benralizumab

General

Pronunciation:
ben-ra-liz-ue-mab

Trade Name(s)

  • Fasenra

Ther. Class.
antiasthmatics

Pharm. Class.
monoclonal antibodies
interleukin antagonists

Indications

Add-on maintenance treatment of severe asthma that is of an eosinophilic phenotype.

Action

Interleukin-5 (IL-5) antagonist that inhibits binding of IL-5 to the surface of the eosinophil, which reduces the production and survival of eosinophils.

Therapeutic Effect(s):

  • Decreased incidence of asthma exacerbations.
  • Reduction in use of maintenance oral corticosteroid therapy.

Pharmacokinetics

Absorption: 58% absorbed following subcut administration.

Distribution: Minimally distributed to tissues.

Metabolism and Excretion: Degraded by proteolytic enzymes located throughout the body.

Half-life: 15 days

TIME/ACTION PROFILE (blood levels)

ROUTEONSETPEAKDURATION
Subcutunknownunknownunknown

Contraindication/Precautions

Contraindicated in:

  • Hypersensitivity;
  • Acute bronchospasm or status asthmaticus.

Use Cautiously in:

  • Pre-existing helminth infections;
  • OB: Use only if potential maternal benefit outweighs potential fetal risk;
  • Lactation: Use only if potential maternal benefit outweighs potential risk to child;
  • Pedi: Children <12 yr (safety and effectiveness not established).

Adverse Reactions/Side Effects

CNS: headache

EENT: pharyngitis

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS, ANGIOEDEMA, URTICARIA, AND RASH), fever, injection site reactions

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

None known.

Route/Dosage

SC (Adults and Children) ≥12 yr) 30 mg every 4 wk for first three doses, then 30 mg every 8 wk thereafter.

Availability

Solution for subcut injection (prefilled syringe): 30 mg/mL

Assessment

  • Assess lung sounds, pulse, and BP periodically during therapy. Note amount, color, and character of sputum produced.
  • Monitor for signs and symptoms of hypersensitivity reactions (rash, pruritus, hives, swelling of face and neck, dyspnea, fainting, dizziness, feeling lightheaded) periodically during therapy; usually occur within hours, but may occur days after injection. Discontinue medication if reaction occurs.

Potential Diagnoses

Implementation

  • SC Administer every 4 wks for the 1st three doses and every 8 wks thereafter in upper arm, thigh or abdomen. Store in refrigerator; protect from light. Do not freeze or shake. Leave carton at room temperature for 30 min before administration. Solution is clear to opalescent, colorless to slightly yellow; may contain a few translucent or white to off-white particles. Do not administer if liquid is cloudy, discolored, or contains large particles or foreign particulate matter. Do not expel the air bubble prior to administration. Pinch skin to inject medication.

Patient/Family Teaching

  • Instruct patient to have medication administered by health care professional as scheduled.
  • Advise patient that benralizumab should not be used to treat an acute asthma attack. Patient should continue asthma medications, including corticosteroids, unless otherwise instructed by health care professional.
  • Advise patient to stop using medication and notify health care professional immediately if signs and symptoms of hypersensitivity reactions occur.
  • Instruct 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 any OTC medications or alcoholic beverages concurrently with this therapy. Caution patient also to avoid smoking and other respiratory irritants.
  • Instruct patient whose systemic corticosteroids have been recently reduced or withdrawn to carry a warning card indicating the need for supplemental systemic corticosteroids in the event of stress or severe asthma attack unresponsive to bronchodilators.
  • Advise patient to have helminth infections treated before starting benralizumab therapy.
  • Advise female patients to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

Decreased incidence of asthma exacerbations. Reduction in use of maintenance oral corticosteroid therapy.

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