Drug Action
Siltuximab is a monoclonal antibody that inhibits interleukin-6 receptor binding.
PDF page 957
Loading InternPractice…
Drug reference
Siltuximab is a monoclonal antibody that inhibits interleukin-6 receptor binding.
PDF page 957
Treatment of multicentric Castleman’s disease (MCD) in patients who are human immunodeficiency virus (HIV) negative and human herpesvirus-8 (HHV-8) negative ▶BY INTRAVENOUS INFUSION ▶Adult: 11 mg/kg every 3 weeks
PDF page 957
Patients at increased risk of gastrointestinal perforation—promptly investigate those presenting with symptoms suggestive of gastrointestinal perforation. severe infection—withhold treatment until resolved. treat infection prior to treatment CAUTIONS, FURTHER INFORMATION ▶Hypersensitivity reactions Infusion-related side-effects are reported commonly with siltuximab; resuscitation facilities should be available during treatment. Consult product literature for further information about siltuximab cautions.
PDF page 957
→Appendix 1: monoclonal antibodies
PDF page 957
▶Common or very common Abdominal pain. hypersensitivity. hypertension. hypertriglyceridaemia. increased risk of infection. infusion related reaction. localised oedema. neutropenia. renal impairment. skin reactions. thrombocytopenia. weight increased SIDE-EFFECTS, FURTHER INFORMATION Siltuximab therapy should be discontinued permanently in the event of a severe infusion-related reaction, anaphylaxis, a severe allergic reaction, or the occurrence of cytokine-release syndrome. Mild to moderate infusion-related reactions may improve by temporarily reducing the rate or stopping the infusion. When restarting treatment, a reduced infusion rate and the administration of antihistamines, paracetamol, and corticosteroids may be considered. Consider discontinuation of siltuximab if more than 2 doses are delayed due to treatment-related toxicities during the first 48 weeks—for full details consult product literature.
PDF page 957
Women of Immune system and malignant disease childbearing potential should use effective contraception during and for 3 months after treatment.
PDF page 957
Manufacturer advises avoid unless potential benefit outweighs risk.
PDF page 957
Manufacturer advises avoid—no information available.
PDF page 957
Manufacturer advises caution (no information).
PDF page 957
▶Monitor neutrophil and platelet count, and haemoglobin levels prior to each dose of siltuximab treatment for the first 12 months and thereafter prior to every third dosing cycle. Consider delaying treatment if required neutrophil, platelet, and haemoglobin levels not achieved—consult product literature for details. ▶Monitor for infection during treatment.
PDF page 957
For intravenous infusion (Sylvant ®), give intermittently in Glucose 5%. Allow vials to reach room temperature over approximately 30 minutes, then reconstitute each 100 mg vial with 5.2 mL of water for injection, and each 400 mg vial with 20 mL of water for injection, to produce a 20 mg/mL solution. Gently swirl without shaking to dissolve. Further dilute to 250 mL with glucose 5% and gently mix. Use within 6 hours of dilution and give over 60 minutes using an administration set lined with polyvinyl chloride or polyurethane, through a low-protein binding in-line 0.2 micron filter.
PDF page 957
There can be variation in the licensing of different medicines containing the same drug. Powder for solution for infusion ▶Sylvant (Janssen-Cilag Ltd) A Siltuximab 100 mg Sylvant 100mg powder for concentrate for solution for infusion vials | 1 vial P £415.00 (Hospital only) Siltuximab 400 mg Sylvant 400mg powder for concentrate for solution for infusion vials | 1 vial P £1,661.00 (Hospital only)
PDF page 957
11 mg/kg every 3 weeks
First-line fragment. Read the complete Indications and Dose section above.
PDF page 957