Drug reference

Alemtuzumab

Immunosuppressant · Disease-Modifying Drug for Multiple Sclerosis

Also known as Lemtrada

ImmunosuppressantDisease-Modifying Drug for Multiple Sclerosis

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

[MHRA/CHM advice]. . Multiple sclerosis p. 893 and Nausea and labyrinth

FDA category + note

Top interactionssee all 12 →

Purine AnaloguesSevereTextbookG&G 14e · p1426
BaricitinibSevereDatabaseDDInter
CladribineSevereDatabaseDDInter
ClozapineSevereDatabaseDDInter

Mechanism

Alemtuzumab is a humanized IgG1 monoclonal antibody that targets CD52, a glycoprotein found on B and T lymphocytes, NK cells, monocytes, and macrophages. Binding to CD52 induces direct antibody-dependent cell lysis, leading to the depletion of these immune cells. This results in profound lymphopenia, which transiently rebalances the immune system and produces an immunosuppressive effect.

Indications

Relapsing-remitting multiple sclerosis (for more active disease)chronic lymphocytic leukemiamsprevention of transplant rejectiontreatment of transplant rejectionrelapsing-remitting ms (recommended for patients who have had suboptimal response to two other disease-modifying agents)B-cell CLL (single agent)relapsing forms of multiple sclerosis

Dosing

Adult: adults and adolescents [MHRA/CHM advice]. . Empagliﬂozin p. 744 (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice]. Ertugliﬂozin p. 746 (SGLT2 inhibitors): monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness [MHRA/CHM advice]. Etonogestr...

Pharmacokinetics

Half-life

initial mean 1 hour, but after multiple doses, extends to 12 days

Side effects

Common

neutropeniathrombocytopeniaanemiaprolonged lymphocyte depletionsecondary autoimmunity

Serious

Serious cardiovascular reactions
Serious immune-mediated reactions
autoimmune hemolytic anemia
other autoimmune diseases (due to immune reconstitution after profound lymphocyte depletion)
adverse infusion responses
serious autoimmune reactions
association with malignancies
high risk of second-degree thyroiditis
acute infusion reactions
depletion of normal neutrophils and T cells
myelosuppression (with depletion of all blood lineages)
immunosuppression (significant risk of fungal, viral, and other opportunistic infections)
reactivation of cytomegalovirus infections
profound CD4+ T-cell depletion (<200 cells/μL) for 1 year

Pregnancy & lactation

Pregnancy

[MHRA/CHM advice]. . Multiple sclerosis p. 893 and Nausea and labyrinth

Drug interactions

Purine Analogues

Severe

Textbook

Significant risk of fungal, viral, and other opportunistic infections, particularly in patients who have previously received purine analogues.

Patients should receive prophylaxis against Pneumocystis carinii and herpesvirus during treatment and for at least 2 months following therapy with alemtuzumab.

Source: G&G 14e · p1426

Baricitinib

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Cladribine

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Clozapine