vutrisiran

Therapeutic Classification: none assigned

Pharmacologic Classification: antitransthyretin small interfering rnas

Indications ⬆ ⬇

REMS

Polyneuropathy of hereditary transthyretin-mediated amyloidosis.

Action ⬆ ⬇

Contains a double-stranded small interfering ribonucleic acid that causes degradation of mutant and wild-type transthyretin (TTR) mRNA through RNA interference, which results in a reduction of serum TTR protein and TTR protein deposits in tissues.

Therapeutic effects:

Improvement in neuropathy.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Well distributed to tissues.

Metabolism/Excretion: Primarily metabolized by nucleases to nucleotides; 19% excreted in urine as unchanged drug.

Half-Life: 5.2 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
SUBQ	unknown	4 hr	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

None.

Use Cautiously in:

Moderate or severe hepatic impairment;
Severe renal impairment or end-stage renal disease;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: heart block

Local: injection site reactions

MS: arthralgia, pain

Resp: dyspnea

Misc: ↓serum vitamin A concentrations

Interactions ⬆ ⬇

Drug-drug:

None reported.

Route/Dosage ⬆ ⬇

SC (Adults ): 25 mg every 3 mo.

Availability ⬆ ⬇

Solution for injection (prefilled syringes): 25 mg/0.5 mL

Assessment ⬆ ⬇

Assess for symptoms of vitamin A deficiency during therapy. If night blindness occurs, refer for ophthalmic evaluation.
Monitor for atrioventricular block (chest pain, dizziness, fainting, dyspnea) during therapy. If symptoms occur, discontinue vutrisiran and treat as clinically indicated.

Lab Test Considerations:

May cause ↓ serum vitamin A levels.

Implementation ⬆ ⬇

SC: Bring syringe to room temperature. Inject into abdomen, thigh, or upper arm; avoid scar tissue, nonintact skin, and 5 cm around naval. Vutrisiran is only administered by a health care professional.
- Solution is clear and colorless to yellow. Do not use if solution is cloudy, discolored, or contains particulates.
- If dose missed, administer as soon as possible. Resume every 3 mo from most recent dose.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Advise patient to take vitamin A supplement at recommended daily allowance and no higher during therapy; notify health care professional immediately for visual changes.
Advise patient to notify health care professional for pain in extremity, arthralgia, and dyspnea.
Advise patient 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.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes ⬆ ⬇

Improvement in polyneuropathy of hereditary transthyretin-mediated amyloidosis.

US Brand Names ⬆ ⬇

Code ⬆

NDC Code

70596- Agilent Technologies, Inc.
- 70596-1004-
  - 70596-1004-1- 50 g in 1 BOTTLE (70596-1004-1)

71336- Alnylam Pharmaceuticals, Inc.
- 71336-1003- AMVUTTRA
  - 71336-1003-1- 1 SYRINGE, GLASS in 1 CARTON (71336-1003-1) / .5 mL in 1 SYRINGE, GLASS

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Pronunciation ⬇

Classifications ⬆ ⬇