity symptoms

Treatment: Supportive care; discontinue use; provide antihistamines or corticosteroids for hypersensitivity as needed

Storage and Handling

Storage: Store vials refrigerated at 2-8°C; protect from light; do not freeze

Stability: Stable until expiration date when refrigerated; after reconstitution, use within 24 hours if stored refrigerated

🛡️ 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.