Aldesleukin Dosage

This dosage information may not include all the information needed to use Aldesleukin safely and effectively. See additional information for Aldesleukin.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Renal Cell Carcinoma

0.037 mg/kg by IV infusion every 8 hours

Infusions may be administered every 8 hours for a maximum of 14 doses. Following 9 days of rest, the schedule may be repeated for another 14 doses, to a maximum of 28 doses per course, as tolerated.


Patients should be evaluated for response approximately 4 weeks after completion of a course of therapy and again immediately prior to the scheduled start of the next treatment course. Additional courses of treatment should be given to patients only if there is some tumor shrinkage following the last course and retreatment is not contraindicated. Each treatment course should be separated by a rest period of at least 7 weeks from the date of hospital discharge.

Usual Adult Dose for Malignant Melanoma

0.037 mg/kg by IV infusion every 8 hours

Infusions may be administered every 8 hours for a maximum of 14 doses. Following 9 days of rest, the schedule may be repeated for another 14 doses, to a maximum of 28 doses per course, as tolerated.


Patients should be evaluated for response approximately 4 weeks after completion of a course of therapy and again immediately prior to the scheduled start of the next treatment course. Additional courses of treatment should be given to patients only if there is some tumor shrinkage following the last course and retreatment is not contraindicated. Each treatment course should be separated by a rest period of at least 7 weeks from the date of hospital discharge.

Renal Dose Adjustments

Contraindications for retreatment with aldesleukin include renal failure requiring dialysis for more than 72 hours.

Aldesleukin doses should be held for:
1) Serum creatinine greater than or equal to 4.5 mg/dL or 4 mg/dL in the presence of severe volume overload, acidosis, or hyperkalemia (Subsequent doses may be given if serum creatinine <4 mg/dL and fluid and electrolyte status is stable.);
2) Persistent oliguria, urine output less than or equal to 10 mL/hr for 16 to 24 hours with a rising serum creatinine (Subsequent doses may be given if urine output is >10 mL/hour with a decrease of serum creatinine by >1.5 mg/dL or normalization of serum creatinine.)

Liver Dose Adjustments

Aldesleukin doses should be held for hepatic failure, including encephalopathy, increasing ascites, liver pain, and/or hypoglycemia.

Subsequent doses may be given if all signs of hepatic failure have resolved.

Note: Discontinue all further treatment for that course. A new course of treatment, if warranted, should be initiated no sooner than 7 weeks after cessation of adverse event and hospital discharge.

Dose Adjustments

Dose modification for toxicity should be accomplished by withholding or interrupting a dose rather than reducing the dose to be given. Decisions to stop, hold, or restart aldesleukin therapy must be made after a global assessment of the patient. The following guidelines have been recommended by the manufacturer:

Contraindications for retreatment with aldesleukin include:
Cardiovascular:
1) Sustained ventricular tachycardia (greater than or equal to 5 beats);
2) Cardiac rhythm disturbances not controlled or unresponsive to management;
3) Chest pain with ECG changes, consistent with angina or myocardial infarction;
4) Cardiac tamponade.
Respiratory:
1) Requiring intubation for more than 72 hours.
Nervous System:
1) Coma or toxic psychosis lasting greater than 48 hours;
2) Repetitive or difficult to control seizures.
Gastrointestinal:
1) Bowel ischemia/perforation;
2) Gastrointestinal bleeding necessitating surgery.

Aldesleukin doses should be held for any of the following:
Cardiovascular:
1) Atrial fibrillation, supraventricular tachycardia, or bradycardia that requires treatment or is recurrent or persistent (Subsequent doses may be given if the patient is asymptomatic with full recovery to normal sinus rhythm.);
2) Systolic pressure <90 mmHg with increasing requirement for pressors (Subsequent doses may be given if systolic BP >=90 mmHg and stable or improving requirements for pressors.);
3) Any ECG change consistent with myocardial infarction or ischemia with or without chest pain and/or suspicion of cardiac ischemia (Subsequent doses may be given if the patient is asymptomatic, MI and myocarditis have been ruled out, clinical suspicion of angina is low, and there is no evidence of ventricular hypokinesia.)
Respiratory:
1) Oxygen saturation is <90% (Subsequent doses may be given if oxygen saturation >90%.)
Nervous System:
1) Mental status changes which include moderate confusion or agitation (Subsequent doses may be given if mental status changes completely resolve.)
Dermatologic:
1) Bullous dermatitis or marked worsening of preexisting skin condition (Subsequent doses may be given if there is a resolution of all signs of bullous dermatitis.) Note: Avoid topical steroid therapy.
General:
Sepsis syndrome, patient is clinically unstable (Subsequent doses may be given if sepsis syndrome has resolved, patient is clinically stable, and/or the infection is under treatment.)
Gastrointestinal:
1) Stool guaiac repeatedly >3-4+ (Subsequent doses may be given if the stool guaiac result is negative.)

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available.

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