ixekizumab
ix-ee-kiz-ue-mab
Trade Name(s): (Taltz)
Do not confuse ixekizumab with daclizumab, eculizumab, gevokizumab, secukinumab, or ustekinumab.
Plaque psoriasis: Treatment of moderate to severe plaque psoriasis in adults and children 6 yrs and older who are candidates for systemic therapy or phototherapy. Psoriatic arthritis: Treatment of active psoriatic arthritis in adults. Ankylosing spondylitis: Treatment of active ankylosing spondylitis in adults. Axial spondyloarthritis: Treatment of active nonradiographic axial spondyloarthritis with objective signs of inflammation in adults.
Contraindications: Hypersensitivity to ixekizumab. Cautions: Baseline neutropenia, thrombocytopenia; inflammatory bowel disease (Crohn's disease, ulcerative colitis), HIV infection, concomitant immunosuppressant therapy, conditions predisposing to infection (e.g., diabetes, renal failure, open wounds), pts who have been exposed to tuberculosis. Concomitant use of live vaccines not recommended.
Selectively binds to and inhibits interaction of interleukin-17A receptor, a naturally occurring cytokine that is involved in inflammatory and immune response. Therapeutic Effect: Alters biologic immune response; inhibits release of proinflammatory cytokines and chemokines.
Widely distributed. Degraded into small peptides and amino acids via catabolic pathway. Peak plasma concentration: 4 days. Steady state reached in 8–10 wks. Elimination not specified. Half-life: 13 days.
Pregnancy/Lactation: Unknown if distributed in breast milk. However, human immunoglobulin G is present in breast milk and is known to cross placenta. Children: Safety and efficacy not established in pts younger than 6 yrs. Elderly: No age-related precautions noted.
DRUG: None significant. HERBAL: None significant. FOOD: None known. LAB VALUES: May decrease neutrophils, platelets. May decrease diagnostic effect of Coccidioides immitis skin test.
Auto-injector Pen: 80 mg/mL. Prefilled Syringe: 20 mg/0.25 mL, 40 mg/0.5 mL, 80 mg/mL.
Ankylosing Spondylitis
SQ: ADULTS, ELDERLY: 160 mg (two 80-mg injections) once, then 80 mg q4wks.
Plaque Psoriasis
SQ: ADULTS, ELDERLY: Initially, 160 mg (two injections of 80 mg) once, then 80 mg at wks 2, 4, 6, 8, 10, 12, then 80 mg once q4wks. ADOLESCENTS, CHILDREN 6 YRS AND OLDER: (WEIGHING 50 KG OR MORE): 160 mg (two 80-mg injections) once, then 80 mg q4wks. (25–50 KG): 80 mg once, then 40 mg q4wks. (LESS THAN 25 KG): 40 mg once, then 20 mg q4wks.
Psoriatic Arthritis
Note: For pts with coexisting plaque psoriasis, use dosage for plaque psoriasis. SQ: ADULTS, ELDERLY: 160 mg (two 80-mg injections) once, then 80 mg q4wks. May give alone or in combination with conventional disease-modifying antirheumatic drugs (e.g., methotrexate).
Nonradiographic Axial Spondyloarthritis
SQ: ADULTS, ELDERLY: 80 mg q4wks.
Dosage in Renal/Hepatic Impairment
Not specified; use caution.
Occasional (17%): Injection site reactions (pain, erythema). Rare (2%): Nausea.
May increase risk of infection including tuberculosis. Infections including upper respiratory tract infection (14% of pts), nasopharyngitis (14% of pts), tinea infections (2% of pts) have occurred. Cytopenias including neutropenia (11% of pts), thrombocytopenia (3% of pts) were reported. May cause exacerbation of Crohn's disease and ulcerative colitis. Hypersensitivity reactions, including angioedema, occur rarely.
- BASELINE ASSESSMENTObtain CBC in pts with known history of neutropenia, thrombocytopenia. Screen for active infection. Pts should be evaluated for active tuberculosis and tested for latent infection prior to initiating treatment and periodically during therapy. Induration of 5 mm or greater with tuberculin skin testing should be considered a positive test result when assessing if treatment for latent tuberculosis is necessary. Consider administration of age-appropriate immunizations (if applicable) before initiation. Question history of Crohn's disease, ulcerative colitis, hypersensitivity reaction. Conduct dermatologic exam; record characteristics of psoriatic lesions.INTERVENTION/EVALUATIONMonitor for symptoms of tuberculosis, including pts who tested negative for latent tuberculosis infection prior to initiating therapy. Interrupt or discontinue treatment if serious infection, opportunistic infection, or sepsis occurs, and initiate appropriate antimicrobial therapy. Assess skin for improvement of lesions. Monitor for hypersensitivity reaction, symptoms of inflammatory bowel disease.PATIENT/FAMILY TEACHING
- A healthcare provider will show you how to properly prepare and inject your medication. You must demonstrate correct preparation and injection techniques before using medication at home.
- Treatment may depress your immune system response and reduce your ability to fight infection. Report symptoms of infection such as body aches, chills, cough, fatigue, fever. Avoid people with active infection.
- Do not receive live vaccines.
- Expect frequent tuberculosis screening.
- Report travel plans to possible endemic areas.
- Immediately report difficulty breathing, itching, hives, rash, swelling of the face or tongue; may indicate allergic reaction.
- Treatment may cause worsening of Crohn's disease or cause inflammatory bowel disease. Report abdominal pain, diarrhea, weight loss.
Canadian trade name
Non-Crushable Drug
High Alert drug
underlined - top prescribed drug