Drug Action
Caplacizumab is a monoclonal antibody fragment (nanobody) that binds to von Willebrand factor, thereby inhibiting platelet adhesion.
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Drug reference
Caplacizumab is a monoclonal antibody fragment (nanobody) that binds to von Willebrand factor, thereby inhibiting platelet adhesion.
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Acquired thrombotic thrombocytopenic purpura (specialist use only) ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: Initially 10 mg for 1 dose, given before plasma exchange, followed by (by subcutaneous injection) 10 mg once daily given after each plasma exchange during, and for 30 days after finishing, daily plasma exchange therapy, treatment may be continued after this if there is evidence of unresolved immunological disease
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Active bleeding (interrupt treatment)
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Increased risk of bleeding
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Caplacizumab is a biological medicine. Biological medicines must be prescribed and dispensed by brand name, see Biological medicines and Biosimilar medicines, under Guidance on prescribing p. 1. l HANDLING AND STORAGE Manufacturer advises store in a refrigerator (2-8°C) and protect from light—consult product literature for further information regarding storage outside refrigerator.
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→Appendix 1: caplacizumab
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▶Common or very common Cerebral infarction. dyspnoea. fatigue. fever. haemorrhage. headache. menorrhagia. myalgia. subarachnoid haemorrhage. urticaria
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Manufacturer advises avoid—no information available.
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Manufacturer advises avoid—no information available.
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Manufacturer advises caution in severe impairment (no information available).
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Manufacturer advises injection into the abdomen. Patients may self-administer Cablivi ® after appropriate training in subcutaneous injection technique.
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There can be variation in the licensing of different medicines containing the same drug. Powder and solvent for solution for injection Blood and nutrition EXCIPIENTS: May contain Polysorbates A ▶Cablivi (Sanofi) Caplacizumab 10 mg Cablivi 10mg powder and solvent for solution for injection vials | 1 vial P £4,143.00 (Hospital only) 4.2b Immune thrombocytopenia Immune thrombocytopenic purpura Overview Acute immune (idiopathic) thrombocytopenic purpura is usually self-limiting in children. In adults, immune thrombocytopenic purpura can be treated with a corticosteroid, e.g. prednisolone p. 716, gradually reducing the dose over several weeks. Splenectomy is considered if a satisfactory platelet count is not achieved or if there is a relapse on reducing the dose of corticosteroid or withdrawing it. Immunoglobulin preparations, are also used in immune thrombocytopenic purpura or where a temporary rapid rise in platelets is needed, as in pregnancy or pre-operatively; they are also used for children often in preference to a corticosteroid. Anti-D (Rh0) immunoglobulin p. 1356 is effective in raising the platelet count in about 80% of unsplenectomised rhesus-positive individuals; its effects may last longer than normal immunoglobulin p. 1358 for intravenous use, but further doses are usually required. Other therapies that have been tried in refractory immune thrombocytopenic purpura include: azathioprine p. 881, cyclophosphamide p. 945, vincristine sulfate p. 980, ciclosporin p. 883, and danazol p. 783. Rituximab p. 933 [unlicensed indication] may also be effective and in some cases induces prolonged remission. For patients with chronic severe thrombocytopenia refractory to other therapy, tranexamic acid p. 117 may be given to reduce the severity of haemorrhage. Eltrombopag p. 1094 and romiplostim p. 1095 are thrombopoietin receptor agonists. They are licensed for the treatment of chronic immune thrombocytopenic purpura in patients refractory to other treatments, such as corticosteroids or immunoglobulins. They should both be used under the supervision of a specialist. ANTIHAEMORRHAGICS › THROMBOPOIETIN RECEPTOR AGONISTS
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Missed doses Manufacturer advises if a dose is more than 12 hours late, the missed dose should not be given and the next dose should be given at the normal time.
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Initially 10 mg for 1 dose, given before plasma
First-line fragment. Read the complete Indications and Dose section above.
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