nedosiran

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

Local: injection site reactions

Interactions ⬆ ⬇

Drug-drug:

Availability ⬆ ⬇

Solution for SUBQ injection: 80 mg/0.5 mL (vials); 128 mg/0.8 mL (prefilled syringes); 160 mg/mL (prefilled syringes)

Route/Dosage ⬆ ⬇

SC (Adults and Children ≥12 yr and ≥50 kg): 160 mg once monthly.
SC (Adults and Children ≥12 yr and <50 kg): 128 mg once monthly.
SC (Children 9–11 yr and ≥50 kg): 160 mg once monthly.
SC (Children 9–11 yr and <50 kg): 3.3 mg/kg (max = 128 mg) once monthly.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

A double-stranded small interfering RNA (siRNA), conjugated to N-acetyl-D-galactosamine residues that bind to asialoglycoprotein receptors, allowing delivery to hepatocytes. It ultimately interrupts formation of hepatic lactate dehydrogenase, which reduces the production of oxalate by the liver.

Therapeutic effects:

Classifications ⬆ ⬇

Therapeutic Classification: none assigned

Pharmacologic Classification: small interfering ribonucleic acid agents

Pharmacokinetics ⬆ ⬇

Absorption: Extent of absorption following SUBQ administration unknown.

Distribution: Extensively distributed to tissues.

Metabolism/Excretion: Metabolized by endonucleases and exonucleases to shorter oligonucleotides. 27% excreted unchanged in the urine.

Half-Life: 15 hr.

Time/Action Profile ⬆ ⬇

(↓ in urinary oxalate excretion)

ROUTE	ONSET	PEAK	DURATION
SUBQ	several days	4–5 mo	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient/caregiver. Advise patient to read Patient Information before starting therapy. If a dose is missed, administer as soon as possible. If dose is missed by >7 days, administer as soon as possible and resume monthly dosing from the most recently administered dose.
Advise patient/caregivers to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Instruct patient/caregivers on the appropriate dose, timing of the dose, how and where to inject SUBQ, and what to do if a dose is missed.
Instruct patient/caregivers to monitor for injection site reactions and signs and symptoms of kidney stones. Notify health care professional if any occur.
Rep: Advise patients of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.