Home Drug Guide Brodalumab

Drug Guide

Generic Name

Brodalumab

Brand Names Siliq

Classification

Therapeutic: Immunosuppressant; Monoclonal antibody for psoriasis

Pharmacological: Interleukin-17 receptor A antagonist

FDA Approved Indications

  • Plaque psoriasis in adults who are candidates for systemic therapy or phototherapy

Mechanism of Action

Brodalumab binds to and inhibits interleukin-17 receptor A, blocking the activity of interleukin-17A and related cytokines, thereby reducing inflammation and psoriatic plaque formation.

Dosage and Administration

Adult: Subcutaneous injection of 210 mg at Weeks 0, 1, 2, then every 2 weeks thereafter.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustment suggested, but caution in elderly patients due to potential infections.

Renal Impairment: No specific adjustment necessary.

Hepatic Impairment: No specific adjustment necessary.

Pharmacokinetics

Absorption: Subcutaneous bioavailability approximately 30%.

Distribution: Generally limited to the vascular and interstitial spaces.

Metabolism: Degraded by proteolytic enzymes into small peptides and amino acids.

Excretion: Eliminated primarily through catabolic pathways.

Half Life: Approximately 16 to 19 days.

Contraindications

  • Hypersensitivity to brodalumab or any of its components.

Precautions

  • Risk of serious infections, including fungal, bacterial, and viral infections; screening for tuberculosis prior to initiation.
  • Monitoring for hypersensitivity reactions.
  • Not recommended during active infections or for patients with a history of inflammatory bowel disease.

Adverse Reactions - Common

  • Injection site reactions (Common)
  • Upper respiratory tract infections (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Suicidal ideation and behavior (Reported post-marketing, black box warning)
  • Inflammatory bowel disease exacerbation (Reported)

Drug-Drug Interactions

  • Immunosuppressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, hypersensitivity, and mood changes.

Diagnoses:

  • Risk for infection,
  • Risk for adverse immune response

Implementation: Administer as prescribed via subcutaneous injection; educate patients on recognizing signs of infection.

Evaluation: Assess for improvement in psoriatic lesions and adverse effects.

Patient/Family Teaching

  • Report any signs of infection, mood changes, or allergic reactions promptly.
  • Do not initiate during active infections.
  • Maintain regular follow-up visits and laboratory testing as advised.

Special Considerations

Black Box Warnings:

  • Serious infections, including fungal, bacterial, and viral infections, with some cases of opportunistic infections and demyelinating diseases.
  • Suicidal ideation and behavior

Genetic Factors: None specified.

Lab Test Interference: May affect certain immune function tests.

Overdose Management

Signs/Symptoms: Potential increased risk of infections and hypersensitivity reactions.

Treatment: Supportive care; no specific antidote.

Storage and Handling

Storage: Refrigerate at 2°C to 8°C (36°F to 46°F).

Stability: Stable until the expiration date printed on the vial if 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.