Parenteral Manual


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): 
Antisense oligonucleotide
Original Date: 
May 2017
  • Duchenne muscular dystrophy
Reconstitution and Stability: 
  • Available as 188.7 mg/mL vial - single use only
  • Clear, colourless to yellow solution  - must be free of visible particles and discolouration
  • Vial stable 24 months refrigerated (2-8 C) in the original packaging
  • Protect from light

Solutions Compatible:  0.9% NaCl


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

SC Yes - undiluted
IV Direct NO
IV Intermittent Infusion YES
Usual Dilution:  see mixing instructions below
Infusion Time:  83.3 mL/hour over 3 hours
IV Continuous Infusion NO



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


  • 6 mg/kg/dose once weekly
  • Dose should be given on the same day each week.  If a dose is missed, give as soon as possible unless it is within 2 days of the next injection date.  If it is within 2 days, wait until the next scheduled dose
  • Allow medication to come to room temperature before administration
  • Dose calculation: body weight (kg) x 6 mg/kg drisapersen = patient dose (mg)
  • Dose volume: patient dose (mg) divided by 188.7 mg/mL  = volume (mL)
  • For subcutaneous use the dose may be split into 2 portions if needed and injected into the same area on any given treatment day

Mixing instructions for IV administration:

  • Withdraw 25 mL from a 250 mL 0.9% NaCl bag. This removes the overfill volume from the bag.
  • Withdraw the equivalent volume of 0.9% NaCl to the volume of drisapersen that will be added to the bag
  • Measure the volume of drisapersen needed and add to the 250 mL bag of 0.9% NaCl.
  • Gently shake the bag to mix the contents. Cover with an amber bag to PROTECT FROM LIGHT while infusing.
  • Set the pump infusion rate to 83.3 mL/h to run over 3 hours. Flush the line after administration


Potential hazards of parenteral administration: 
  • Prolonged aPTT
  • Thrombocytopenia
  • Proteinuria
  • Hematuria
  • Hypersensitivity reactions
  • Rotate injection sites with every injection. Sites that may be used include: abdomen (not including the 5 cm area around the navel), front of middle thighs, upper outer areas of buttocks and upper back or upper arm
  • Each 0.9 mL vial contains 11.3 mg sodium and each 0.6 mL vial contains 7.5 mg of sodium
  • Does not inhibit or induce CYP450 enzymes


  • Platelet count: Baseline and every 2 weeks while on therapy
  • Urine protein (dipstick): Baseline and every 2 weeks
    -  A complete 24 hour collection must be done and dosing withheld for patients with 2 consecutive positive dipsticks of ≥1+ (30-100 mg/dL) or a single positive dipstick of ≥2+ (100-300 mg/dL)
    -  Patients with nephrotic level proteinuria (>1000 mg/m2 per 24 hours) should discontinue drisapersen permanently
    -  Patients with a urine protein >300 mg/m2 per 24 hours should interrupt treatment and may resume when urine protein is < 250 mg/m2 per 24 hours OR a urine dipstick is negative or shows trace proteinuria
  • Serum Cystatin C: Baseline and monthly
  • Liver function testing: Baseline and monthly. Monitor ALT, AST, ALP, total bilirubin, GGT
  • aPTT: Baseline and monthly
    -  Patients testing positive for Factor VIII inhibition must immediately discontinue therapy
  • Injection site reactions: with every administration. Dermatologic assessments are required every 6 months in patients that develop injection site reactions


  • Concomitant use of antiplatelet, thrombolytic or anticoagulants
  • Use of nephrotoxic agents (eg. Aminoglycosides, diuretics, NSAIDs or lithium) may increase the risk of renal adverse reactions (proteinuria)

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