ee-KAL-lan-tide

Therapeutic Classification: antiangioedema agents

Pharmacologic Classification:

• Treatment of acute attacks of hereditary angioedema (HAE).

• Acts as a selective, reversible inhibitor of kallikrein, thereby inhibiting its action in initiating bradykinin production, part of the cascade of events in hereditary angioedema (HAE).

• Decreased severity of attack of HAE.

Absorption: Well absorbed following SUBQ administration.

Distribution: Unknown.

Metabolism/Excretion: Renally eliminated.

Half-life: 2 hr.

(symptom improvement)

Contraindicated in:

• Hypersensitivity.

Use Cautiously in:

• OB: Other agents preferred for treatment of hereditary angioedema during pregnancy
• Lactation: Safety not established in breastfeeding
• Pedi: Children <12 yr (safety and effectiveness not established)
• Geri: Consider age-related ↓ in hepatic, renal, or cardiac function, concomitant diseases or other drug therapy in older adults; lower initial dose may be considered.

Derm: pruritus, rash , urticaria.

EENT: nasopharyngitis.

GI: nausea, abdominal pain, diarrhea.

Local: injection site reactions.

Neuro: headache, fatigue.

Misc: HYPERSENSITIVITY REACTIONS INCLUDING ANAPHYLAXIS, , fever.

Drug-Drug:

• None noted.

• SC (Adults and Children ≥12 yr): 30 mg given as three 10 mg injections; an additional dose of 30 mg may be given within 24 hr.

• Solution for injection: 10 mg/mL;

• Assess for symptoms of hereditary angioedema (submucosal or SUBQ swelling) before and following treatment.
• Assess for signs and symptoms of anaphylaxis (chest discomfort, flushing, pharyngeal edema, pruritus, rhinorrhea, sneezing, nasal congestion, throat irritation, urticaria, wheezing, hypotension); usually occur within 1 hr of administration.

• Ecallantide should only be administered by a health care professional with medical support to manage anaphylaxis and hereditary angioedema.
• SC: Use a large bore needle to withdraw ecallantide from vial. Change needles. Solution is clear and colorless; do not administer solutions that are discolored or contain a precipitate. Administer three 1 mL (10 mg/mL) injections using a 27 gauge needle into abdomen, thigh, or upper arm for a total dose of 30 mg. Injection site for each of the 3 injections may be in the same or different locations; no need for rotation. Separate injection sites by as least 2 inches from site of angioedema attack. If attack persists, may repeat dose, using same instructions, within 24 hrs.

• Explain purpose for ecallantide and the need for administration by health care professional to patient. Advise patient to read Medication Guide prior to administration.
• Caution patient of the risk for anaphylactic reaction usually within 1 hr of injection. Advise patient to notify health care professional immediately if signs and symptoms of anaphylactic reactions occur.
• Inform patient that injection site reactions (local pruritus, erythema, pain, irritation, uriticaria, bruising) may occur.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
• Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

• Resolution of signs and symptoms of an acute attack of hereditary angioedema.

Kalbitor

NDC Code^*

• 47783- Dyax Corp.
  • 47783-101- KALBITOR
    • 47783-101-01- 3 VIAL, GLASS in 1 CARTON (47783-101-01) > 1 mL in 1 VIAL, GLASS