brodalumab

Contraindicated in:

Hypersensitivity;
Crohn's disease (may worsen disease);
Active tuberculosis (TB).

Use Cautiously in:

History of suicidality or depression;
Chronic infection or history of recurrent infection;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

EENT: oropharyngeal pain

GI: Crohn's disease, diarrhea, nausea

Hemat: neutropenia

Local: injection site reactions

MS: arthralgia, myalgia

Neuro: fatigue, headache, SUICIDAL THOUGHTS/BEHAVIORS

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), INFECTION (INCLUDING REACTIVATION TB)

Interactions ⬆ ⬇

Drug-drug:

May ↓ antibody response to live-virus vaccine and ↑ risk of adverse reactions; do not administer concurrently.
May affect activity of CYP450 enzymes and may alter the effectiveness/toxicity of drugs that are substrates of CYP450 (including warfarin and cyclosporine); close monitoring is recommended and necessary dose modifications undertaken.

Availability ⬆ ⬇

Solution for SUBQ injection (prefilled syringes): 210 mg/1.5 mL

Route/Dosage ⬆ ⬇

SC (Adults ): 210 mg once weekly for 3 wk; then 210 mg every 2 wk; consider discontinuing therapy if adequate response not achieved after 12–16 wk of therapy.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

A monoclonal antibody that acts as an antagonist of interleukin (IL)-17RA by selectively binding to it and preventing its interaction with numerous IL cytokines. Antagonism prevents production of inflammatory cytokines and chemokines.

Therapeutic effects:

Decreased plaque formation and spread.

Classifications ⬆ ⬇

Therapeutic Classification: antipsoriatics

Pharmacologic Classification: interleukin antagonists

Pharmacokinetics ⬆ ⬇

Absorption: 55% absorbed following SUBQ administration.

Distribution: Minimally distributed to tissues.

Metabolism/Excretion: Primarily eliminated by being catabolized into small peptides and amino acids.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
SUBQ	unknown	3 days	unknown

Patient/Family Teaching ⬆ ⬇

Educate patient on reason for brodalumab and side effects. Instruct them to self-administer as directed. Take missed doses as soon as remembered unless almost time for next dose. Do not double doses. Advise patient to read Patient Information before starting and with each Rx refill in case of changes.
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.
REMS: Advise patient to administer injection as directed, according to schedule. Health care professional should supervise first self-injection. Instruct patient to inject full dose and to use proper technique for syringe and needle disposal. Inform patient that they must enroll in SILIQ REMS program and to carry SILIQ Patient Wallet Card at all times and share with other health care professionals. Card describes symptoms that, if experienced, should prompt patient to seek immediate medical evaluation. Provide patient with telephone number and website for pharmacies participating in SILIQ REMS program.
Caution patient to avoid live vaccines during therapy.
Counsel patient to report symptoms of Crohn's disease (abdominal pain, cramps, diarrhea, blood in stools, mouth sores).
May cause depression or suicide. Instruct patients and caregivers to monitor for emergence of suicidal thoughts and behaviors. Notify health care professional immediately if suicidal thoughts; new or worsening depression; anxiety; changes in behavior or mood; thoughts of suicide, dying, or hurting self; or acting on dangerous impulses occur. Instruct patient to carry wallet card and to call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit www.988lifeline.orgif they experience suicidal thoughts.
Instruct patient to notify health care professional if signs and symptoms of infection or any worsening rashes occur.
Rep: Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇