Drugs Causing Capillary Leak
Severe
Database
Additive capillary leak
Premedicate; monitor weight / albumin / BP
Source: Kimi deep-research + Cla
Drug reference
moxetumomab pasudotox-tdfk
Anti-CD22 recombinant immunotoxin (antineoplastic)
START
40 mcg/kg IV over 30 min days 1, 3, 5 per 28-day cycle
TYPICAL MAX
40 mcg/kg IV per dose; up to 6 cycles or until response
STOP IF
Capillary leak syndrome, HUS, severe infusion reaction, or AKI
WATCH
BP/weight (CLS), creatinine + LDH + platelets (HUS), albumin, hydration
CDSCO approvedATC L01XC32
KDIGO 2024 + manufacturer label
- ONSET
- 6min · infusion start
- PEAK
- 30min · end infusion
- t½
- 2h · t½
- DURATION
- 4w · q28d cycle
EXCRETION
Proteolytic catabolism; not excreted intact
route + CYP
INTERACTIONS
3 major
SEVERE in our sources
PREGNANCY
Can cause fetal harm — avoid; effective contraception during and 30 days after.
FDA category + note
Top interactionssee all 5 →
- Drugs Causing Capillary LeakSevereDatabaseKimi deep-research + Cla
- Live VaccinesSevereDatabaseKimi deep-research + Cla
- Nephrotoxic DrugsSevereDatabaseKimi deep-research + Cla
Mechanism
Recombinant single-chain anti-CD22 Fv fused to truncated Pseudomonas exotoxin A (PE38) — binds CD22 on B-cell leukaemic blasts, is internalised, and the exotoxin moiety ADP-ribosylates eEF2 to halt protein synthesis and induce apoptosis.
Indications
Relapsed/refractory hairy cell leukaemia (after ≥2 prior systemic therapies including a purine nucleoside analog)
Dosing
- Adult
- 40 mcg/kg IV over 30 min on days 1, 3, 5 of each 28-day cycle, for up to 6 cycles or until response.
- Pediatric
- Not established.
- Renal adjustment
- No adjustment for CrCl ≥30; not studied below.
- Hepatic adjustment
- No specific adjustment.
- Geriatric
- Higher AE risk; monitor closely.
- Max dose
- 40 mcg/kg IV per dose day (days 1, 3, 5 per 28-day cycle)
Pharmacokinetics
Onset
Cytoreduction over cycles
Peak effect
End of infusion (serum)
Duration
28-day cycle
Half-life
~2 h (rapid clearance; immunogenicity reduces exposure over cycles)
Bioavailability
IV 100%
Protein binding
Not applicable
Metabolism
Proteolytic catabolism
Excretion
Catabolised (not excreted intact)
Contraindications
- Severe hypersensitivity to moxetumomab
- Caution: prior haemolytic-uraemic syndrome / capillary-leak history
Side effects
Common
Infusion reactionsOedema (peripheral / facial)NauseaFatigueHeadachePyrexiaHypertension
Serious
- Capillary leak syndrome (boxed)
- Haemolytic uraemic syndrome (boxed)
- Severe infusion / hypersensitivity reactions
- Renal failure
- Severe electrolyte / coagulation abnormalities
Pregnancy & lactation
Pregnancy
Can cause fetal harm — avoid; effective contraception during and 30 days after.
Lactation
Avoid breastfeeding during therapy.
Drug interactions
Live Vaccines
Severe
Database
Immunosuppression
Avoid live vaccines
Source: Kimi deep-research + Cla
Nephrotoxic Drugs
Severe
Database
Additive renal injury + HUS risk
Avoid; monitor renal function
Source: Kimi deep-research + Cla
Antithrombotic Drugs
Moderate
Database
HUS / thrombocytopenia + bleeding risk
Monitor platelets / coagulation
Source: Kimi deep-research + Cla
Other Myelosuppressive Chemotherapy
Moderate
Database
Additive marrow suppression
Per protocol monitoring
Source: Kimi deep-research + Cla
Related guidelines
Ask House about moxetumomab pasudotox-tdfk
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20