Home Drug Guide Tildrakizumab-asmn

Drug Guide

Generic Name

Tildrakizumab-asmn

Brand Names Ilumya

Classification

Therapeutic: Immunosuppressant, Monoclonal antibody

Pharmacological: Anti-IL-23 monoclonal antibody

FDA Approved Indications

  • Plaque psoriasis in adult patients

Mechanism of Action

Tildrakizumab is a humanized monoclonal antibody that binds specifically to the p19 subunit of interleukin-23 (IL-23), inhibiting its interaction with the IL-23 receptor, thereby reducing inflammation associated with psoriasis.

Dosage and Administration

Adult: My first dose is 100 mg subcutaneously at week 0, then every 12 weeks thereafter.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustment necessary, but monitor closely due to potential comorbidities.

Renal Impairment: No specific dosage adjustment recommended.

Hepatic Impairment: No specific dosage adjustment recommended.

Pharmacokinetics

Absorption: Subcutaneous administration with peak concentrations reached in approximately 7 days.

Distribution: Limited distribution, primarily within the vascular and interstitial spaces.

Metabolism: Metabolized via proteolytic pathways.

Excretion: Excreted as peptides via catabolic pathways.

Half Life: Approximately 20 days.

Contraindications

  • Hypersensitivity to tildrakizumab or excipients.

Precautions

  • Risk of infection; monitor for signs of infection, including TB prior to initiation.
  • Use with caution in patients with a history of demyelinating diseases, as immune modulation could exacerbate such conditions.
  • Pregnancy Category B: No adequate data; weigh benefits vs. risks.

Adverse Reactions - Common

  • Upper respiratory infections (Likely)
  • Headache (Likely)
  • Injection site reactions (Likely)

Adverse Reactions - Serious

  • Serious infections (Uncommon)
  • Hypersensitivity reactions including anaphylaxis (Rare)
  • Potential increase in malignancy risk (Unknown)

Drug-Drug Interactions

  • Other immunosuppressants, live vaccines (avoid)

Drug-Food Interactions

  • No significant interactions reported

Drug-Herb Interactions

  • Limited data, but caution with immune-modulating herbs

Nursing Implications

Assessment: Monitor for signs of infection, injection site reactions, and general immune status.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Administer by subcutaneous injection as per schedule, educate patient on signs of infection, and ensure monitoring during therapy.

Evaluation: Assess efficacy by reduction in psoriasis plaques, monitor for adverse effects, and patient compliance.

Patient/Family Teaching

  • Report any signs of infection or adverse reactions immediately.
  • Do not receive live vaccines during therapy.
  • Follow the injection schedule carefully.
  • Maintain good skin and hygiene practices.

Special Considerations

Black Box Warnings:

  • Risk of serious infections; report any signs or symptoms of infection.

Genetic Factors: Not specifically indicated for genetic factors.

Lab Test Interference: May affect immune response-related lab tests.

Overdose Management

Signs/Symptoms: Potential increased risk of infection or immune response abnormalities.

Treatment: Supportive care; no specific antidote. Dispose of unused medication properly.

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.