Alternate Name(s):
Ilaris
Classification:
Disease-Modifying Antirheumatic Drug; Interleukin-1 Receptor Antagonist
Original Date:
June 2013
Indications:
- Active Systemic Juvenile Idiopathic Arthritis (SJIA)
- Cryopyrin-Associated Periodic Syndromes (CAPS) (Familial Cold Autoinflammatory Syndrome & Muckle-Wells Syndrome)
- Neonatal-Onset Multisystem Inflammatory Disease (NOMID)/Chronic Infantile Neurological, Cutaneous, Articular Syndrome (CINCA)
Reconstitution and Stability:
- Available as 150 mg vial - single use, preservative-free
- Refrigerate vials; DO NOT freeze; Protect from light
- Reconstitute each vial by slowly injecting 1 mL of preservative-free Sterile Water for Injection to get a 150 mg/mL solution
- Swirl vial slowly at an angle (about 45 degrees) for approximately 1 minute and allow to stand for 5 minutes
- Gently turn vial upside down and back again 10 times
- Allow to stand 15 minutes at room teperature to obtain a clear soltuion
- DO NOT SHAKE
- DO NOT use if particulate matter is present in the solution - final product should be free from particulates and colourless to slightly brownish-yellow tint. DO NOT use if solution has a distinctly brown discoloration
- Slight foaming of the product upon reconstitution is not unusual
- Refrigerate syringe and protect from light; Stable 60 minutes at room temperature or 24 hours refrigerated
Compatibility:
- Solutions Compatible: no information
- Additives/Above Cassette Compatible: no information
- Y-Site Compatible: no information
- Incompatible: No information
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | YES Rotate injection sites |
| IM | NO |
| IV Push | NO |
| IV Intermittent Infusion | NO |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- Systemic Juvenile Idiopathic Arthritis (SJIA):
- greater than or equal to 7.5 kg: 4 mg/kg/dose (up to MAXIMUM 300 mg) subcutaneously every 4 weeks
- Cryopyrin-Associated Periodic Syndromes (CAPS):
- less than or equal to 40 kg: 2 mg/kg/dose (up to 3 mg/kg/dose if inadequate response) subcutaneously every 8 weeks
- greater than 40 kg: 150 mg subcutaneously every 8 weeks
Potential hazards of parenteral administration:
- Contraindicated in patients with active, severe infections or neutropenia
- There have been some cases of mild hypersensitivity reactions in clinical trials. No anaphylactic reactions have been reported, but the risk of severe hypersensitivity reactions cannot be excluded
- Monitor for injection site reactions (mild to moderate)
Notes:
- DO NOT inject live vaccines concurrently - ensure immunizations are up to date before initiating therapy (including pneumococcal and inactivated influenza vaccine)
- DO NOT inject into scar tissue (may result in insufficient exposure)
- Possible adverse reactions: increased incidence of severe infections, high blood pressure, neutropenia, hypersensitivity or injection - site reactions, elevated transaminases or bilirubin, and vertigo
- Monitor ANC
- Annual monitoring for changes in lipid profile is recommended