Home Drug Guide Daclizumab

Drug Guide

Generic Name

Daclizumab

Brand Names Zinbryta

Classification

Therapeutic: Immunosuppressant / Monoclonal antibody

Pharmacological: Il-2 receptor antagonist

FDA Approved Indications

  • Multiple sclerosis, relapsing forms

Mechanism of Action

Daclizumab is a humanized monoclonal antibody that binds to the alpha subunit (CD25) of the IL-2 receptor on activated T-lymphocytes, blocking IL-2 mediated activation and proliferation of T-cells, thereby modulating immune responses in multiple sclerosis.

Dosage and Administration

Adult: 150 mg subcutaneously once every four weeks, starting with a loading dose of 150 mg at week 0 and week 4.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustments; use with caution in elderly patients.

Renal Impairment: No specific adjustments required.

Hepatic Impairment: No specific adjustments documented.

Pharmacokinetics

Absorption: Rapidly absorbed after subcutaneous administration.

Distribution: Distributed primarily in plasma and extracellular fluid.

Metabolism: Metabolized via proteolytic degradation to peptides and amino acids.

Excretion: Excreted mainly through proteolytic pathways.

Half Life: Approximately 21 days.

Contraindications

  • Hypersensitivity to daclizumab or any component of the formulation.

Precautions

  • Risk of serious infections due to immunosuppression, including serious infections like herpes zoster, herpes simplex, and respiratory infections.
  • Potential for immune-mediated disorders, including autoimmune hepatitis and encephalitis.
  • Monitoring for signs of infections or immune dysregulation is essential.

Adverse Reactions - Common

  • Nasopharyngitis (Common)
  • Elevated liver enzymes (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Immune-mediated encephalitis (Rare)
  • Hepatotoxicity, including autoimmune hepatitis (Rare)
  • Serious infections, including herpes zoster (Serious, less than 1%)

Drug-Drug Interactions

  • Other immunosuppressants, risk of increased immunosuppression.

Drug-Food Interactions

  • No significant interactions reported.

Drug-Herb Interactions

  • Limited data; caution advised with herbal supplements affecting immune function.

Nursing Implications

Assessment: Monitor for signs of infection, liver function tests, neurologic status.

Diagnoses:

  • Risk for infection, risk for hepatotoxicity, impaired immune response.

Implementation: Administer subcutaneously as directed, monitor for adverse effects, educate patient on infection prevention.

Evaluation: Assess for adverse reactions, effectiveness of MS symptom control.

Patient/Family Teaching

  • Report signs of infection promptly.
  • Avoid live vaccines during treatment.
  • Use proper injection technique and site rotation.
  • Understand potential side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

  • Serious infections and immune-mediated neurological disorders.

Genetic Factors: No specific genetic testing required.

Lab Test Interference: Can elevate liver enzymes, monitor regularly.

Overdose Management

Signs/Symptoms: No specific overdose symptoms identified.

Treatment: Supportive care, monitor vital signs, and manage complications as they arise.

Storage and Handling

Storage: Store in a refrigerator at 2°C to 8°C (36°F to 46°F).

Stability: Stable until the expiration date on the package when 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.