Names and pronunciation
(en-fyoo′vir-tide) Fuzeon
PDF page 469
Loading InternPractice…
Drug reference
(en-fyoo′vir-tide) Fuzeon
PDF page 469
Func. class.: Antiretroviral
PDF page 469
Chem. class.: Fusion inhibitor
PDF page 469
ACTION: Inhibitor of the fusion of HIV-1 with CD4+ cells
PDF page 469
USES: Treatment of HIV-1 infection in combination with other antiretrovi- rals in those who are treatment experi- enced only
PDF page 469
Unlabeled uses: HIV prophylaxis after occupational exposure
PDF page 469
CONTRAINDICATIONS: Breast- feeding, hypersensitivity Precautions: Pregnancy, children <6 yr, liver disease, myelosuppression, infections
PDF page 469
SIDE EFFECTS CNS: Anxiety, peripheral neuropathy, taste disturbance, Guillain-Barré syn- drome, insomnia, depression, fatigue, peripheral neuropathy GI: Nausea, abdominal pain, anorexia, constipation, pancreatitis, dry mouth, weight loss GU: Glomerulonephritis, renal failure HEMA: Thrombocytopenia, neutropenia INTEG: Injection site reactions, skin papilloma MISC: Influenza, cough, conjunctivitis, lymphadenopathy, myalgia, hyperglyce- mia, pneumonia, rhinitis, bacterial fatigue, hypersensitivity
PDF page 469
INTERACTIONS Drug/Lab Increase: LFTs, lipase, CK, triglycerides Decrease: Hb Drug/Drug Increase: effect of either product— protease inhibitor
PDF page 469
DOSAGE AND ROUTES • Adult: SUBCUT 90 mg (1 mL) bid • Child ≥11 kg: SUBCUT 2 mg/kg bid, max 90 mg bid HIV prophylaxis (unlabeled) • Adult: SUBCUT 90 mg bid added to PEP regimen
PDF page 469
Available forms: Powder for injection, lyophilized 108 mg (90 mg/mL when reconstituted)
PDF page 469
Administer: SUBCUT route • Reconstitute vial with 1.1 mL sterile water for injection; tap and roll to mix; allow to stand until completely dis- solved, may take up to 45 min; after dissolved, immediately inject or refrig- erate up to 24 hr • Do not mix with other medications E • SUBCUT: Give bid, rotate sites; pre- ferred sites: upper arm, anterior thigh, abdomen • Storage: Use reconstituted product within 24 hr, refrigerated, let product come to room temperature prior to injecting
PDF page 469
Assess: • Signs of infection, injection site re- actions: use analgesics; bacterial pneu- monia may occur if blood counts are low or viral load is high or low CD4 counts, IV drug user, lung disease, smoker • Peripheral neuropathy: may occur and last for several months, where nerves are close to the skin those with coagulation disorders are at greater risk • Glomerulonephritis/renal failure: BUN, creatinine, renal failure may occur • Bowel pattern prior to, during treat- ment; if severe abdominal pain or consti- pation occurs, notify prescriber; monitor hydration • Hypersensitivity: skin eruptions, rash, urticaria, itching; assess allergies prior to treatment, reaction to each med- ication; may occur quickly or later after continued use, stop product, do not re- start • Pneumonia: those with low CD4 count or increased viral load are more susceptible • Immune reconstitution syndrome: with combination theory • HIV: CBC, blood chemistry, plasma HIV RNA, absolute CD4+/CD8+ cell counts/%, serum β2 microglobulin, serum ICD+24 antigen levels, cholesterol • Injection site reactions: monitor for pain, redness, swelling at site, treat as needed • Pregnancy/breastfeeding: identify if pregnancy is planned or suspected, if breastfeeding; if pregnant, register with the Antiretroviral Pregnancy Registry (800-258-4263)
PDF page 470
Evaluate: • Therapeutic response: increased CD4 cell counts; decreased viral load; slowing progression of HIV-1 infection
PDF page 470
CLINICAL CONSIDERATIONS
PDF page 470
Patient and caregiver information: • That pneumonia may occur; to contact prescriber if cough, fever occur • That hypersensitive reactions may oc- cur; rash, pruritus; to stop product, con- tact prescriber • That product is not a cure for HIV-1 infection but controls symptoms; HIV-1 can still be transmitted to others; that product is to be used in combination only with other antiretrovirals • How to prepare and give using SUBCUT injection, watch for site reactions, rotate sites; if more information is needed, call 877-438-9366 • To notify prescriber if pregnancy is suspected; not to breastfeed, to register with the Antiretroviral Pregnancy Registry (800-258-4263) HIGH ALERT
PDF page 470
PHARMACOKINETICS Peak 8 hr, terminal half-life 3.8 hr, well absorbed, undergoes catabolism, 92% protein binding
PDF page 469
• Adult: SUBCUT 90 mg (1 mL) bid
PDF page 469
• Adult: SUBCUT 90 mg bid added to PEP regimen
PDF page 469