Crizanlizumab Dosage

Medically reviewed by Drugs.com. Last updated on Sep 30, 2022.

Usual Adult Dose for Sickle Cell Anemia

Initial dose: 5 mg/kg via IV infusion every 2 weeks for 2 doses, then
Maintenance dose: 5 mg/kg via IV infusion every 4 weeks

Comments:

• This drug may be given with or without hydroxyurea.
• Use patient's actual body weight for dose calculation.

Use: To reduce the frequency of vasoocclusive crises in patients 16 years or older with sickle cell disease.

Usual Pediatric Dose for Sickle Cell Anemia

16 years or older:
Initial dose: 5 mg/kg via IV infusion every 2 weeks for 2 doses, then
Maintenance dose: 5 mg/kg via IV infusion every 4 weeks

Comments:

• This drug may be given with or without hydroxyurea.
• Use patient's actual body weight for dose calculation.

Use: To reduce the frequency of vasoocclusive crises in patients 16 years or older with sickle cell disease.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Management of Infusion Related Reactions:
MILD TO MODERATE infusion-related reaction:

• Temporarily interrupt or slow the rate of infusion
• Initiate symptomatic treatment (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, antihistamines, IV fluids, and/or oxygen therapy)
• For subsequent infusions, consider premedication and/or reduced infusion rate

SEVERE infusion-related reaction:

• Discontinue infusion
• Institute medical care
• Consider permanent discontinuation

Precautions

CONTRAINDICATIONS: None

Safety and efficacy have not been established in patients younger than 16 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Administer by IV infusion over 30 minutes
• This drug should be prepared and administered by a healthcare professional
• IV line should contain a sterile, nonpyrogenic 0.2-micron inline filter
• After administration, flush line with at least 25 mL or NS or D5W

Missed dose: If a dose is missed, administer as soon as possible:

• If administered within 2 weeks after missed dose, continue dosing according to original schedule
• If administered more than 2 weeks after missed dose, continue dosing every 4 weeks thereafter

Storage requirements:
In-Use: If not administered immediately, protect from light, and store as follows:

• Stable at temperatures up to 25C (77F) for up to 4.5 hours from initial piercing of first vial to completion of infusion, OR
• Refrigerated (2C to 8C [36F to 46F]) for no more than 24 hours from initial piercing of first vial to completion of infusion (this includes storage of diluted solution and time to warm up to room temperature)

Prior to Use:

• Store and transport refrigerated at 2C to 8C (36F to 46F) in the original carton to protect from light
• Do not shake; do not freeze

Preparation techniques:

• Bring vials to room temperature for a maximum of 4 hours prior to start of preparation (piercing the first vial)
• Drug is to be diluted in NS or D5W to a total volume of 100 mL prior to administration; infusion bags should be made of polyvinyl chloride, polyethylene, or polypropylene
• From 100 mL bag of NS or D5W, remove volume of NS or D5W that is equal to volume of drug to be added; once removed, add volume of drug to infusion bag, volume of drug should not exceed 96 mL
• Gently invert infusion bag to mix diluted solution; do not shake
• Administer prepared solution as soon as possible not exceeding storage requirements listed above

IV compatibility: Do not mix or coadminister with other drugs

General:

• This drug is the first targeted therapy approved for sickle cell disease that specifically inhibits selectin, a substance that contributes to cells sticking together and leads to vaso-occlusive crisis.
• Efficacy in clinical trials was based on patients having fewer health care visits for vaso-occlusive crisis annually (median annual rate of 1.63 visits), compared to patients who received a placebo (median annual rate of 2.98 visits).

Monitoring:

• Monitor for signs and symptoms of infusion-related reactions.

Patient advice:

• Patients should be instructed to read the US FDA-approved patient labeling (Patient Information).
• Patients should be instructed to immediately report signs or symptoms of infusion-related reactions.
• Patient should inform healthcare provider that they are receiving this drug prior to any blood tests used to measure platelet counts.

Frequently asked questions

• What type of drug is Adakveo and how does it work?
• How is Adakveo administered?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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