What is Siltuximab?
Siltuximab can be used to treat multicentric Castleman's disease. MCD is an uncommon condition where the body produces excessive amounts of a specific type of white cell. MCD increases your risk of cancer by altering the immune system.
Siltuximab should not be used in patients with HIV or human herpesvirus-8. Siltuximab can be used in other ways not mentioned in this guide.
Side effects of Siltuximab
If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: hives, chest tightness, difficulty breathing, swelling of your lips, face, tongue, or throat.
Some side effects can occur during the injection. You should tell your carer if you experience nausea, back or chest pain, or any of the following: warmth or redness beneath your skin, chest or chest pain, or heartbeats that are pounding, fluttering, or swelling on your face.
Siltuximab can cause serious side effects. If you experience:
- Bloody or tarry stools; a cough that produces bloody mucus; or vomit that looks like coffee grounds.
- Signs of infection include fever and symptoms such as chills, sores in the mouth, difficulty swallowing, cold or flu symptoms, coughing, or trouble breathing.
- Signs of kidney problems include little or no urination, painful or difficult urination, swelling in the feet or ankles, and severe pain on your side or lower spine.
Side effects of siltuximab include:
- Weight gain
- Itching, or rash.
- Cold symptoms like a stuffy nose and sneezing, sore neck
- High levels of uric acid in the blood can cause kidney problems or gout symptoms like joint pain, swelling, or stiffness.
There may be other side effects. For medical advice on side effects, call your doctor. The FDA can be contacted at 1-800-FDA-1088 to report side effects.
Warnings
If you have an infection that is severe, siltuximab should be avoided. You should tell your doctor if any symptoms of infection have been present in the past (such as fever, chills, or body aches).
Before you take this drug
If you have an infection or are allergic to siltuximab, you should not receive treatment.
Siltuximab may not be prescribed if you are suffering from a severe infection or fever. If you've recently experienced any symptoms of infection (fevers, chills, or body aches), tell your doctor.
Inform your doctor of any of the following conditions:
- A chronic infection
- A stomach or intestinal disorder, including diverticulitis
- Stomach or intestinal bleeding
- Gout is a condition that causes inflammation of the joints.
- If you've recently had a vaccine or are scheduled to get one in the near future,
Siltuximab can harm an unborn child. Prevent pregnancy by using effective contraception while taking this medication and for 3 months following your last dose. This medicine should not be used while breastfeeding.
How to take Siltuximab?
Siltuximab infusions are given into the vein once every three weeks. This injection will be given by a healthcare provider.
The infusion should take no more than an hour. Siltuximab increases your risk of bleeding and infection. You will be required to undergo frequent medical tests. The results of your siltuximab treatment may delay it.
Details on dosage
Adult dose for Castleman's Disease:
11 mg/kg IV over 1 hour every 3 weeks until treatment failure
Treatment Criteria
Before the first dose, the absolute neutrophil (ANC) count must be greater than 1 x 10(9), the platelet count must be greater than 75 x 10(9), and the haemoglobin level must be lower than 17 g/dl.
Retreatment criteria: Absolute neutrophil count (ANC), platelet count, and haemoglobin level must all be below 17 g/dl.
Comments:
This drug has not been studied in MCD patients who are HIV or HHV-8 negative because, in a nonclinical trial, it failed to bind virally produced IL-6.
Perform haematology lab tests before each dose during the first 12-month period and then every three dosing cycles.
Do not start therapy on patients with severe infections until the infection has resolved.
Discontinue treatment for patients who have severe reactions to infusions, anaphylaxis, or severe allergic reactions. Reinstitute the treatment.
Use: To treat patients with Castleman's multicentric disease (MCD) who are HIV-negative and HHV-8-negative.
What happens if I miss the dose?
If you missed your appointment for siltuximab, call your doctor to get instructions.
What happens if I overdose?
Overdoses are unlikely because siltuximab will be administered by a healthcare provider in a medical environment.
What should be avoided?
Avoid receiving a "live vaccine" while taking siltuximab. It may not protect you as well from disease, and the vaccine may not perform as well. Live vaccines are available for measles (MMR), rubella, mumps (MMR), yellow fever, typhoid (rotavirus), varicella, chickenpox, zoster, and influenza (nasal flu).
Interaction with other drug
Other drugs, such as vitamins and herbal remedies, may also affect siltuximab. Inform your doctor of all the medicines you are taking and those that you stop or start using.
