Ecallantide

INTRODUCTION

Indications

Treatment of acute attacks of hereditary angioedema (HAE) in patients ≥16 yr.

Action

Acts as a selective, reversible inhibitor of kallikrein, thereby inhibiting its action in initiating bradykinin production, part of the cascade of events in HAE. Therapeutic Effects: Decreased severity of attack of HAE.

Adverse Reactions/Side Effects

CNS: headache, fatigue. EENT: nasopharyngitis. GI: nausea, abdominal pain, diarrhea. Derm: pruritus, rash, urticaria. Local: injection-site reactions. Misc: HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS, fever.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Watch for signs of hypersensitivity reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria, dermatitis, welts, burning/itching skin, swelling in the face). Notify physician or nursing staff immediately if these reactions occur.

• Monitor subcutaneous injection site for pain, swelling, and irritation. Report prolonged or excessive injection site reactions to the physician.

Patient/Client-Related Instruction

• Instruct patient to report other troublesome side effects such as prolonged or severe headache, fatigue, fever, upper respiratory tract irritation, skin reactions (rash, itching, hives), or GI problems (nausea, diarrhea, abdominal pain).

Pharmacokinetics

Absorption: Well absorbed following subcutaneous administration.

Distribution: Unknown.

Metabolism and Excretion: Renally eliminated.

Half-life: 2 hr.

Contraindications/Precautions

Contraindicated in: Hypersensitivity.

Use Cautiously in: Geri: Consider age-related ↓ in hepatic, renal, or cardiac function, concomitant diseases or other drug therapy; lower initial dose may be considered; Lactation: Use cautiously; OB: Use only if clearly needed.

Interactions

Drug-Drug: None noted.

Route/Dosage

Subcut (Adults ≥ 16 yr): 30 mg given as 3 10-mg injections; an additional dose of 30 mg may be given within 24 hr.

Availability

Injection for subcutaneous use: 10 mg/mL.