Formulary
Donanemab: Indications, Dosing, Side Effects and Interactions
Donanemab is a humanised monoclonal antibody which binds to insoluble N-terminal truncated form of amyloid beta (N3pG A), thereby reducing amyloid plaques in...
MedNext Academy | 3 min read
Donanemab: Indications, Dosing, Side Effects and Interactions
Donanemab is a humanised monoclonal antibody which binds to insoluble N-terminal truncated form of amyloid beta (N3pG A), thereby reducing amyloid plaques in...
Drug action
Donanemab is a humanised monoclonal antibody which binds to insoluble N-terminal truncated form of amyloid beta (N3pG A), thereby reducing amyloid plaques in the brain.
Indications and dose
**Mild cognitive impairment or mild dementia in Alzheimer's disease [in apolipoprotein E 4 (ApoE4) heterozygotes or non-carriers] (under expert supervision)**
- **Adult** (By Intravenous Infusion): Initially 700 mg every 4 weeks for the first 3 doses, for dose interruption or treatment discontinuation due to side-effects-consult product literature, followed by 1.4 g every 4 weeks for up to a total of 18 months, for dose interruption or treatment discontinuation due to side-effects-consult product literature.
Cautions
Infusion-related reactions; risk factors for intracerebral haemorrhage Cautions, further information Infusion-related reactions Infusion-related reactions can occur and donanemab should only be administered when appropriately trained staff are available; these reactions can be managed by reducing the rate or stopping the infusion and appropriate management initiated. Patients should be closely monitored for signs of infusion-related reactions during and for at least 30 minutes after completion of the infusion. Premedication may be considered for subsequent infusions. M
Contraindications
MRI findings suggestive of cerebral amyloid angiopathy-consult product literature
Side effects
Common or very common Amyloid related imaging abnormalities; CNS haemorrhage; cortical superficial siderosis; headache; infusion related reaction; nausea; vomiting Uncommon Hypersensitivity
Interactions
**Other interactions (3):**
- No pharmacokinetic drug interactions are expected based on the characteristics of donanemab.
- The risk of intracerebral haemorrhage with donanemab treatment is increased in patients receiving anticoagulant therapy or thrombolytic agents (see sections 4.3 and 4.4).
- Caution should be exercised when considering the administration of antithrombotics because ARIA-H and intracerebral haemorrhages greater than 1 cm in diameter have been observed in patients taking...
Pregnancy
Avoid (no information available). M
Breast feeding
Use only if potential benefit outweighs risk (no information available). M
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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