Formulary
Brodalumab: Indications, Dosing, Side Effects and Interactions
Brodalumab is a recombinant human monoclonal antibody that binds with high affinity to interleukin-17RA and blocks the activity of pro-inflammatory cytokines.
MedNext Academy | 3 min read
Brodalumab: Indications, Dosing, Side Effects and Interactions
Brodalumab is a recombinant human monoclonal antibody that binds with high affinity to interleukin-17RA and blocks the activity of pro-inflammatory cytokines.
Drug action
Brodalumab is a recombinant human monoclonal antibody that binds with high affinity to interleukin-17RA and blocks the activity of pro-inflammatory cytokines.
Indications and dose
**Moderate-to-severe plaque psoriasis (under expert supervision)**
- **Adult** (By Subcutaneous Injection): 210 mg every week for 3 doses, followed by 210 mg every 2 weeks, consider discontinuing treatment if no response after 16 weeks.
Cautions
Chronic infection; history of Crohn's disease (monitor for exacerbations); history of depressive disorders (discontinue if new or worsening symptoms develop); history of recurrent infection; history of suicidal ideation or behaviour (discontinue if new or worsening symptoms develop) Cautions, further information Infection Manufacturer advises to consider anti-tuberculosis therapy for patients with latent tuberculosis before starting treatment with brodalumab. Manufacturer advises patients should be brought up-to-date with current immunisation schedule before initiating treatment.
Contraindications
Crohn's disease; clinically significant active infection
Side effects
Common or very common Arthralgia; diarrhoea; fatigue; headache; increased risk of infection; myalgia; nausea; oropharyngeal pain Uncommon Conjunctivitis Rare or very rare Anaphylactic reaction Frequency not known Meningitis cryptococcal; suicidal behaviours
Interactions
**Severe interactions:**
- In patients with moderate to severe plaque psoriasis, a single subcutaneous dose of 210 mg brodalumab increased the exposure of midazolam, a CYP3A4/3A5 substrate by 24%.
**Other interactions (3):**
- Live vaccines should not be given concurrently with brodalumab (see section 4.4).
- Although a role for interleukin (IL)-17A and IL-17RA in the regulation of CYP450 enzymes has not been reported, the effect of brodalumab on CYP3A4/3A5 activity was evaluated in a disease-drug-drug...
- Based on the magnitude of change in exposure of midazolam, no dose adjustment of CYP3A4/3A5 substrates is necessary when administered concomitantly with brodalumab.
Pregnancy
Manufacturer advises avoid-limited information available.
Breast feeding
Manufacturer advises avoid-no information available.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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