pegloticase

Generic Name: pegloticase (peg LOE ti kase)
Brand Name: Krystexxa

What is pegloticase?

Pegloticase is an enzyme that metabolizes uric acid into a harmless chemical that is eliminated from the body in urine.

Pegloticase is used to treat chronic gout. Pegloticase is usually given after other gout medications have been tried without successful treatment of symptoms.

Pegloticase may also be used for purposes not listed in this medication guide.

What is the most important information I should know about pegloticase?

You should not receive pegloticase if you are allergic to it, or if you have a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Some drugs can interact with pegloticase and should not be used at the same time, especially allopurinol (Zyloprim), probenecid (Benemid), or febuxostat (Uloric).

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

To make sure pegloticase is safe for you, tell your doctor if you have gout, congestive heart failure, other heart problems, or high blood pressure.

You may be given other medications to prevent certain side effects of pegloticase. You may need to start taking these medications at least a week before you receive your pegloticase injection. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

Tell your caregiver right away if you feel itchy, nervous, light-headed, short of breath, or have a fast heartbeat, chest discomfort, or redness of your skin when the medicine is injected into your vein.

What should I discuss with my healthcare provider before taking pegloticase?

You should not receive pegloticase if you are allergic to it, or if you have a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Some drugs can interact with pegloticase and should not be used at the same time. Tell your doctor about all other medications you use, especially:

  • allopurinol (Zyloprim);

  • probenecid (Benemid); or

  • febuxostat (Uloric).

To make sure pegloticase is safe for you, tell your doctor about your other medical conditions, especially:

  • gout;

  • congestive heart failure;

  • other heart problems; or

  • high blood pressure.

FDA pregnancy category C. It is not known whether pegloticase will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether pegloticase passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using pegloticase.

How should I take pegloticase?

Pegloticase is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Pegloticase must be given slowly, and the IV infusion can take at least 2 hours to complete.

You may be given other medications to prevent certain side effects of pegloticase. You may need to start taking these medications at least a week before you receive your pegloticase injection. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

Pegloticase is usually given once every 2 weeks. Follow your doctor's dosing instructions very carefully.

When you first start using pegloticase, you may have an increase in gout flares. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 3 months of treatment.

Your doctor may recommend other gout medications during the first 6 months of your treatment with pegloticase.

To be sure this medication is helping your condition, your blood may need to be tested often. This will help your doctor determine how long to treat you with pegloticase. Visit your doctor regularly.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your pegloticase injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking pegloticase?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Pegloticase side effects

Some people receiving a pegloticase injection have had a reaction to the infusion (when the medicine is injected into the vein). Infusion reactions may also occur after the injection is given. Tell your caregiver right away if you feel itchy, nervous, light-headed, short of breath, or have a fast heartbeat, chest discomfort, or redness of your skin during the injection.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; wheezing, difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • chest pain; or

  • flushing (warmth, redness, or tingly feeling).

Less serious side effects may include:

  • new gout flares;

  • nausea, vomiting, constipation;

  • easy bruising; or

  • stuffy nose, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Pegloticase dosing information

Usual Adult Dose for Gout:

The recommended dose and regimen of pegloticase for adult patients is 8 mg given as an intravenous infusion every two weeks.

The pegloticase admixture should only be administered by intravenous infusion over no less than 120 minutes via gravity feed, syringe type pump, or infusion pump.

Patients should receive preinfusion medications (e.g. antihistamines, corticosteroids), to minimize the risk of anaphylaxis and infusion reactions. Pegloticase should be administered in a healthcare setting and by healthcare providers prepared to manage anaphylaxis and infusion reactions, and observe patients for an appropriate period of time after administration.

What other drugs will affect pegloticase?

There may be other drugs that can interact with pegloticase. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about pegloticase.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2012-09-10, 3:22:40 PM.

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