Formulary
Ofatumumab: Indications, Dosing, Side Effects and Interactions
The anti-lymphocyte monoclonal antibodies cause lysis of B lymphocytes.
MedNext Academy | 3 min read
Ofatumumab: Indications, Dosing, Side Effects and Interactions
The anti-lymphocyte monoclonal antibodies cause lysis of B lymphocytes.
Drug action
The anti-lymphocyte monoclonal antibodies cause lysis of B lymphocytes.
Indications and dose
**Multiple sclerosis (initiated by a specialist)**
- **Adult** (By Subcutaneous Injection): Initially 20 mg once weekly for 3 doses (weeks 0, 1 and 2), then maintenance 20 mg once a month, starting on week 4 (2 weeks after the third dose).
Cautions
Active infection; hepatitis B carriers (seek expert advice before starting); history of progressive multifocal leukoencephalopathy Cautions, further information Immunisation Patients should receive all recommended vaccinations before starting treatment; live vaccines should be given at least 4 weeks before, and inactivated vaccines ideally at least 2 weeks before, starting ofatumumab. M
Contraindications
Active hepatitis B infection; active malignancies; severe active infection; severely immunocompromised patients
Side effects
Common or very common Cystitis; increased risk of infection; injection related reaction Frequency not known Hepatitis B reactivation; JC virus infection; progressive multifocal leukoencephalopathy (PML) Side-effects, further information If progressive multifocal leukoencephalopathy (PML) is suspected, treatment should be suspended until PML has been excluded. If a patient develops an opportunistic infection or PML, ofantumumab should be permanently discontinued.
Interactions
**Other interactions (4):**
- Vaccinations The safety of and the ability to generate a primary or anamnestic (recall) response to immunisation with live, live-attenuated or inactivated vaccines during ofatumumab treatment has...
- It is recommended that patients complete immunisations prior to the start of ofatumumab therapy (see section 4.4).
- Other immunosuppressive or immune-modulating therapies The risk of additive immune system effects should be considered when co-administering immunosuppressive therapies with ofatumumab.
- When initiating ofatumumab after other immunosuppressive therapies with prolonged immune effects or initiating other immunosuppressive therapies with prolonged immune effects after ofatumumab, the...
Pregnancy
Avoid unless potential benefit outweighs risk-no information available; if exposed during pregnancy, monitor infant for B-cell depletion. M
Breast feeding
Avoid during first few days after birth-possible risk from transfer of antibodies to infant. After this time, use during breast-feeding only if clinically needed. If ofatumumab is used throughout the third trimester, breast-feeding can start immediately after birth. 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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