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Siltuximab Dosage

Medically reviewed on August 28, 2017.

Applies to the following strengths: 100 mg; 400 mg

Usual Adult Dose for Castleman's Disease

11 mg/kg intravenously over 1 hour every 3 weeks.

Duration of therapy: Until treatment failure.

-Siltuximab was not studied in patients with MCD who are HIV positive or HHV-8 positive because siltuximab did not bind to virally produced IL-6 in a nonclinical study.

Use: Treatment of patients with multicentric Castleman's disease (MCD) who are human immunodeficiency virus (HIV) negative and human herpesvirus-8 (HHV-8) negative.

Renal Dose Adjustments

Mild to severe renal impairment (CrCl 15 mL/min to under 90 mL/min): No adjustment recommended.
End stage renal disease (CrCl less than 15 mL/min): Data not available

Liver Dose Adjustments

Mild or moderate liver dysfunction (Child-Pugh A or B): No adjustment recommended.
Severe liver dysfunction (Child-Pugh C): Data not available


Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.


Data not available

Other Comments

Administration Advice:
-If treatment criteria are not met a delay in treatment may be necessary; dose should not be reduced.
-Do not administer to patients with severe infections until the infection resolves.
-Perform hematology lab tests prior to each dose for the first 12 months and every 3 dosing cycles thereafter.
-Absolute Neutrophil Count should be 1.0 x 10(9)/L or higher before administration.
-Platelet count should be 75 × 10(9)/L or higher before first dose and 50 × 10(9)/L or higher before subsequent doses.
-Hemoglobin should be less than 17 g/dL before administration.
-Administer in a setting that provides resuscitation equipment, medication, and personnel trained to provide resuscitation.
-Stop infusion if patient develops signs of anaphylaxis. Discontinue further therapy.
-Stop infusion if patient develops mild to moderate infusion reactions. If reaction resolves, infusion may be restarted at a lower infusion rate. Consider medication with antihistamines, acetaminophen, and corticosteroids. Discontinue if patient does not tolerate infusion following these interventions.

Storage requirements:
-Refrigerate; protect from light.

Reconstitution/preparation techniques: The manufacturer product information should be consulted.

IV compatibility:
-Do not infuse concomitantly in the same intravenous line with other agents.

Patient advice:
-May lower resistance to infections. Contact your doctor immediately when symptoms suggesting infection appear in order to assure rapid evaluation and appropriate treatment.
-Discuss recommended vaccinations prior to treatment.
-Seek immediate medical attention for any symptoms of serious allergic reactions during the infusion. Signs include: difficulty breathing, chest tightness, wheezing, severe dizziness or light-headedness, swelling of the lips or skin rash.
-Patients of childbearing potential should avoid pregnancy which may include use of contraception during treatment and for 3 months after siltuximab therapy.

Further information

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