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Care During Chemotherapy and Beyond

Eculizumab

(ek-u-liz-oo-mab)

Generic Name: Eculizumab

Trade Name: Soliris®

Eculizumab is the generic name for the trade chemotherapy drug Soliris.  In some cases, health care professionals may use the trade name Soliris when referring to the generic drug name eculizumab.

Drug Type:

Eculizumab is a “monoclonal antibody” that binds or attaches to a protein present in the blood.

What Eculizumab Is Used For:

Eculizumab is used for the treatment of the blood disorders:

  • paroxysmal nocturnal hemoglobinuria (PNH)

  • atypical Hemolytic Uremic Syndrome (aHUS)

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Exulizumab Is Given:

  • Eculizumab is given through an infusion into a vein (intravenous, IV). 

The amount of eculizumab that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact eculizumab dosage and schedule.

Side Effects:

Important things to remember about the side effects of eculizumab:

  • Most people will not experience all of the eculizumab side effects listed.
  • Eculizumab side effects are often predictable in terms of their onset, duration, and severity.
  • Eculizumab side effects are almost always reversible and will go away after therapy is complete.
  • Eculizumab side effects may be quite manageable. There are many options to minimize or prevent the side effects of eculizumab.

The following eculizumab side effects are common (occurring in greater than 30%) for patients taking eculizumab:

These are less common side effects for patients receiving eculizumab:

This list includes common and less common side effects for those taking eculizumab. Eculizumab side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. Always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your doctor or health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C), chills (possible signs of infection)
  • Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling of facial features, hives (possible allergic reaction).
  • Change in thinking clearly and with logic.
  • Dark urine (tea or coca-cola colored urine).

The following symptoms require medical attention, but are not an emergency. Contact your doctor or health care provider within 24 hours of noticing any of the following:

  • Signs of infection such as redness or swelling, pain on swallowing, mouth sores, sore throat, coughing up mucous, or burning with urination.
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools or urine
  • Extreme fatigue (unable to carry on self-care activities)
  • Yellowing of the skin or eyes
  • Swelling of the feet or ankles. Sudden weight gain
  • Very bad headache
  • Neck stiffness.

Always inform your doctor or health care provider if you experience any unusual symptoms.

Precautions:

  • Very bad meningococcal infections have happened in patients who have taken this drug.  A meningococcal vaccine is recommended at least 2 weeks before starting this drug. 
  • Before starting eculizumab treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • While taking eculizumab, do not receive any kind of immunization or vaccination without your doctor’s approval.  It is recommended that you are up to date with your vaccinations before starting treatment with eculizumab discuss this with your doctor.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
  • For both men and women: Use contraceptives and do not conceive a child (get pregnant) while taking eculizumab. Barrier methods of contraception such as condoms are recommended.
  • Do not breast feed while taking eculizumab.

Self-Care Tips:

  • While taking eculizumab drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • To help treat/prevent mouth sores while taking eculizumab, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals while taking eculizumab.
  • Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely while you are taking eculizumab. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition while being treated with eculizumab.

If you experience symptoms or side effects while being treated with eculizumab, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking eeculizumab, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How Eculizumab Works:

Eculizumab is classified as a monoclonal antibody.  Monoclonal antibodies are a relatively new type of "targeted" cancer or biologic therapy. Antibodies are an integral part of the body's immune system.  Normally, the body creates antibodies in response to an antigen (such as a protein in a germ) that has entered the body.  The antibodies attach to the antigen in order to mark it for destruction by the immune system.

In the laboratory, scientists analyze specific antigens on the surface of cancer cells (target) to determine a protein to match the antigen. Then, using protein from animals and humans, scientists work to create a special antibody that will attach to the target antigen. An antibody will attach to a matching antigen like a key fits a lock. This technology allows treatment to target specific cells, causing less toxicity to healthy cells. Monoclonal antibody therapy can be done only for cancers or diseases in which antigens (and the respective antibodies) have been identified.

Eculizumab is a targeted therapy that targets and binds to the complement protein C5, this in turn prevents the splitting of this protein interfering with the formation of membrane attack complex (MAC).  This interference prevents the destruction of red blood cells (hemolysis) and therefore results in stabilization of hemoglobin and a decrease in the need for blood transfusions in persons with paroxysmal nocturnal hemoglobinuria (PNH).

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.


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