Names and pronunciation
Egrifta
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Drug reference
Egrifta
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Func. class.: Pituitary hormone, growth hormone modifiers
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ACTION: Binds to growth hormone (GH) releasing factor receptors on the pituitary somatotroph cells; binding stimulates the production, release of endogenous GH
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USES: Treatment of excess abdominal fat in HIV-infected patients with lipodystrophy
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CONTRAINDICATIONS: Hyper- sensitivity to this product or mannitol, neoplastic disease, pregnancy, disruption of the hypothalamic-pituitary axis (hypothalamic-pituitary-adrenal [HPA] suppression) due to hypophysectomy, hypopituitarism, pituitary tumor/surgery, radiation therapy of the head or head trauma, IV/IM administration Precautions: Breastfeeding, CABG, dia- betes, diabetic retinopathy, edema, geriat- ric patients, children, infants, adolescents
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SIDE EFFECTS CNS: Depression, peripheral neuropathy paresthesias, hypoesthesia, flushing, night sweats, insomnia, headache CV: Hypertension, edema, peripheral edema, chest pain, palpitations GI: Nausea, vomiting, upper abdominal pain, dyspepsia, diarrhea, constipation T INTEG: Pruritus, urticaria, rash, flush- ing, injection site reactions MS: Arthralgia, joint swelling, stiff- ness, myalgias, carpal tunnel syndrome RESP: Upper respiratory tract infection SYST: Secondary malignancy META: Hypercalcemia, hyperuricemia
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INTERACTIONS Decrease: effect of—simvastatin, ritona- vir, cortisone, predniSONE
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DOSAGE AND ROUTES • Adult: SUBCUT 2 mg/day
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Available forms: Powder for injection 1 mg
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Administer: Subcut route: • Visually inspect parenteral products for particulate matter and discoloration before use • To reconstitute, use 2, 1-mg vials, inject 2.1 mL sterile water for inj into the first 1-mg vial; use syringe with needle attached; to avoid foaming, push plunger in slowly and roll for 30 sec until mixed; do not shake; withdraw 2.1 mL of the reconstituted sol and add to second 1-mg vial; roll, do not shake • Use a 0.5-inch 27-G safety injection needle; use immediately; inject subcut into abdomen; avoid scar tissues, bruises, navel; rotate sites; slowly push plunger down until all sol has been injected • Use a piece of sterile gauze to rub the inj site clean; if bleeding, apply pressure to site with gauze for 30 sec; if bleeding continues, apply a bandage to site • Properly dispose of used syringe, nee- dles, vial, and sterile water for injection bottle
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Assess: • Lipodystrophy: sunken cheeks, thin- ning arms and legs, fat accumulation in the abdomen, jaws, and back of neck; after treatment these should lessen • Monitor for edema, joint pains, carpal tunnel syndrome, therapy may need to be discontinued • Monitor glycosylated hemoglobin A1c (HbA1c), serum IGF-1 concentrations, ophthalmologic exam • Beers: avoid in older adults except as hor- mone replacement following pituitary gland removal; may cause edema, arthralgia • Pregnancy/breastfeeding: do not use in pregnancy, breastfeeding
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Evaluate: • Decreasing lipodystrophy in HIV patients Patient and caregiver information: • That body fat distribution should change • That lab exams will be needed • If dose is missed, skip and continue with regular schedule • About injection technique and pre- ferred injection sites; to avoid bruised, scarred, or broken skin • About expectations; the product is not indicated for weight-loss management • Hypersensitivity: To report rash, swelling of face, trouble breathing im mediately • Fluid retention: To report edema, joint pain • To notify prescriber if pregnancy is planned or suspected, to avoid breast- feeding
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CLINICAL CONSIDERATIONS
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PHARMACOKINETICS Half-life 26 min in healthy patients, 38 min in those with HIV infection; peak 0.15 hr
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• Adult: SUBCUT 2 mg/day
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