Home Drug Guide Brincidofovir

Drug Guide

Generic Name

Brincidofovir

Brand Names Tembexa

Classification

Therapeutic: Antiviral

Pharmacological: Nucleoside analog antiviral agent

FDA Approved Indications

  • Treatment of smallpox (vaccinia virus daniello strain) in adults and pediatric patients 2 years of age and older

Mechanism of Action

Brincidofovir inhibits viral DNA polymerase, leading to chain termination and suppression of viral DNA synthesis. It is a lipid conjugate of cidofovir, facilitating improved cellular uptake and reduced nephrotoxicity.

Dosage and Administration

Adult: Initial dose of 200 mg orally once every week; treatment duration varies based on clinical response and CDC guidance.

Pediatric: Dosing based on weight and age, as determined by CDC guidance; typically, 4 mg/kg once weekly, with adjustments as needed.

Geriatric: No specific dosage adjustment required; however, monitor for hepatic function and overall health status.

Renal Impairment: Use caution; dose adjustments may be necessary due to limited data.

Hepatic Impairment: No specific dosage adjustment recommended, but monitor liver function.

Pharmacokinetics

Absorption: Orally absorbed with bioavailability increased via lipid conjugation.

Distribution: Extensively distributed into tissues, especially infected cells.

Metabolism: Metabolized intracellularly to active cidofovir diphosphate.

Excretion: Eliminated primarily via feces and urine.

Half Life: Approximately 17 hours

Contraindications

  • Hypersensitivity to brincidofovir or any component of the formulation

Precautions

  • Monitor liver function due to potential hepatotoxicity
  • Use with caution in immunocompromised patients
  • Potential for gastrointestinal adverse effects

Adverse Reactions - Common

  • Gastrointestinal symptoms (nausea, diarrhea) (Common)
  • Elevated liver enzymes (Common)

Adverse Reactions - Serious

  • Hepatotoxicity (Uncommon)
  • Myelosuppression (Uncommon)
  • Hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • Potential increased risk of hepatotoxicity with other hepatotoxic agents

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor hepatic function tests, renal function, and for gastrointestinal symptoms.

Diagnoses:

  • Risk for hepatotoxicity
  • Risk for dehydration due to gastrointestinal effects

Implementation: Administer as prescribed, monitor labs regularly, educate patient on side effects.

Evaluation: Assess clinical response and adverse effects; adjust therapy if necessary.

Patient/Family Teaching

  • Take medication exactly as prescribed and maintain scheduled doses.
  • Report any symptoms of liver trouble, severe diarrhea, or allergic reactions.
  • Attend regular laboratory monitoring appointments.
  • Inform healthcare provider of all ongoing medications.

Special Considerations

Black Box Warnings:

  • Potential for hepatotoxicity and depletion of tissue antioxidant defenses.

Genetic Factors: Limited data; no specific genetic considerations identified.

Lab Test Interference: None reported.

Overdose Management

Signs/Symptoms: Severe gastrointestinal symptoms, hepatotoxicity, or allergic reactions.

Treatment: Supportive care, discontinue medication, monitor organ functions, and provide symptomatic treatment as needed.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable for the duration specified in the package insert.

🛡️ 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.