Home Drug Guide Emapalumab-lzsg

Drug Guide

Generic Name

Emapalumab-lzsg

Brand Names Gamifant

Classification

Therapeutic: Immunosuppressant, Antiviral

Pharmacological: Monoclonal Antibody, Anti-Interferon Gamma

FDA Approved Indications

  • Treatment of primary hemophagocytic lymphohistiocytosis (HLH) in pediatric and adult patients.

Mechanism of Action

Emapalumab-lzsg is a monoclonal antibody that binds to interferon gamma (IFN-γ), neutralizing its activity, thereby reducing immune system overactivation associated with HLH.

Dosage and Administration

Adult: Initial dose: 1 mg/kg IV bolus, then 0.50 mg/kg every 3 days, adjustable based on clinical response.

Pediatric: Dosing based on weight, with adjustments for body surface area; specific dosing regimen should be determined by clinician.

Geriatric: No specific dosage adjustments identified; use with caution due to limited data.

Renal Impairment: No specific dosage adjustments established; consider renal function monitoring.

Hepatic Impairment: No specific dosage adjustments; consider hepatic function.

Pharmacokinetics

Absorption: Administered intravenously; absorption not applicable.

Distribution: Distributes widely in vascular and extravascular compartments.

Metabolism: Metabolized via proteolytic degradation; specific pathways not well characterized.

Excretion: Cleared primarily through catabolic pathways.

Half Life: Approximately 25 days.

Contraindications

  • Known hypersensitivity to emapalumab or any component.
  • Active, serious infections that contraindicate immunosuppression.

Precautions

  • Use caution in patients with ongoing infections; monitor for infections, as immunosuppression can exacerbate these.

Adverse Reactions - Common

  • Infusion-related reactions (Common)
  • Elevated liver enzymes (Less common)

Adverse Reactions - Serious

  • Severe infections (Less common)
  • Hematologic abnormalities (e.g., neutropenia) (Less common)
  • Anaphylaxis (Rare)

Drug-Drug Interactions

  • Immunosuppressants increase infection risk.
  • Potential interactions with other biologics or immune modulating agents.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, infusion reactions, and liver function.

Diagnoses:

  • Risk for Infection
  • Impaired Skin Integrity

Implementation: Administer as per protocol; monitor vital signs and adverse reactions during infusion.

Evaluation: Assess clinical response and monitor for adverse effects; adjust treatment as needed.

Patient/Family Teaching

  • Report signs of infection immediately.
  • Notify healthcare provider before any new medications or vaccines.
  • Understand the importance of follow-up and laboratory tests.

Special Considerations

Black Box Warnings:

  • Serious infections leading to death; monitor closely.
  • Progression or reactivation of infections, including tuberculosis.

Genetic Factors: No specific genetic considerations noted.

Lab Test Interference: May alter laboratory tests related to immune function; interpret with caution.

Overdose Management

Signs/Symptoms: Potential for increased immunosuppression, infection symptoms.

Treatment: Supportive care; no specific antidote; consult poison control or applicable guidelines.

Storage and Handling

Storage: Store at 2°C to 8°C (36°F to 46°F); do not freeze.

Stability: Stable under recommended storage conditions; use within specified period after reconstitution.

🛡️ 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.