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Efalizumab Injection : Uses, Dosage, Contraindications, Side Effects, Overdose


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BRAND NAME :  Efalizumab Injection

Brand Names:


Medication prescribed:

Efalizumab is used to treat chronic plaque psoriasis (a skin disease in which red scaly patches form on some areas of the body). Efalizumab is in a class of medications called immunosuppressants. It works by stopping the action of cells in the body that cause the symptoms of psoriasis.

How should this medicine be used:

Efalizumab comes as a powder to mix with sterile water and inject subcutaneously (under the skin). It is usually injected once a week. You should inject efalizumab on the same day every week. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use efalizumab exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of efalizumab and increase your dose after 1 week. Efalizumab controls chronic plaque psoriasis but does not cure it. It may take several weeks before you feel the full benefit of efalizumab. Do not stop taking efalizumab without talking to your doctor. You can inject efalizumab yourself or have a friend or relative give the injections. Your doctor will train the person who will be injecting the medication, and will test him to be sure he can give the injection correctly. Be sure that you and the person who will be giving the injections read the manufacturer's information for the patient that comes with efalizumab before you use it for the first time at home. If you are injecting efalizumab yourself, you can inject it anywhere on your thighs or stomach. If someone else will be giving you your injections, he or she can also inject it anywhere on the back of your upper arms or buttocks. To reduce the chances of soreness or redness, choose a different area for each injection. If your doctor has told you to use two injections for each dose, choose two spots that are at least 1 inch apart. Do not inject efalizumab near a vein that you can see through the surface of the skin. Try to inject efalizumab in skin that is free of symptoms of psoriasis. Never reuse needles, syringes, vials of efalizumab, or syringes of sterile water. Throw away used needles and syringes in a puncture-resistant container. You can throw away used alcohol pads, needle caps, and vials in the trash. Talk to your doctor or pharmacist about what to do with the puncture-resistant container when it is full. Never mix efalizumab powder with any liquid other than the sterile water provided. Never add any other medications to the syringe you will use to inject efalizumab. To prepare and inject efalizumab, follow these steps: Take one or two blister trays of efalizumab and supplies out of the refrigerator and place the tray(s) on a clean, well-lit, flat work surface. You will need one tray if your doctor has told you to inject 1.25 mL or less each week or two trays if your doctor has told you to inject more than 1.25 mL each week. Wash your hands well with soap and warm water. Open the blister tray(s) and place the contents on the work surface. Each tray should contain one vial of efalizumab, one prefilled syringe of sterile water, two alcohol pads, and two needles. The vial(s) of efalizumab and syringe(s) of sterile water should be marked with expiration dates that have not passed. Call your pharmacist if your tray(s) do not contain all of these supplies or if your medication or water has expired. Wait to allow the medication and water to warm to room temperatureSteps 5-14 tell how to mix efalizumab with sterile water. If your dose is more than 1.25 mL, you will need to follow these directions twice to prepare two separate vials of efalizumab. Remove the plastic cap from the vial of efalizumab and wipe the rubber stopper with an alcohol pad. When you handle the vial, be careful not to touch the rubber stopper with your fingers. Remove one of the needles from its package, but do not remove the cap. Remove the cap from the tip of the prefilled syringe, and place the capped needle onto the syringe tip. Remove the cap from the needle but be careful not to touch the needle with your fingers. Place the vial of efalizumab upright on a firm surface and slowly push the needle through the rubber stopper. Aim the tip of the needle toward the wall of the vial and slowly push down on the plunger to inject all of the sterile water into the vial. The powder in the vial may foam when you inject the water. Leave the needle and syringe in the vial stopper. Pick up the vial and swirl it gently to mix the medication. Do not shake the vial. Wait 5 minutes to allow the medication to dissolve. Look at the vial to be sure it contains a clear or pale yellow liquid. Call your pharmacist and do not use the liquid if it is cloudy, contains particles, or is a different color. Slowly remove the needle and syringe from the vial. Place the needle cap on a flat surface and slide the needle into the cap. When the needle is covered by the cap, push the cap all the way down and twist the capped needle to remove it from the syringe. Throw the needle away in a puncture-resistant container.Steps 15-31 tell how to fill the syringe with the correct amount of medication and inject the medication. If your dose is more than 1.25 mL, you will need to follow these steps twice to fill and inject two syringes that each contain half of your dose. Wipe the rubber stopper of the vial with an alcohol pad. Remove the other needle from its package but do not remove the cap. Connect the needle to the tip of the syringe and carefully remove the cap. Place the vial of efalizumab upright on a flat surface and push the needle straight down through the rubber stopper on the vial. Pick up the vial and turn it upside down without removing the needle. The entire tip of the needle should be covered by the liquid in the vial. Pull back the plunger to fill the syringe with the amount of medication your doctor told you to use. (If your dose is more than 1.25 mL, you will fill the syringe with half the amount of medication your doctor told you to use and then prepare a second syringe containing the other half of your dose.) Read the numbers on the side of the syringe to fill the syringe with the right amount of medication. Hold the syringe upright and tap it gently to push any air bubbles to the top. Gently push in the plunger to push the air bubbles out. Check to be sure the syringe still contains the right amount of medication. Pull back the plunger to refill the syringe if necessary. Remove the needle and syringe from the vial. Place the needle cap on a flat surface and slide the needle into the cap. Push the cap all the way down over the needle and leave the syringe on a flat surface. Wash your hands and the skin in the area where you plan to inject the medication with soap and warm water. Let the skin in the area where you will inject efalizumab air dry, then clean it with an alcohol pad or alcohol-soaked cotton ball using a circular motion. Allow the skin to air dry and do not touch it with your fingers until after you are finished injecting your medication. Pick up the syringe and remove the needle cap by twisting and pulling it. Be careful not to touch the needle to your fingers or any surface. Hold the syringe firmly between your thumb and fingers with one hand and use your other hand to pinch a fold of skin in the area where you will inject your medication. Push the needle straight into your skin at a 90-degree angle. Let go of the pinched fold of skin and use that hand to slowly push down on the plunger until it stops. Remove the needle from your skin and throw it away properly. Use a dry sterile gauze pad to press down on the spot where you injected efalizumab. Do not use an alcohol wipe. You may cover the spot with a small bandage if needed.

Other uses for this medicine:

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special precautions:

Before using efalizumab, tell your doctor and pharmacist if you are allergic to efalizumab or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: other medications for psoriasis and medications that suppress the immune system such as azathioprine (Imuran), cancer chemotherapy medications, cyclosporine (Neoral, Sandimmune), methotrexate (Rheumatrex), sirolimus (Rapamune), and tacrolimus (Prograf). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you or any of your close relatives have or have ever had cancer or if you have or have ever had any disease that affects your immune system such as Acquired Immunodeficiency Syndrome (AIDS), or Severe Combined Immunodeficiency Syndrome (SCID), or liver or kidney disease. Also tell your doctor if you have any type of infection, including infections that come and go (such as cold sores) and chronic infections that never go away, or if you frequently get any type of infection (such as urinary tract or bladder infections). tell your doctor if your psoriasis is being treated with phototherapy. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using efalizumab or within 6 weeks after you stop using efalizumab, call your doctor. if you are having surgery, including dental surgery, tell the doctor or dentist that you are using efalizumab. do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor. you should know that efalizumab may decrease your ability to fight infection. Stay away from people who are sick and wash your hands often while you are using this medication. you should know that your psoriasis may worsen or you may develop a new type of psoriasis during or after your treatment with efalizumab. Call your doctor if you notice a new or worsening rash during or after your treatment. tell your doctor if you gain or lose weight while you are using efalizumab. Your doctor may have to change the dose of your medication if your weight changes. Do not change the dose of your medication without talking to your doctor.

Special dietary instructions:

Unless your doctor tells you otherwise, continue your normal diet.

If I forget a dose:

Call your doctor to find out when you should inject your next dose and what schedule you should follow after that. Never inject a double dose to make up for a missed one.

What side effects:

Efalizumab may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: headache upset stomach pain, especially in your muscles, back, or joints weakness acne runny nose sneezing Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: sore throat, fever, chills, or other signs of infection flu-like symptoms easy bruising or bleeding bleeding gums tiny red spots under surface of skin hives itching difficulty breathing or swallowing wheezing swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness unusual skin changes new lumps or masses anywhere in your body Efalizumab may increase the risk that you will develop cancer. Talk to your doctor about the risks of using this medication. Efalizumab may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

What storage conditions:

Keep this medication in the carton it came in, tightly closed, away from light, and out of reach of children. Store unopened blister trays of efalizumab in the refrigerator, but do not freeze them. You may store mixtures of efalizumab and water for up to 8 hours at room temperature. Throw away mixtures of efalizumab and water after 8 hours have passed and throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of overdose:

In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services at 911. Symptoms of overdose may include: severe vomiting

Other information:

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to efalizumab. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

More information:    Efalizumab Injection

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