Alemtuzumab Injection (Multiple Sclerosis) : Uses, Side Effects, Interactions & More
Alemtuzumab injection can cause serious or life-threatening autoimmune disorders (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage), including thrombocytopenia (a low number of platelets [a type of blood cell necessary for blood clotting] ) and kidney problems. Tell your doctor if you have bleeding problems or kidney disease. If you experience any of the following symptoms, call your doctor immediately: unusual bleeding, swelling of the legs or feet, coughing up blood, bleeding from a cut that is difficult to stop, heavy or irregular menstrual bleeding, spotting on the skin that are red, pink or purple, bleeding from the gums or nose, blood in the urine, chest pain, decreased amount of urine, and fatigue.
You may experience a serious or life-threatening infusion reaction while receiving a dose of alemtuzumab injection or for up to 3 days afterward. You will receive each dose of medicine at a medical facility and your doctor will monitor you carefully during the infusion and after you receive the medicine. It is important that you remain in the infusion center for at least 2 hours after completing the infusion. If you experience any of the following symptoms during or after the infusion, tell your doctor immediately: fever; cold; nausea; headache; vomiting hives; eruption; itching; heartburn redness; dizziness; difficulty breathing; difficulty breathing or swallowing; slow breathing; throat tightness; swelling of the eyes, face, mouth, lips, tongue, or throat; hoarseness; dizziness; daze; Fainting; fast or irregular heartbeat; or chest pain.
Alemtuzumab injection can cause a stroke or tears in the arteries that supply blood to the brain, especially during the first 3 days after treatment. If you experience any of the following symptoms during or after the infusion, tell your doctor immediately: drooping on one side of the face, severe headache, neck pain, sudden weakness or numbness in an arm or leg, especially in the one side of the body. , or difficulty speaking or understanding.
Alemtuzumab injection can increase your risk of developing certain cancers, including thyroid cancer, melanoma (a type of skin cancer), and certain blood cancers. You should have a doctor examine your skin for signs of cancer before starting treatment and once a year thereafter. Call your doctor if you have the following symptoms that may be a sign of thyroid cancer: new lump or swelling in the neck; pain in front of the neck; unexplained weight loss; bone or joint pain; lumps or swellings on your skin, neck, head, groin, or stomach; changes in the shape, size, or color of the mole or bleeding; small lesion with irregular border and portions that appear red, white, blue or blue-black; hoarseness or other voice changes that do not go away; difficulty swallowing or breathing; or cough.
Due to the risks of this drug, alemtuzumab injection is available only through a special restricted distribution program. A program called A program called Lemtrada Risk Assessment and Mitigation Strategy Program (REMS). Ask your doctor if you have any questions about how you will receive your medicine.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body’s response to alemtuzumab injection before and during your treatment and for 4 years after you receive your final dose.
Talk to your doctor about the risks of receiving alemtuzumab injection.
Why is this medication prescribed?
Alemtuzumab injection is used to treat adults with various forms of multiple sclerosis (MS; a disease in which the nerves do not function properly and people may experience weakness, numbness, loss of muscle coordination, and problems with vision, speech, and bladder control) who have not improved with at least two or more MS medications including:
- relapsing-remitting forms (course of disease where symptoms flare up from time to time) or
- secondary progressive forms (course of disease where relapses occur more often).
Alemtuzumab is in a class of drugs called monoclonal antibodies. It works by decreasing the action of immune cells that can cause nerve damage.
Alemtuzumab is also available as an injection (Campath) which is used to treat chronic lymphocytic leukemia (a slow-growing cancer in which too many white blood cells of a certain type build up in the body). This monograph only provides information on alemtuzumab (Lemtrada) injection for multiple sclerosis. If you are receiving alemtuzumab for chronic lymphocytic leukemia, read the monograph entitled Alemtuzumab Injection (Chronic Lymphocytic Leukemia).
How should this medicine be used?
Alemtuzumab injection comes as a solution (liquid) that a doctor or nurse must inject intravenously (into a vein) over 4 hours in a hospital or doctor’s office. It is usually given once a day for 5 days during the first treatment cycle. Typically, a second treatment cycle is given once a day for 3 days, 12 months after the first treatment cycle. Your doctor may prescribe an additional treatment cycle for 3 days at least 12 months after the previous treatment.
Alemtuzumab injection helps control multiple sclerosis, but it does not cure it.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before receiving alemtuzumab injection,
- Tell your doctor and pharmacist if you are allergic to alemtuzumab, any other medications, or any of the ingredients in alemtuzumab injection. Ask your pharmacist or see the Medication Guide for a list of ingredients.
- Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements you are taking or plan to take. Be sure to mention the following: alemtuzumab (Campath; brand name of product used to treat leukemia); anticancer drugs; or immunosuppressive medications such as cyclosporine (Gengraf, Neoral, Sandimmune), mycophenolate (Cellcept), prednisone, and tacrolimus (Astagraf, Envarsus, Prograf). Your doctor may need to change the doses of your medications or monitor you closely for side effects.
- Tell your doctor if you have the human immunodeficiency virus (HIV). Your doctor will probably tell you not to receive alemtuzumab injection.
- Tell your doctor if you have an infection. Also, tell your doctor if you have or have ever had tuberculosis (TB; a serious infection that affects the lungs and sometimes other parts of the body), herpes zoster (shingles; a rash that can occur in people who have had chickenpox in the past), genital herpes (a herpes virus infection that causes sores to form around the genitals and rectum from time to time), chickenpox (chickenpox), liver disease such as hepatitis B or hepatitis C, or thyroid, heart, lung, or gallbladder disease.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you are a woman, you will need to take a pregnancy test before starting treatment and use birth control to prevent pregnancy during your treatment with alemtuzumab injection and for 4 months after your course of treatment. Talk to your doctor about the types of birth control you can use to prevent pregnancy during this time. If you become pregnant while receiving alemtuzumab injection, call your doctor immediately. Alemtuzumab can harm the fetus.
- Check with your doctor to see if you need any vaccinations before receiving alemtuzumab. Tell your doctor if you have received a vaccination in the last 6 weeks. Don’t get vaccinated without checking with your doctor during your treatment.
What special dietary instructions should I follow?
Avoid the following foods that can cause infection for at least 1 month before you start alemtuzumab and during your treatment: deli meats, dairy products made from unpasteurized milk, soft cheeses, or undercooked meats, seafood, or poultry.
What side effects can this medication cause?
Alemtuzumab injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- difficulty sleeping or falling asleep
- pain in legs, arms, toes, and hands
- back, joint, or neck pain
- tingling, pricking, chilling, burning, or numb sensation on the skin
- red, itchy, or scaly skin
- swelling of nose and throat
Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:
- shortness of breath, chest pain or tightness, cough, coughing up blood, or wheezing
- fever, chills, diarrhea, nausea, vomiting, headache, joint or muscle pain, neck stiffness, difficulty walking, or mental status changes
- excessive sweating, eye swelling, weight loss, nervousness, or fast heartbeat
- unexplained weight gain, tiredness, feeling cold, or constipation
- thinking about harming or killing oneself or planning or trying to do so
- genital sores, sensation of pins and needles, or rash on penis or in vaginal area
- cold sores or fever blisters on or around the mouth
- painful rash on one side of face or body, with blisters, pain, itching, or tingling in rash area
- (in women) vaginal odor, white or yellowish vaginal discharge (may be lumpy or look like cottage cheese), or vaginal itching
- white lesions on tongue or inner cheeks
- stomach pain or tenderness, fever, nausea, or vomiting
- nausea, vomiting, stomach pain, extreme tiredness, loss of appetite, yellow eyes or skin, extreme tiredness, dark urine, or bleeding or bruising more easily than normal
- weakness on one side of the body that worsens over time; clumsiness of the arms or legs; changes in your thinking, memory, walking, balance, speech, eyesight, or strength that last several days; headaches; seizures; confusion; or personality changes
- fever, swollen glands, rash, seizures, changes in thinking or alertness, or new or worsening unsteadiness or difficulty walking
Alemtuzumab injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medicine.
If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at . If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
What other information should I know?
Ask your pharmacist any questions you have about alemtuzumab injection.
It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.
Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.