Home Drug Guide Inebilizumab-cdon

Drug Guide

Generic Name

Inebilizumab-cdon

Brand Names Uplizna

Classification

Therapeutic: Immunosuppressant, Monoclonal Antibody

Pharmacological: Anti-CD19 Monoclonal Antibody

FDA Approved Indications

  • Adult patients with Neuromyelitis Optica Spectrum Disorder (NMOSD) who are seropositive for anti-aquaporin-4 antibodies

Mechanism of Action

Inebilizumab-cdon targets CD19, a protein on the surface of B cells, leading to B cell depletion which reduces immune-mediated damage in NMOSD.

Dosage and Administration

Adult: The recommended dose is 300 mg administered intravenously on days 1 and 15, followed by 300 mg every 6 months.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustments available, use with caution.

Renal Impairment: No specific adjustments recommended.

Hepatic Impairment: No specific adjustments recommended.

Pharmacokinetics

Absorption: Administered via intravenous infusion; absorption discontinuous, directed into bloodstream.

Distribution: Widely distributed with extensive binding to B cells; specific volume of distribution not established.

Metabolism: Cleaved by proteolytic enzymes; degraded into amino acids.

Excretion: Excreted primarily in urine as metabolites; unchanged drug not applicable.

Half Life: Approximately 11 days.

Contraindications

  • Hypersensitivity to Inebilizumab or its components.

Precautions

  • Risk of infections due to immunosuppression; monitor for signs of infection, hepatitis B reactivation, and malignancies. Use with caution in patients with active infections or other immune deficiencies. Vaccination responses may be diminished.

Adverse Reactions - Common

  • Infusion-related reactions (fever, chills, hypotension) (Common)
  • Infections (upper respiratory, urinary tract infections) (Common)
  • Back pain (Common)

Adverse Reactions - Serious

  • Progressive multifocal leukoencephalopathy (PML) (Rare)
  • Severe infections (pneumonia, herpes zoster) (Rare)
  • Malignancies (Rare)

Drug-Drug Interactions

  • Other immunosuppressants, live vaccines (avoid simultaneous use)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Baseline immune status, history of infections, and vaccination status.

Diagnoses:

  • Risk for infection related to immunosuppressive therapy.

Implementation: Administer drug as per schedule, monitor for infusion reactions and infections, ensure vaccinations are current before therapy if possible.

Evaluation: Monitor patient for signs of infection, infusion reactions, and effectiveness in reducing NMOSD relapses.

Patient/Family Teaching

  • Report any signs of infection immediately.
  • Avoid live vaccines during treatment and for some months after.
  • Inform about possible infusion reactions and what to do.
  • Follow-up appointments for monitoring.

Special Considerations

Black Box Warnings:

  • Progressive multifocal leukoencephalopathy (PML)

Genetic Factors: No specific genetic considerations noted.

Lab Test Interference: May cause falsely low levels of B-cell markers, monitor immune status regularly.

Overdose Management

Signs/Symptoms: Unknown; monitor for exaggerated immunosuppression or infusion reactions.

Treatment: Supportive care, corticosteroids for infusion reactions, and infection management.

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 when refrigerated. Do not freeze.

🛡️ 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.