pegloticase

Contraindicated in:

Serious hypersensitivity, including anaphylaxis;
Glucose-6-phosphate dehydrogenase (G6PD) deficiency (↑ risk of hemolysis and methemoglobinemia).

Use Cautiously in:

HF (may ↑ risk of exacerbation);
Retreatment after a drug-free interval (↑ risk of allergic reactions, monitor carefully);
OB: Use during pregnancy only if clearly needed;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Safety and effectiveness not established in children;
Geri: Older adults may be more sensitive to drug effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: chest pain

Derm: contusion/ecchymoses

EENT: nasopharyngitis

GI: nausea, constipation, vomiting

Hemat: HEMOLYSIS, METHEMOGLOBINEMIA

Metab: gout flare

Misc: infusion reactions, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

May interfere with the action of other PEG-containing therapies.

Availability ⬆ ⬇

Solution for injection: 8 mg/mL

Route/Dosage ⬆ ⬇

IV (Adults ): 8 mg every 2 wk.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Consists of recombinant uricase covalently bonded to monomethoxypoly(ethylene glycol); uricase catalyzes the oxidation of uric acid to allantoin, a water soluble by-product that is readily excreted in urine.

Therapeutic effects:

↓serum uric acid levels with resultant ↓ in attacks of gout and its sequelae.

Classifications ⬆ ⬇

Therapeutic Classification: antigout agents

Pharmacologic Classification: enzymes

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(effects on serum uric acid concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	within 24 hr	>300 hr

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Advise patient to notify health care provider immediately if signs of anaphylaxis or infusion reaction occur.
Advise patient not to take pegloticase if they have G6PD deficiency.
Inform patient that gout flares may initially ↑ during the 1st 3 mo of therapy. Advise patient to take concurrent colchicine or NSAIDs to ↓ flares.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
Instruct patient not to take oral urate-lowering medications before or during therapy.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected and to avoid breastfeeding during therapy.

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Indications ⬇

Contraind./Precautions ⬆ ⬇