Formulary
Satralizumab: Indications, Dosing, Side Effects and Interactions
Satralizumab is a recombinant humanised monoclonal antibody that inhibits interleukin-6 signalling.
MedNext Academy | 3 min read
Satralizumab: Indications, Dosing, Side Effects and Interactions
Satralizumab is a recombinant humanised monoclonal antibody that inhibits interleukin-6 signalling.
Drug action
Satralizumab is a recombinant humanised monoclonal antibody that inhibits interleukin-6 signalling.
Indications and dose
**Neuromyelitis optica spectrum disorder (initiated under specialist supervision)**
- **Adult** (By Subcutaneous Injection): Initially 120 mg every 2 weeks for the first 3 doses, followed by maintenance 120 mg every 4 weeks.
**Neuromyelitis optica spectrum disorder (initiated under specialist supervision) for satralizumab**
- **Child 12-17 years (body-weight 40 kg and above)** (By subcutaneous injection): Initially 120 mg every 2 weeks for the first 3 doses, followed by maintenance 120 mg every 4 weeks.
Cautions
Active infection (delay treatment until infection is controlled); immunisation Cautions, further information Immunisation Patients should receive all recommended vaccinations before starting treatment-immunisation during treatment has not been studied. Live or live attenuated vaccines should be avoided during treatment-safety is unknown. M
Side effects
Common or very common Allergic rhinitis; arthralgia; bradycardia; gastritis; headaches; hyperlipidaemia; hypertension; hypofibrinogenaemia; injection related reaction; insomnia; musculoskeletal stiffness; peripheral oedema; skin reactions; weight increased Side-effects, further information If increased liver transaminase, low platelet count, or low neutrophil count occurs treatment should be interrupted or discontinued-consult product literature.
Interactions
**Other interactions (3):**
- Population pharmacokinetic (PK) analyses did not detect any effect of azathioprine (AZA), oral corticosteroids (OCs) or mycophenolate mofetil (MMF) on the clearance of satralizumab.
- Therefore caution should be exercised when starting or discontinuing satralizumab treatment in patients also receiving substrates of CYP450 3A4, 1A2, 2C9 or 2C19, particularly those with a narrow...
- Given the prolonged terminal half-life of satralizumab, the effect of satralizumab may persist for several weeks after stopping treatment.
Pregnancy
Avoid (limited information available). M
Breast feeding
Specialist sources indicate use with caution, especially if breast-feeding a newborn or premature infant (limited information available). Risk of transfer to infant may be minimised by resuming treatment at least 2 weeks postpartum.
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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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