Thông tin thuốc gốc
Chỉ định và Liều dùng
Multicentric Castleman’s disease
Adult: In patient who are HIV-negative and human herpesvirus-8 (HHV-8) negative: 11 mg/kg, given via infusion over 1 hour every 3 weeks until treatment failure. Interrupt dosing if absolute neutrophil count (ANC) <1,000 cells/mm3; platelet count <75,000 cells/mm3 before the 1st dose or <50,000 cells/mm3 before succeeding doses; Hb <17 g/100 mL. Dose reduction is not recommended.
Hướng dẫn pha thuốc
Reconstitute vial labelled as 100 mg and 400 mg with 5.2 mL and 20 mL sterile water for inj respectively, to make a final concentration containing 20 mg/mL. Gently swirl and do not shake. To prepare the solution for infusion, further dilute with 250 mL dextrose 5% in water.
Chống chỉ định
Concomitant use with live viral vaccines.
Thận trọng
Patient with risk for gastrointestinal perforation (e.g. diverticulitis, ulcers), concurrent active severe infection. Pregnancy and lactation. Not indicated for use for HIV and human herpesvirus-8 (HHV-8) positive patients.
Phản ứng phụ
Significant: Hypersensitivity/infusion related reactions (e.g. anaphylaxis, cytokine release syndrome), serious infection (e.g. pneumonia, sepsis), lipid and cholesterol elevations, gastrointestinal perforation, increased Hb level.
Blood and lymphatic system disorders: Neutropenia, thrombocytopenia.
Gastrointestinal disorders: Abdominal pain/distention, constipation, diarrhoea, oropharyngeal pain.
General disorders and administration site conditions: Fatigue.
Investigations: Increased weight.
Metabolism and nutrition disorders: Peripheral/localised oedema, hypertriglyceridaemia, hypercholesterolaemia, hyperuricaemia.
Musculoskeletal and connective tissue disorders: Arthralgia, limb pain.
Nervous system disorders: Headache.
Renal and urinary disorders: Renal impairment.
Respiratory, thoracic and mediastinal disorders: Respiratory tract infection, nasopharyngitis.
Skin and subcutaneous tissue disorders: Maculopapular rash, pruritus.
Vascular disorders: Hypertension, hypotension.
IV/Parenteral: C
Monitor CBC with differential prior to each dose for 1 year and every 3 dosing cycles, thereafter, or as needed; anaphylaxis and signs or symptoms of infusion-related, allergic, or cytokine release reactions; gastrointestinal perforation, infection.
Tương tác
May decrease serum concentration of CYP3A4 substrate (e.g. warfarin, ciclosporin). May enhance adverse effects of live vaccines. May diminish therapeutic effects of inactivated and live vaccines. May decrease therapeutic effect of oral contraceptives, atorvastatin.
Tác dụng
Description: Siltuximab is a chimeric murine/human monoclonal antibody that selectively binds cytokine interleukin-6 (IL-6) and prevents its binding to soluble and membrane-bound receptors. This leads to inhibition of immunoglobulin secretion and hepatic acute phase protein synthesis, thereby lowering IL-6 and C-reactive protein levels.
Distribution: Volume of distribution: 4.5 L.
Excretion: Elimination half-life: Approx 21 days.
Bảo quản
Store between 2-8°C. Do not freeze. Protect from light.
Phân loại MIMS
Phân loại ATC
L04AC11 - siltuximab ; Belongs to the class of interleukin inhibitors. Used as immunosuppressants.
Anon. Siltuximab. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. Accessed 31/01/2018.

Anon. Siltuximab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 31/01/2018.

Buckingham R (ed). Siltuximab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 31/01/2018.

Joint Formulary Committee. Siltuximab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. Accessed 31/01/2018.

Sylvant Injection, Powder, Lyophilized, for Solution (Janssen Biotech, Inc.). DailyMed. Source: U.S. National Library of Medicine. Accessed 31/01/2018.

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