Palivizumab (Intramuscular)

Palivizumab refers to the monoclonal antibody which reduces the multiplication of RSV cells in the body.

Overview

Palivizumab helps in preventing severe lung illness caused by the respiratory syncytial virus in infants born with a lung disorder, heart disease or born prematurely. It works best for children younger than two. The medicine does not treat the children who already have the RSV disease as it is only designed to prevent it. It is administered into the child's body by a professional health provider through a muscle injection. Palivizumab injection keeps the child protected from RSV for one month, hence it is only given once in every 28 to 30 days. To be sure that the drug is safe for your kid, inform the doctor if the child has low platelets level in the blood or a blood clotting disorder.

Condition Treated

  • Respiratory Syncytial Virus Prevention

Type Of Medicine

  • Immunizing agent Monoclonal Antibody

Side Effects

Along with the needed effects, other unwanted effects may be caused by this drug. Not all these effects may occur but if any of them occurs, seek medical help right away. Blurred vision, cough, confusion, dizziness, welts or hives are some of the main effects. Check with your doctor if the patient gets fever, breathing and swallowing difficulty, faintness while suddenly getting up, loss of energy and strength and skin rashes.

Palivizumab may also cause other rare effects like redness on the skin, muscle weakness, fast heartbeat, and black or tarry stools, bleeding gums, unusual bruising or bleeding and blood in stools or urine. In most cases, patients experience the minor effects that do not require medical help. The effects go away with time since the body adjusts to the drug. Your nurse or doctor may advise you on tips you can use to reduce the effects. However, inform your doctor immediately when the effects persist.

Other rare side effects that should not be ignored are blistering, bleeding, burning, excess coldness, bleeding gums, inflammation, tenderness ulceration, tingling, and lumps, most children feel excess warmth or swell at the point of injection, but this goes away. Palivizumab may cause allergic reactions. To reduce their occurrence, inform the doctor if your child is allergic to any of the drug's ingredients. You can also ask your healthcare provider to tell you the elements to be on the safe side.

No side effect should be ignored especially if it takes more than 48 hours. The patient may experience other effects that are not listed here hence it's always good to consult your doctor on any issue.

Dosage

The usual recommended Palivizumab dosage is 15 mg per kg as per the body weight administered monthly through intramuscular injection. The initial dosage is given before the commencement of RSV season then the remaining doses provided once per month in the entire RSV season. Typically, the RSV seasons commence in November in the northern hemisphere, but it can begin earlier or later in some regions.

Palivizumab serum levels are reduced after a cardiopulmonary bypass. This means that children under cardiopulmonary bypass should be given an additional dose of the drug immediately after the procedure. After that, the treatments can be given monthly as planned. The efficiency of the drug for a less than 15 mg per kg dosage or a dosage done less frequently during the RSV season has not yet been established

Palivizumab requires careful administration and preparations. Avoid diluting the product. Also, do not vigorously agitate or shake the vial. The drug products must be visually inspected for any discoloration or particulate matter before the injection. By use of aseptic techniques, carefully attach a sterile needle to a syringe. Remove the top flip and use a disinfectant to wipe the stopper.( 70% isopropyl alcohol can be used.) Insert the needle then withdraw an appropriate solution. Inject immediately after drawing from the vial.

Dosage (injection volume per month in ml) = the patients weight (kg) 15mg/kg Ã' 100 mg / mL of Palivizumab. The injection volumes that use more than 1ml should be administered as divided dosage. The medicine should be administered intramuscularly preferably in the thigh (anterolateral aspect). It is not advisable to use the gluteal muscle as the injection point regularly because it can damage the sciatic nerve.

Palivizumab does not have any preservatives hence is packed as a single dose. Avoid re-entering the vial once you have withdrawn the drug. The unused portion should be well discarded. Only sterile and disposable syringes and needles should be used to prevent transmitting infectious agents and hepatitis viruses. The needles and syringes should not be reused.

The safety and efficiency of the medicine on children above 24 months as well as those with renal and liver impairment has not yet been determined.

Interactions

Most drugs interact with others in the body and reduce the effectiveness of each other. It's therefore crucial for a patient to have a record of the medications they are currently taking including the over the counter medicines. Also, do not start, change the dosage or stop taking a drug without consulting your doctor.

Some of the products that interact with Palivizumab are blood thinners like heparin and warfarin. This drug may interfere with some laboratory tests like virus culture tests and RSV diagnostic tests and provide false results for the tests. If your child is on this medication, inform your laboratory physicians and your doctors before they carry out any other test.

Warnings

This medicine has been reported to cause some allergic reactions in some children these reactions may occur after the administration of any dose. Seek medical attention immediately when you notice signs of an allergic reaction like:

  • Itching,
  • Hives
  • Abnormal swelling of the face, lips, mouth, throat or tongue
  • Low blood pressure
  • Sloppiness or weak muscle tone
  • Swallowing or breathing difficulty
  • Bluish discoloration of the lips or skin

Other severe hypersensitivity reactions have also been reported primarily on the initial exposure to the drug. The common signs and symptoms to observe are urticaria, angioedema, pruritus, dyspnea, cyanosis, respiratory failure, hypotonia, unresponsiveness, and hypotension. The drug should be discontinued if the reactions persist. Epinephrine can also be given to the child to reduce the hypersensitivity reactions.

This drug should only be administered intramuscularly (muscle injection) by a trained doctor. It is recommended to inject the outer thigh part. The child may experience redness, mild pain or swelling at the injection site. Check with your medical practitioner immediately if the reactions become persistent or severe. The drug should be administered with caution to the children who have a thrombocytopenia or coagulation disorder.

Palivizumab is always packed in single vials which do not have any preservative. The injection must, therefore, be administered as quickly as possible once it has been withdrawn from the jar. Any remaining dose cannot be used for another patient or kept for future use hence it should be discarded immediately.

Although this drug has been approved to prevent the respiratory syncytial virus, its safety and effectiveness on the children who already have the infection are unknown. However, it is advisable to continue with the monthly dosage to the children who develop the RSV infection.

Palivizumab may sometimes react with other drugs. Some of the products that cause reactions once taken with Palivizumab are Belimumab and Abciximab. These adverse reactions may increase the risk of infections, allergic reactions or reduce the blood cell counts. To minimize the complications, it's essential for the parent to tell the doctor if the child is taking any prescribed or non prescribed drugs, herbal supplements or vitamin drugs.

Storage

Palivizumab should be stored in the original container and refrigerated at 2®C and 8®C (36®F and 46®F) temperature. Keep the drug away from direct sunlight.Do not freeze or use after its expiration date. The used up needles and syringes should be discarded after use.

Summary

Palivizumab injection helps in preventing RSV (a virus that can lead to severe lung disease) in premature infants or children under the age of 2 years. It is a monoclonal agent that slows down the immune system to stop the virus from multiplying and spreading in the body. It comes in liquid form and is injected into the thigh muscles by a nurse or doctor. The first dose is supposed to be administered before the RSV season then the other doses given on a monthly basis during the season.

The usual administered dose is 15 mg per kg depending on the body weight. Additional treatment may be added to the children with any heart disease or surgery immediately after the surgery, even in cases where one month has not elapsed since the previous dose. Palivizumab can sometimes cause side effects and allergic reactions. However, the doctor may use epinephrine to minimize the hypersensitive responses. The side effects should be reported immediately if they become bothersome. To benefit from the drug, the parent should tell the doctor about other medications that the child is taking or other conditions the child is suffering from; this will help in determining the right dosage.