Parenteral Manual

Daclizumab (NON-FORMULARY)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
ZENAPAX®
Classification: 
Monoclonal antibody immune suppressant
Original Date: 
August 2005
Indications: 
  • Adjunctive prophylaxis of acute organ rejection in renal transplantation
  • GVHD in bone marrow transplant patients
Reconstitution and Stability: 
  • Available as 5 mg/mL solution, preservative free
  • Refrigerate
  • Do not shake (avoid foaming) or freeze
  • Protect from direct light
  • Diluted solution stable 24 hours at 2-8°C and 4 hours at room temperature
  • Single use vial; discard any remaining solution
  • Discard if coloured or if particulate matter is present
Compatibility: 

- Solutions Compatible: 0.9% NaCl

- Incompatible: should not be mixed or infused with any other medications

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Push

NO
IV Intermittant Infusion YES
Usual dilution: dilute in 50 mL of 0.9% NaCl
Fluid restricted patients: 1 mg/mL
Infusion time: 15 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric/Adult:
- Renal Transplant:

  • 1 mg/kg/dose IV Q 14 days for a total of 5 doses (Maximum: 100 mg/dose)
  • First dose is given <24 hours before transplantation
  • Doses should be given within 24 hours of scheduled date

- GVHD:

  • 0.5-1.5 mg/kg IV
  • Has been repeated in 11-48 days

- Dosage may differ according to protocol

Potential hazards of parenteral administration: 
  • Anaphylactoid reactions
  • Diaphoresis, chills after first dose
  • Hypertension, fever, vomiting, pruritis- more common in pediatrics than adults
  • Increased susceptibility to infection
  • Increased risk for developing lymphoproliferative disorders

- Treatment from unusual side effects are available through the study chair identified on the front page of the protocol and/or pharmacy

Notes: 
  • Monitor CBC with differential, vital signs, renal function tests, serum glucose
  • Contraindicated in patients with known hypersensitivity to mouse cell proteins
  • Avoid concurrent use of Echinacea (may antagonize immunosuppressant effect of daclizumab)

  • No dosage adjustment necessary in renal impairement

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