lecanemab

Contraindicated in:

Previous localized superficial siderosis, >4 brain microhemorrhages, and/or brain hemorrhage (↑ risk of intracerebral hemorrhage).

Use Cautiously in:

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: atrial fibrillation

GI: diarrhea

Hemat: lymphopenia

Neuro: amyloid-related imaging abnormalities (including edema and hemosiderin deposition), headache, SEIZURES

Resp: cough

Misc: infusion-related reactions

Interactions ⬆ ⬇

Drug-drug:

Antithrombotic drugs and thrombolytics may ↑ risk of intracerebral hemorrhage.

Availability ⬆ ⬇

Solution for injection: 100 mg/mL

Route/Dosage ⬆ ⬇

IV (Adults ): 10 mg/kg every 2 wk.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as a monoclonal antibody directed against aggregated soluble and insoluble forms of amyloid beta.

Therapeutic effects:

Reduction in clinical decline.
Reduction in amyloid beta plaques in the brain.

Classifications ⬆ ⬇

Therapeutic Classification: anti-Alzheimers's agents

Pharmacologic Classification: monoclonal antibodies, anti amyloid monoclonal antibodies

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Not widely distributed to extravascular tissues.

Metabolism/Excretion: Degraded into small peptides and amino acids via catabolic pathways.

Half-Life: 5–7 days.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	unknown	2 wk

Patient/Family Teaching ⬆ ⬇

Explain purpose of lecanemab to patient and family. Advise patient and caregiver to read the Medication Guide before and periodically during therapy in case of changes. If an infusion is missed, schedule next infusion as soon as possible.
Advise patient to notify health care professional if signs an symptoms of ARIA (headache, confusion, dizziness, vision changes, nausea, difficulty walking, seizures) or infusion-related reaction occur.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Advise patients that the Alzheimer’s Network for Treatment and Diagnostics (ALZ-NET) is a voluntary provider-enrolled patient registry that collects information on treatments for Alzheimer’s disease, including Leqembi. Encourage patients to participate in the ALZ-NET registry.
Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇