Infusion-Related Reactions
In the SUSTAIN clinical trial, infusion-related reactions (defined as occurring within 24 hours of infusion) were observed in 2 (3%) patients treated
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Dosing and Administration
Dosing Schedule
ADAKVEO is the first and only FDA-approved, once-monthly treatment to reduce the frequency of VOCs in SCD
ADAKVEO® (crizanlizumab-tmca) 5 mg/kg is administered by IV infusion over 30 minutes at Weeks 0 and 2, then every 4 weeks
Each dose is the same: 5 mg/kg (based on patient’s actual body weight).
ADAKVEO may be given with or without hydroxyurea.
FDA, US Food and Drug Administration; SCD, sickle cell disease; VOCs, vaso-occlusive crises.
ADAKVEO gives you the confidence of knowing your patients are receiving their once-monthly treatment with each infusion
Missed Dose
If a dose is missed, administer ADAKVEO as soon as possible
- If ADAKVEO is administered within 2 weeks after the missed dose, continue dosing according to the patient’s original schedule
- If ADAKVEO is administered more than 2 weeks after the missed dose, schedule the next appointment 4 weeks later
Expert Presentation: Dosing and Administration
Watch a Medical Expert's presentation about the Dosing Schedule and what to do in the event of a Missed Dose
Before the Infusion
Calculate
Calculate the required volume and number of vials of ADAKVEO needed based on the patient’s actual body weight
Formula
Example
Each vial of ADAKVEO is single-dose only. Discard any unused portion.
Each vial of ADAKVEO is single-dose only. Discard any unused portion.
Please refer to full Prescribing Information for additional dosage and administration instructions.
Prepare
- Bring vials to room temperature for up to 4 hours prior to the start of preparation (piercing the first vial)
- For vials that have not been pierced, the cumulative time out of refrigeration cannot exceed 4 hours
- Visually inspect the vials
- The solution should be clear to opalescent, colorless, or may have a slightly brownish-yellow tint
- Do not use if particles are present in the solution
Important Reminder:
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Before preparation, ADAKVEO vials should be stored and transported:
Do not shake or freeze the vials. |
Dilute
Dilute ADAKVEO in 0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP to a total volume of 100 mL for intravenous infusion as follows:
- Obtain a 100-mL Infusion bag/container (containing either 0.9% Sodium Chloride or 5% Dextrose)
- Remove the volume of 0.9% Sodium Chloride or 5% Dextrose from the infusion bag/container that is equal to the calculated volume of ADAKVEO solution
- Add the 0.9% solution from the vials to the infusion bag/container
- The volume of ADAKVEO added to the infusion bag/container should not exceed 96 mL
- Gently invert (don't shake) the infusion bag to mix the diluted solution
Important Reminder:
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Store the Diluted Solution
Once prepared, if not administering ADAKVEO immediately, store the diluted solution (infusion bag/container) either:
- At room temperature up to 25°C (77°F) for no more than 4.5 hours
- From the start of preparation (piercing the first vial) to the completion of infusion
- Under refrigeration at 2°C to 8°C (36°F to 46°F) for no more than 24 hours
- From the start of preparation (piercing the first vial) to the completion of infusion
This includes the storage of the diluted solution and the time to warm up to room temperature - Protect the diluted solution from light during storage under refrigeration
REMEMBER, THE DILUTED ADAKVEO SOLUTION SHOULD BE ADMINISTERED AS SOON AS POSSIBLE
Administer
- Be sure to administer ADAKVEO diluted solution by intravenous infusion as soon as possible
- Infuse ADAKVEO diluted solution over a 30-minute period through an IV line
- IV line must contain a sterile, nonpyrogenic 0.2-micron inline filter
- Flush the line with at least 25 mL 0.9% sodium chloride or 5% dextrose after administration of ADAKVEO
Important Reminder:
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Monitor
- Monitor your patient for infusion-related reactions according to your facility’s infusion protocol. Discontinue the ADAKVEO infusion for severe reactions and institute appropriate medical care
- Watch for signs and symptoms of infusion-related reactions, such as:
- Fever
- Chills
- Nausea
- Vomiting
- Fatigue
- Dizziness
- Pruritus
- Urticaria
- Sweating
- Shortness of breath or wheezing
ADVISE YOUR PATIENTS TO CONTACT THEIR HEALTH CARE PROVIDER IMMEDIATELY IF THEY EXPERIENCE ANY OF THE ABOVE SIGNS OR SYMPTOMS
Dosing and Administration Video
Watch this video for more information about the ADAKVEO dosing schedule, dosing calculation, and administration process
Dosing and Administration Guide
Download this resource designed to guide you through dosing and administering ADAKVEO
For additional ADAKVEO Safety Information, click here
Reference: Adakveo [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; 2019.
Indication
ADAKVEO® (crizanlizumab-tmca) is indicated to reduce the frequency of vaso-occlusive crises (VOCs) in adults and pediatric patients, aged 16 years and older, with sickle cell disease.
Important Safety Information
Infusion-Related Reactions
In the SUSTAIN clinical trial, infusion-related reactions (defined as occurring within 24 hours of infusion) were observed in 2 (3%) patients treated with ADAKVEO 5 mg/kg. Monitor patients for signs and symptoms of infusion-related reactions, which may include fever, chills, nausea, vomiting, fatigue, dizziness, pruritus, urticaria, sweating, or shortness of breath or wheezing. Discontinue ADAKVEO infusion for severe reactions and institute appropriate medical care.
Laboratory Test Interference: Platelet Counts
Interference with automated platelet counts (platelet clumping) has been observed following administration of ADAKVEO, in particular, when blood samples were collected in tubes containing EDTA.
Run blood samples within 4 hours of blood collection or collect blood samples in tubes containing citrate. When needed, estimate platelet count via peripheral blood smear.
Pregnancy
Based on animal data ADAKVEO has the potential to cause fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to a fetus. ADAKVEO should only be used during pregnancy if the expected benefit to the patient justifies the potential risk to the fetus.
Most Common Adverse Reactions
The most frequently reported adverse reactions (≥10%) in patients treated with ADAKVEO were nausea (18%), arthralgia (18%), back pain (15%), and pyrexia (11%).
Other Clinically Important Adverse Reactions
Clinically relevant adverse reactions (all grades) that were reported in <10% of patients treated with ADAKVEO included: oropharyngeal pain, abdominal pain (abdominal pain, upper abdominal pain, lower abdominal pain, abdominal discomfort, and abdominal tenderness), diarrhea, vomiting, pruritus (pruritus and vulvovaginal pruritus), musculoskeletal chest pain, myalgia, infusion-site reaction (infusion-site extravasation, infusion-site pain, and infusion-site swelling), and infusion-related reaction.
Please see full Prescribing Information.
