Skip to Content

Mylotarg Dosage

Generic name: GEMTUZUMAB OZOGAMICIN 5mg in 5mL
Dosage form: injection, powder, lyophilized, for solution

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

Premedication and Special Considerations

  • Premedicate adults with acetaminophen 650 mg orally and diphenhydramine 50 mg orally or intravenously 1 hour prior to MYLOTARG dosing and 1 mg/kg methylprednisolone or an equivalent dose of an alternative corticosteroid within 30 minutes prior to infusion of MYLOTARG. Premedicate children with acetaminophen 15 mg/kg (maximum of 650 mg), diphenhydramine 1 mg/kg (maximum of 50 mg), and 1 mg/kg methylprednisolone orally or intravenously; additional doses of acetaminophen and diphenhydramine may be administered every 4 hours after the initial pretreatment dose. Repeat with the same dose of methylprednisolone or an equivalent corticosteroid for any sign of an infusion reaction, such as fever, chills, hypotension, or dyspnea during the infusion or within 4 hours afterwards [see Warnings and Precautions (5.2)].
  • Use appropriate measures to prevent tumor lysis syndrome.
  • For patients with hyperleukocytosis (leukocyte count greater than or equal to 30 Gi/L), cytoreduction is recommended prior to administration of MYLOTARG.

Recommended Dosage

Newly-Diagnosed De Novo CD33-positive AML (combination regimen)

A treatment course including MYLOTARG in combination therapy for adults with newly-diagnosed de novo CD33-positive AML consists of 1 induction cycle and 2 consolidation cycles [see Clinical Studies (14.1)].

For the induction cycle, the recommended dose of MYLOTARG is 3 mg/m2 (up to one 4.5 mg vial) on Days 1, 4, and 7 in combination with daunorubicin and cytarabine. For patients requiring a second induction cycle, do NOT administer MYLOTARG during the second induction cycle.

For the consolidation cycles, the recommended dose of MYLOTARG is 3 mg/m2 on Day 1 (up to one 4.5 mg vial) in combination with daunorubicin and cytarabine.

Newly-Diagnosed CD33-positive AML (single-agent regimen)

A treatment course of MYLOTARG as a single agent for adults with newly-diagnosed CD33-positive AML consists of 1 cycle of induction and up to 8 cycles of continuation therapy [see Clinical Studies (14.1)].

For the induction cycle, the recommended dose of MYLOTARG is 6 mg/m2 as a single agent on Day 1, and 3 mg/m2 on Day 8.

For continuation, the recommended dose of MYLOTARG is 2 mg/m2 as a single agent on Day 1 every 4 weeks.

Relapsed or Refractory CD33-positive AML (single-agent regimen)

The recommended dose of MYLOTARG as a single agent for treatment of relapsed or refractory CD33-positive AML is 3 mg/m2 (up to one 4.5 mg vial) on Days 1, 4, and 7 [see Clinical Studies (14.1)].

Dosage Modifications for Toxicities

Monitor blood counts frequently through resolution of cytopenias. Monitor blood counts and chemistries at least three times per week through recovery from treatment-related toxicities. Management of some adverse reactions [see Warnings and Precautions (5) and Adverse Reactions (6)] may require dose interruptions or permanent discontinuation of MYLOTARG Table 1 shows the dose modification guidelines for hematologic and nonhematologic toxicities.

Table 1. Dosage Modifications for Hematologic and Nonhematologic Toxicities
Hematologic and Nonhematologic Toxicities Recommended Action
Abbreviations: ALT=alanine aminotransferase; AST=aspartate aminotransferase; VOD=veno-occlusive disease; ULN=upper limit of normal.
For patients receiving MYLOTARG in combination therapy
Persistent thrombocytopenia
  • If platelet count does not recover to greater than or equal to 100 Gi/L within 14 days following the planned start date of the consolidation cycle (14 days after hematologic recovery following previous cycle), discontinue MYLOTARG (do not administer MYLOTARG in the consolidation cycles).
Persistent neutropenia
  • If neutrophil count does not recover to greater than 0.5 Gi/L within 14 days following the planned start date of the consolidation cycle (14 days after hematologic recovery following previous cycle), discontinue MYLOTARG (do not administer MYLOTARG in the consolidation cycles).
For all patients receiving MYLOTARG (Monotherapy or in Combination)
VOD
Total bilirubin greater than 2 × ULN, or AST and/or ALT greater than 2.5 × ULN
  • Delay treatment with MYLOTARG until recovery of total bilirubin to less than or equal to 2 × ULN and AST and ALT to less than or equal to 2.5 × ULN prior to each dose.
  • Omit scheduled dose if delayed more than 2 days between sequential infusions.
Infusion-related reactions
  • Interrupt the infusion and institute appropriate medical management.
  • Administer acetaminophen, diphenhydramine and/or methylprednisolone, if needed (see Section 2.1)
  • Provide supportive care measures as needed.
  • For mild, moderate or severe infusion related reactions, once symptoms resolve, consider resuming the infusion at no more than half the rate at which the reaction occurred. Repeat the procedure above in the event of recurrence of symptoms.
  • Permanently discontinue MYLOTARG upon occurrence of a severe infusion reaction or for any life-threatening infusion reaction [see Warnings and Precautions (5.2)].
Other severe or life-threatening non-hematologic toxicities
  • Delay treatment with MYLOTARG until recovery to a severity of no more than mild.
  • Omit scheduled dose if delayed more than 2 days between sequential infusions.

Instructions for Reconstitution, Dilution, and Administration

Use appropriate aseptic technique for the reconstitution and dilution procedures. Protect the reconstituted and diluted MYLOTARG solution from light.

Reconstitution

  • MYLOTARG is a cytotoxic drug. Follow applicable special handling and disposal procedures.1
  • Calculate the dose (mg) and number of vials of MYLOTARG required.
  • Prior to reconstitution, allow drug product vials to reach ambient temperature for approximately 5 minutes.
  • Reconstitute each vial with 5 mL of Sterile Water for Injection, USP to obtain a concentration of 1 mg/mL of MYLOTARG that delivers 4.5 mL (4.5 mg).
  • Gently swirl the vial to aid dissolution. DO NOT SHAKE.
  • Inspect the reconstituted solution for particulates and discoloration. The reconstituted solution may contain small white to off-white, opaque to translucent, and amorphous to fiber-like particles.
  • MYLOTARG contains no bacteriostatic preservatives.
  • Use reconstituted solution immediately or after being refrigerated at 2–8°C (36–46°F) for up to 1 hour. PROTECT FROM LIGHT. DO NOT FREEZE.

Dilution

  • Calculate the required volume of the reconstituted solution needed to obtain the appropriate dose according to patient body surface area. Withdraw this amount from the vial(s) using a syringe. PROTECT FROM LIGHT. Discard any unused reconstituted solution left in the vial.
  • Remove a volume of 0.9% Sodium Chloride Injection from the prefilled bag equal to the volume of MYLOTARG product (mL) calculated above.
  • Add the reconstituted solution to an infusion container with 0.9% Sodium Chloride Injection to make a total volume of 50 mL or 100 mL, depending on dose. PROTECT FROM LIGHT.
  • Gently invert the infusion container to mix the diluted solution. DO NOT SHAKE.
  • Following dilution with 0.9% Sodium Chloride Injection, MYLOTARG solution should be infused immediately. If not used immediately, store at room temperature (15–25°C; 59–77°F) for up to 6 hours, which includes the 2-hour infusion time and 1-hour, if needed, to allow the refrigerated diluted solution to equilibrate to room temperature. The diluted solution can be refrigerated at 2–8°C (36–46°F) for up to 12 hours which includes up to 1-hour in the vial post-reconstitution. PROTECT FROM LIGHT and DO NOT FREEZE.

Administration

  • Use an in-line 0.2 micron polyethersulfone (PES) filter for infusion of MYLOTARG.
  • Protect the intravenous bag from light using a light-blocking cover during infusion. The infusion line does not need to be protected from light.
  • Infuse the diluted solution over 2 hours.
  • Do not mix MYLOTARG with, or administer as an infusion with, other medicinal products.
Hide