- Prevention of severe thrombocytopenia and reduction of need for platelet transfusions following myelosuppressive chemotherapy in adult patients with nonmyeloid malignancies who are at high risk of severe thrombocytopenia
- Available as a sterile powder (5 mg) packaged with diluent (1 mL of SWI).
- Refrigerate vials. Do not freeze. Protect from light.
- Reconstitute with provided diluent (SWI) to a final concentration of 5 mg/mL. Gently swirl, do not shake.
- Reconstituted solution stable for 3 hours refrigerated or at room temperature.
- Oprelvekin should not be mixed with other solutions or medications.
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | YES abdomen,thigh,hip or upper arm |
| IM | NO |
| IV Direct | NO |
| IV Intermittent Infusion | NO |
| IV Continuous Infusion | NO |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Note: First dose should not be administered until 6-24 hours after the end of chemotherapy. Discontinue the drug at least 48 hours before beginning next cycle of chemotherapy.
Children (>12 yrs)
· 75-100 mcg/kg once daily subcutaneously for 10-21 days (until post-nadir of platelet count > 50 x109/L)
· Manufacturer states that, until efficacy/toxicity parameters are established use of Oprelvekin should be limited to pediatric patients in controlled clinical trials.
Adults
· 50 mcg/kg once daily subcutaneously for 10-21 days (until post-nadir of platelet count >50 x109/L)
Dosage adjustment in renal failure (adults)
- CLcr < 30 mL/min : 25 mcg/kg
- Hypersensitivity reactions (anaphylaxis, dyspnea, flushing and/or chest pain).
- Serious fluid retention (mean increase of >20% in plasma volume)
- Cardiovascular: Tachycardia (children: 84%), palpitation, atrial arrhythmias, peripheral edema, syncope, stroke, cardiomegaly (children: 21%), CHF, palpitations, pericardial effusion
- Respiratory: Dyspnea, pleural effusion, pulmonary edema, capillary leak syndrome, pneumonia, rhinitis, cough, pharyngitis
- Dilution anemia
- Hypokalemia (mostly in patients requiring chronic diuretic therapy)
- Other side effects include: nausea, vomiting, headache, dizziness, insomnia, fatigue, fever arthralgia, myalgia, rash, skin discoloration papilledema (up to 16% in children, 2% in adults), visual disturbance, conjunctival injection (children: 57%), renal failure
- Have anaphylactic kit available at bedside.
- Monitor vital signs (Pulse, Resp. Rate, BP, Temp) Q15 minutes x 4 after administration, then Q30 minutes x 2
- Not indicated following myeloablative chemotherapy: increased toxicity and severe/fatal adverse reactions reported.
- Monitor: CBC, diff, electrolytes and fluid balance, calcium, creatinine, BUN.