OPRELVEKIN

OPRELVEKIN
(o-prel've-kin)
Neumega
Classifications: blood former; hematopoietic growth factor;
Therapeutic: hematopoietic growth factor

Prototype: Epoetin alfa
Pregnancy Category: C

Availability

5 mg injection

Action

Hematopoietic growth factor (interleukin-11) that is produced by recombinant DNA.

Therapeutic Effect

Indicated by return of postnadir platelet count toward normal (≥50,000). Increases platelet count in a dose-dependent manner.

Uses

Prevention of severe thrombocytopenia following myelosuppressive chemotherapy (not effective after myeloablative chemotherapy).

Contraindications

Hypersensitivity to oprelvekin; myeloablative chemotherapy; myeloid malignancies; pregnancy (category C).

Cautious Use

Patients with left ventricular dysfunction, cardiac disease, CHF, history of atrial arrhythmias, or other arrhythmias; electrolyte imbalance, hypokalemia; respiratory disease; papilledema; thromboembolic disorders; older adults; cerebrovascular disease, stroke, TIAs; pleural effusion, pericardial effusion, ascites; increased intracranial pressure, brain tumor, visual disturbances; hepatic or renal dysfunction; lactation.

Route & Dosage

Thrombocytopenia
Adult: SC 50 mcg/kg once daily starting 6–24 h after completing chemotherapy and continuing until platelet count is ≥50,000 cells/mcL or up to 21 d
Child (8 mo–17 y): SC 75–100 mcg/kg once daily starting 6–24 h after completing chemotherapy and continuing until platelet count is ≥50,000 cells/mcL or up to 21 d

Administration

  • Note: Do not use if solution is discolored or if it contains particulate matter.
Subcutaneous
  • Reconstitute solution by gently injecting 1 mL of sterile water for injection (without preservative) toward the sides of the vial. Keep needle in vial and gently swirl to dissolve but do not shake solution. Without removing needle, withdraw specified amount of oprelvekin for injection.
  • Give as single dose into the abdomen, thigh, hip, or upper arm.
  • Discard any unused portion of the vial. It contains no preservatives.
  • Use reconstituted solution within 3 h; store at 2°–8° C (36°–46° F) until used.
  • Store unopened vials at 2°–8° C (36°–46° F). Do not freeze.

Adverse Effects (≥1%)

Body as a Whole: Edema, neutropenic fever, fever, asthenia, pain, chills, myalgia, bone pain, dehydration. CNS: Headache, dizziness, insomnia, nervousness. CV: Tachycardia, vasodilation, palpitations, syncope, atrial fibrillation/flutter, peripheral edema, capillary leak syndrome. GI: Nausea, vomiting, mucositis, diarrhea, oral moniliasis, anorexia, constipation, dyspepsia. Hematologic: Ecchymosis. Respiratory: Dyspnea, rhinitis, cough, pharyngitis, pleural effusion, pulmonary edema, exacerbation of preexisting pleural effusion. Skin: Alopecia, rash, skin discoloration, exfoliative dermatitis. Special Senses: Conjunctival injection, amblyopia.

Interactions

Drug: No clinically significant interactions established.

Pharmacokinetics

Absorption: 80% from SC injection site. Onset: Days 5–9. Duration: 7 d after last dose. Distribution: Distributes to highly perfused organs. Elimination: In urine. Half-Life: 6.9 h.

Nursing Implications

Assessment & Drug Effects

  • Lab tests: Monitor platelet counts until adequate recovery; periodically monitor CBC with differential and serum electrolytes.
  • Monitor carefully for and immediately report S&S of fluid overload, hypokalemia, and cardiac arrhythmias.
  • Monitor persons with preexisting fluid retention carefully (e.g., CHF, pleural effusion, ascites) for worsening of symptoms.

Patient & Family Education

  • Review patient information leaflet with special attention to administration directions.
  • Report any of the following to the physician: Shortness of breath, edema of arms and/or legs, chest pain, unusual fatigue or weakness, irregular heartbeat, blurred vision.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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