Home Drug Guide Loncastuximab Tesirine-lpyl

Drug Guide

Generic Name

Loncastuximab Tesirine-lpyl

Brand Names Zynlonta

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Antibody-drug conjugate

FDA Approved Indications

  • Relapsed or refractory large B-cell lymphoma (including diffuse large B-cell lymphoma, high-grade B-cell lymphoma, and transformed follicular lymphoma)

Mechanism of Action

Loncastuximab tesirine-lpyl is an antibody-drug conjugate that targets CD19-positive B cells. It binds to CD19 on B cells and delivers a cytotoxic agent, tesirine, which induces cell death.

Dosage and Administration

Adult: Overall, the recommended dosage is 0.15 mg/kg intravenously on Days 1-2 of a 21-day cycle. The dose may be repeated every 3 weeks.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustment; consider age-related factors.

Renal Impairment: No specific adjustment recommended.

Hepatic Impairment: No specific adjustment recommended.

Pharmacokinetics

Absorption: Rapid subcutaneous absorption; intravenous administration provides immediate bioavailability.

Distribution: Extensive in plasma and tissues.

Metabolism: Metabolized through lysosomal degradation of the antibody and release of the cytotoxic payload.

Excretion: Not fully characterized; likely via proteolytic degradation pathways.

Half Life: Approximately 4 days.

Contraindications

  • Hypersensitivity to loncastuximab tesirine-lpyl or its components.

Precautions

  • Monitor for infusion-related reactions, hepatotoxicity, myelosuppression. Use with caution in patients with active infections or comorbidities that could impair immune response.

Adverse Reactions - Common

  • Thrombocytopenia (Common)
  • Neutropenia (Common)
  • Elevated liver enzymes (Common)
  • Infusion-related reactions (Common)

Adverse Reactions - Serious

  • Severe thrombocytopenia leading to bleeding (Serious)
  • Severe neutropenia leading to infections (Serious)
  • Serious infections including pneumonia, sepsis (Serious)
  • Hepatotoxicity including hepatitis, elevated bilirubin (Serious)

Drug-Drug Interactions

  • Caution with other myelosuppressive agents, immunosuppressants, or therapies impacting hepatic function.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood counts, liver function tests, and for symptoms of infection or infusion reactions.

Diagnoses:

  • Risk for bleeding, Risk for infection, Impaired tissue integrity.

Implementation: Administer as scheduled, premedicate for infusion reactions if necessary, monitor patient closely during and after infusion.

Evaluation: Assess for response to therapy, side effects, and adverse reactions; adjust treatment as necessary.

Patient/Family Teaching

  • Report signs of infection, unusual bleeding, or infusion reactions immediately.
  • Maintain good hygiene and infection control measures.
  • Follow-up appointments for blood tests and monitoring.

Special Considerations

Black Box Warnings:

  • Serious infections, hepatotoxicity, and embryo-fetal toxicity.

Genetic Factors: No specific genetic considerations reported.

Lab Test Interference: Can cause increases in serum liver enzymes, which should be interpreted carefully.

Overdose Management

Signs/Symptoms: Severe cytopenias, hepatotoxicity, infusion reactions.

Treatment: Supportive care, including transfusions, corticosteroids, antibiotics, and symptomatic management; no specific antidote.

Storage and Handling

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

Stability: Stable up to the expiration date 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.