Adult Dosing
Chemotherapy related thrombocytopenia prevention
- 50 mcg/kg SC qd in patients without severe renal impairment
- Start dose at 6-24 hrs after the completion of chemotherapy
- Max: For 21 days
Note:
- Monitor PLT count, and continue dose until the post-nadir PLT count is
50,000/µL
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Renal Dose Adjustment (Based on CrCl)
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustment not defined
- Oprelvekin may cause allergic or hypersensitivity reactions, including anaphylaxis. Permanently discontinue the therapy if allergic or hypersensitivity reactions develop [US Black Box Warning]
- Counsel patient to seek medical attention in case of allergic reactions. Edema of the face, tongue, or larynx, shortness of breath, wheezing, chest pain, hypotension, dysarthria, loss of consciousness, mental status changes, rash, urticaria, flushing and fever have been reported after the first dose or subsequent doses of oprelvekin
- Increased incidence of edema, conjunctival bleeding, hypotension, and tachycardia occurred in patients receiving oprelvekin as compared to placebo
- Therapy may cause serious fluid retention which can lead to peripheral edema, dyspnea on exertion, pulmonary edema, capillary leak syndrome, atrial arrhythmias, and exacerbation of pre-existing pleural effusions.
- Use cautiously in patients with CHF, in patients receiving aggressive hydration, and in patients with history of heart failure. Closely monitor fluid and electrolyte status in patients receiving chronic diuretic therapy. Pre-existing fluid collections, pericardial effusions or ascites should also be monitored
- Moderate decreases in hemoglobin, hematocrit, and RBC without a decrease in RBC mass have been reported with this therapy
- Arrhythmias, pulmonary edema and cardiac arrest are associated with oprelvekin use. Use cautiously in patients with history of atrial arrhythmias; patients who experienced atrial arrhythmias have reported stroke while receiving oprelvekin. Patients with a history of stroke or transient ischemic attack may be at increased risk
- Papilledema has occurred in patients receiving this therapy; use cautiously in patients with preexisting papilledema or with tumors involving the CNS
- Changes in visual acuity and/or visual field defects ranging from blurred vision to blindness has been observed in patients with papilledema taking oprelvekin
Cautions: Use cautiously in
- Renal impairment
- CHF
- Hx CHF
- Hx atrial arrhythmias
- CHF risk
- Fluid retention
- Atrial arrhythmias
- Papilledema
- CNS tumor
- Aggressive hydration
- Pleural effusion
- Pericardial effusion
Pregnancy Category:C
Breastfeeding: Safety unknown. Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.
