Names and pronunciation
(treh-meh-LIM-moo-mab) Imjudo
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Drug reference
(treh-meh-LIM-moo-mab) Imjudo
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Func. class.: Antineoplastic
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Chem. class.: Monoclonal antibody ACTIONS: Cytotoxic T-lymphocyte antigen blocking antibody
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USES: Hepatocellular carcinoma in combination with durvalumab; non– small-cell lung cancer with durvalumab and platinum-based chemotherapy
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CONTRAINDICATIONS: Hypersensitivity, pregnancy Precautions: Immune-mediated pneu- monitis, immune-mediated colitis, immune-mediated hepatitis, immune- mediated endocrinopathies, immune- mediated nephritis with renal dysfunc- tion, immune-mediated pancreatitis, hypo/hyperthyroidism, active infections
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SIDE EFFECTS CNS: Fatigue GI: Diarrhea, nausea, abdominal pain MS: Pain ENDO: Hypoparathyroidism HEMA: Hemorrhage INTEG: Infusion-related reactions, rash SYST: Immune-mediated reactions
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INTERACTIONS None known NURSING CONSIDERATIONS
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DOSAGE AND ROUTES Adults <30 kg: IV 4 mg/kg on day 1. Observe the patient for signs of an infu- sion reaction for 60 min, then give durvalumab (20 mg/kg IV); continue durvalumab (4 mg/kg IV) as mono- therapy q4wk until disease progression or unacceptable toxicity Adults ≥30 kg: IV 300 mg on day 1. Observe the patient for signs of an infu- sion reaction for 60 min, then give durvalumab (1500 mg IV); continue durvalumab (1500 mg IV) as mono- therapy q4wk until disease progression or unacceptable toxicity
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Available forms: Solution for injection 25 mg/1.25 mL, 300 mg/15 mL
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Administer: IV route • Inspect for particulate matter and dis- coloration. Discard if the solution is cloudy, discolored, or visible particles are observed • Do not shake • Give tremelimumab prior to dur- valumab when given on the same day; use separate infusion bags and filters for durvalumab and tremelimumab • Withdraw the required volume of drug and transfer into an IV bag of 0.9% so- dium chloride injection or 5% dextrose injection • The maximum diluent volume for pa- tients weighing 30 kg or more (300-mg dose) is 150 mL • The maximum diluent volume for pa- tients weighing less than 30 kg (4 mg/kg dose) is 80 mL • The final concentration should not exceed 10 mg/mL • Mix by gentle inversion; do not shake • Discard partially used or empty vials • Storage after dilution: The storage time of diluted product from start of preparation until completion of the in- fusion max 24 hr under refrigeration (36°F to 46°F [2° to 8°C]) or 24 hr at room temperature (up to 86°F [up to 30°C]). Do not freeze • Give over 60 min using a sterile, low- protein-binding, 0.2- or 0.22-micron in- line filter • Observe the patient for 60 min follow- ing completion of the infusion • Do not coadminister with other drugs APPENDIX A through the same intravenous line
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Assess: • For injection site pain, swelling, red- ness: use cold compress to relieve pain/ swelling • Infections (fever, flulike symptoms, dyspnea, change in urination, redness/ swelling around any wounds), stop treat- ment if some serious infections, includ- ing sepsis, may occur, may be fatal; pa- tients with active infections should not be started on this product • Immune mediated reactions, may be fatal • Pregnancy/breastfeeding: Not to use during pregnancy and for 3 months after last dose and not to use during breast- feeding, confirm pregnancy status before using
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Evaluate: • Therapeutic response: decrease
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Patient and caregiver information: • To report signs of infection, allergic reaction, immediately • To advise all health care profession- als of Rx, OTC, herbals, supplements taken • Pregnancy/breastfeeding: To advise health care professional if pregnancy is planned or suspected or if breastfeed- ing
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