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Efalizumab

Generic name: Efalizumab
Brand names: Raptiva

Why is Efalizumab prescribed?

Psoriasis is a skin disease that is caused, in part, by an overactive immune system. Efalizumab belongs to a class of drugs called immunosuppressives, which decrease the activity of the immune system. It is prescribed for patients with severe plaque psoriasis who can no longer control their disease with medications applied to the skin.

Most important fact about Efalizumab

Efalizumab, like other immunosuppressive agents, has the potential to increase the risk of serious infections and cancer. Call your doctor immediately if you are diagnosed with cancer or your psoriasis worsens. Also contact your doctor if you develop an infection, excessive bleeding, or unusual bruising.

How should you take Efalizumab?

Efalizumab is administered once a week, as an injection under the skin (also called a subcutaneous injection). If you will be giving the injection to yourself or another person, the doctor will instruct you on how to prepare and inject the medication. The usual sites for injection are the upper leg, upper arm, abdomen, or buttocks. The injection site should be rotated each week. Do not change the dose or stop taking Efalizumab without first talking to your doctor.

Once Efalizumab has been mixed, it should be used right away. If you are unable to inject the medication immediately, you may let the mixture sit at room temperature for up to 8 hours before injecting it. However, do not use the mixture once 8 hours has passed; throw it away and mix a new solution instead.

Do not use the solution if it appears discolored or has particles floating in it. Throw it out and mix a new solution instead.

--If you miss a dose...

Call your doctor to find out when to take your next dose and what schedule you should follow after that.

--Storage instructions...

Efalizumab should be stored in its original carton in the refrigerator. Do not freeze the medication. Protect the vial from exposure to light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Efalizumab.

• Common side effects may include:
  Acne, backache, chills, fever, flu-like symptoms, headache, infections, muscle aches, nausea, pain

There have been very rare reports of more serious side effects during Efalizumab treatment. These include cancer (mainly skin cancer), serious and possibly life-threatening infections, and low blood cell platelets, which can lead to abnormal bleeding.

This side effects list is not complete. If you have any questions about side effects you should consult your doctor. Report any new or continuing symptoms to your doctor right away.

Why should Efalizumab not be prescribed?

You should not use Efalizumab if you have an active infection, cancer, or an impaired immune system. You must also avoid Efalizumab if you"ve ever had an allergic reaction to it.

Special warnings about Efalizumab

Many people experience a reaction the first time they receive a dose of Efalizumab. Symptoms include headache, fever, nausea, vomiting, muscle aches, and chills, which usually occur within 2 days following the first two injections. To minimize these side effects, the first dose of Efalizumab will be lower than the following doses.

Your psoriasis may worsen or new forms of psoriasis may appear while you"re using Efalizumab or after treatment has stopped. Tell your doctor right away if your symptoms worsen or if a new rash appears.

Efalizumab may affect the ability of your blood to clot. Be sure to inform your doctor immediately if you develop bleeding gums, unusual bruising, or purplish-red spots on your skin.

Do not undergo phototherapy while taking Efalizumab.

Be sure to throw away all syringes and needles after one use. Do not save them for later.

Possible food and drug interactions when taking Efalizumab

If Efalizumab is taken with certain other drugs, the effects of either drug could be increased, decreased, or altered. It is especially important to check with your doctor before taking the following medications:

Immunosuppressive drugs such as cyclosporine (Neoral, Sandimmune) or methotrexate (Rheumatrex, Trexall)
Vaccines

Special information if you are pregnant or breastfeeding

The effects of Efalizumab during pregnancy have not been adequately studied. If you are pregnant, planning to become pregnant, or if you become pregnant within 6 weeks of stopping Efalizumab, inform your doctor immediately.

It is not known if Efalizumab appears in breast milk. If Efalizumab is essential to your health, your doctor may advise you to stop breastfeeding until your treatment is finished.

Recommended dosage

ADULTS

To avoid an allergic reaction the first time you inject Efalizumab, the recommended initial dose is 0.7 milligrams per 2.2 pounds of body weight. Thereafter, the recommended dose is 1 milligram per 2.2 pounds of body weight, injected once a week. Individual doses should not exceed a total of 200 milligrams. Efalizumab should be injected on the same day each week.

Overdosage

There have been very few reports of Efalizumab overdose. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek emergency treatment immediately.