Dinutuximab (Unituxin) is a monoclonal antibody which is prescribed for the treatment of a certain type of brain tumor in the nerve cells (neuroblastoma) of children. It binds to a site called GD-2 which is present on neuroblastoma cells and kills them. Dinutuximab is used in combination with granulocyte macrophage colony stimulating factor (GM-CSF), interleukin-IL (IL-2) and retinoic acid (13 cis - retinoic acid) for the treatment.
Dinutuximab is contraindicated in children who are allergic to the drug.
The recommended dose of dinutuximab 17.5mg/5mL is administered slowly as an intravenous infusion over a period of 10 to 20 hours for 4 days. The drug can be given for a maximum of 5 cycles.
Dinutuximab is available in the form of an injection to be administered as an intravenous infusion into the vein. Do not administer dinutuximab as an intravenous push or bolus.
• The drug should be discontinued if there are any serious signs of infusion reactions, capillary leakage syndrome (where fluid leaks out of small blood vessels) or low blood pressure.
• The patient should be monitored regularly for any signs and symptoms of infections.
• The drug should be discarded if there is any presence of particulate matter or discoloration of the solution before administration.
• The drug should not be used in a pregnant woman.
• General: Pain, fever, severe infusion or allergic reactions, infections.
• Blood: Anemia, low platelet count, low white blood cell count, bone marrow suppression.
• Gastrointestinal: Nausea, vomiting, diarrhea, decreased appetite.
• Skin: Allergic reactions, hives (urticaria).
• Eye: Blurred vision, vision changes, drooping of the eyelids, photophobia (increased sensitivity to light).
• Urinary System: Loss of proteins in the urine, hemolytic uremic syndrome (destruction of red blood cells resulting in kidney failure).
• Central Nervous System: Dizziness, faintness, lightheadedness, seizures, peripheral neuropathy (damage to the peripheral nerves).
• Cardiovascular System: Capillary leak syndrome, low blood pressure.
• Liver: Abnormal levels of liver enzymes (Alanine amino transferase, Aspartate aminotransferase).
• Metabolic Problems: Low levels of sodium, potassium, magnesium, calcium and phosphate (electrolyte abnormalities), increase in weight.
• Intravenous sodium chloride is given prior to dinutuximab infusion for proper hydration.
• Analgesics like morphine sulfate or fentanyl are administered for managing pain. They are administered just prior to during and after dinutuximab infusion.
• Antihistamines like diphenhydramine are administered to prevent allergic reaction. Acetaminophen to prevent fever and medications to prevent vomiting are also administered.
No drug interactions have been studied with dinutuximab.
Dinutuximab vials should be stored in a refrigerator at 2-8°C. Do not freeze or shake the vials. Protect from excess light by storing it in the outer carton.
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