Nurses Compass
Drug Guide
Ecallantide
Classification
Therapeutic: Antiviral; Hemostatic agent
Pharmacological: Kallikrein inhibitor
FDA Approved Indications
- Hereditary angioedema (HAE) attacks
Mechanism of Action
Ecallantide inhibits plasma kallikrein, reducing the generation of bradykinin, which decreases vascular permeability and alleviates swelling during HAE attacks.
Dosage and Administration
Adult: 30 mg administered via subcutaneous injection in three 10 mg doses, ideally given in a healthcare setting with monitoring.
Pediatric: Not approved for pediatric use; data are limited.
Geriatric: No specific dosage adjustments; use with caution and monitor for adverse effects.
Renal Impairment: No specific adjustments recommended, but caution advised.
Hepatic Impairment: Limited data; use caution and monitor closely.
Pharmacokinetics
Absorption: Rapidly absorbed after subcutaneous injection.
Distribution: Not extensively studied; likely to remain mainly in plasma.
Metabolism: Metabolized by proteolytic enzymes; specific pathways not well defined.
Excretion: Excreted primarily through proteolytic degradation, not via renal pathways.
Half Life: Approximately 2 hours.
Contraindications
- Hypersensitivity to ecallantide or any component of the formulation.
Precautions
- Monitor for anaphylaxis during and after administration; have emergency treatment available. Use with caution in patients with a history of allergic reactions.
Adverse Reactions - Common
- Headache (Common)
- Dizziness (Common)
- Injection site reactions (Common)
Adverse Reactions - Serious
- Anaphylaxis (Rare)
- Hypersensitivity reactions (Rare)
Drug-Drug Interactions
- None specifically identified, but caution with other immunomodulatory agents.
Drug-Food Interactions
- No known significant interactions.
Drug-Herb Interactions
- No known significant interactions.
Nursing Implications
Assessment: Monitor for signs of hypersensitivity, including rash, swelling, difficulty breathing.
Diagnoses:
- Risk for allergic reaction
Implementation: Administer as directed under medical supervision. Have emergency treatment available.
Evaluation: Observe patient for adverse reactions during and after administration.
Patient/Family Teaching
- Inform about potential allergic reactions and importance of reporting symptoms immediately.
- Advise to inform healthcare providers of all medications and allergies.
- Encourage adequate hydration and report any unusual symptoms.
Special Considerations
Black Box Warnings:
- Potential for severe allergic reactions, including anaphylaxis.
Genetic Factors: None identified.
Lab Test Interference: Not known to interfere with laboratory tests.
Overdose Management
Signs/Symptoms: Allergic reactions, hypotension, or other hypersensitivity symptoms.
Treatment: Discontinue infusion immediately, provide supportive care including emergency interventions as needed.
Storage and Handling
Storage: Store unopened vials refrigerated at 2°C to 8°C (36°F to 46°F).
Stability: Stable for up to 18 months when stored properly. Once in use, protect from light and use within 24 hours.