Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 100mg/20mL (5mg/mL)
Ovarian Cancer
Indicated for adults with folate receptor–alpha (FRα) positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer, who have received 1-3 prior systemic treatment regimens
Premedicate with IV corticosteroid and IV/PO antihistamine, antipyretic, and antiemetic
Each cycle is 21 days
6 mg/kg adjusted ideal body weight (AIBW) IV q3Weeks
Continue until disease progression or unacceptable toxicity
Calculate AIBW
- AIBW = Ideal body weight (IBW [kg]) + 0.4 × (actual weight [kg] – IBW)
- Female IBW (kg) = 0.9 × height (cm) – 92
Dosage Modifications
Dosage reduction schedule
- First dose reduction: 5 mg/kg AIBW q3Weeks
- Second dose reduction: 4 mg/kg AIBW q3Weeks
- Unable to tolerate 4 mg/kg AIBW q3Weeks: Permanently discontinue
Keratitis/keratopathy
- Nonconfluent superficial keratitis: Monitor
- Confluent superficial keratitis, a cornea epithelial defect, or ≥3-line loss in best corrected visual acuity: Withhold dose until improved or resolved, then resume at same dose, or consider dose reduction
- Corneal ulcer or stromal opacity or best corrected distance visual acuity 20/200 or worse: Withhold dose until improved or resolved, then reduce by 1 dose level
- Corneal perforation: Permanently discontinue
Uveitis
- Grade 1 – rare cell in anterior chamber: Monitor
- Grade 2 – 1-2+ cell or flare un anterior chamber: Withhold dose until grade ≤1, then resume at same dose
- Grade 3 – 3+ cell or flare in anterior chamber: Withhold dose until grade ≤1, then reduce by 1 lower dose level
- Grade 4 – hypopyon: Permanently discontinue
Pneumonitis
- Grade 1: Monitor
- Grade 2: Withhold dose until grade ≤1, then resume at same dose or consider dose reduction
- Grade 3 or 4: Permanently discontinue
Peripheral neuropathy
- Grade 2: Withhold dose until grade ≤1, then resume at 1 lower dose level
- Grade 3 or 4: Permanently discontinue
Infusion-related reactions/hypersensitivity
- Grade 1: Maintain infusion rate
-
Grade 2
- Interrupt infusion and administer supportive treatment
- After recovery from symptoms, resume infusion at 50% of previous rate, and if no further symptoms appear, increase rate as appropriate until infusion completed
- Administer additional premedication for future cycles
-
Grade 3 or 4
- Immediately stop infusion and administer supportive treatment
- Advise patient to seek emergency treatment and immediately notify their healthcare provider if infusion-related symptoms recur
- Permanently discontinue
Hematologic adverse reactions
- Grade 3 or 4: Withhold dose until grade ≤1, then resume at 1 lower dose level
Other adverse reactions
- Grade 3: Withhold dose until grade ≤1, then resume at 1 lower dose level
- Grade 4: Permanently discontinue
Renal impairment
- Mild-to-moderate (CrCl 30-90 mL/min): No dose adjustment recommended
- Severe (CrCl 15 to <30 mL/min) or end-stage renal disease: Unknown
Hepatic impairment
- Mild (total bilirubin [TB]
ULN or TB >1-1.5 x ULN and any AST): No dose adjustment recommended - Moderate or severe (TB >1.5 x ULN): Avoid use
Dosing Considerations
Verify pregnancy status in females of reproductive potential before initiating
Conduct an ophthalmic exam including visual acuity and slit lamp exam before initiating, every other cycle for the first 8 cycles, and as clinically indicated
Select patients based on presence of FRα tumor expression using an FDA-approved test
Safety and efficacy not established
No clinically meaningful differences in efficacy or safety were observed between patients aged ≥65 years compared with younger patients
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (1)
- etrasimod
etrasimod, mirvetuximab soravtansine. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Risk of additive immune system effects with etrasimod has not been studied in combination with antineoplastic, immune-modulating, or noncorticosteroid immunosuppressive therapies. Avoid coadministration during and in the weeks following administration of etrasimod.
Monitor Closely (27)
- atazanavir
atazanavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- chloramphenicol
chloramphenicol will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- clarithromycin
clarithromycin will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- cobicistat
cobicistat will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- conivaptan
conivaptan will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- darunavir
darunavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- grapefruit
grapefruit will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- idelalisib
idelalisib will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- indinavir
indinavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- itraconazole
itraconazole will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- ketoconazole
ketoconazole will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- lenacapavir
lenacapavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
- levoketoconazole
levoketoconazole will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- lonafarnib
lonafarnib will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- lopinavir
lopinavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- mifepristone
mifepristone will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- nefazodone
nefazodone will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- nirmatrelvir/ritonavir
nirmatrelvir/ritonavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- posaconazole
posaconazole will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- ritonavir
ritonavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- rucaparib
rucaparib will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- saquinavir
saquinavir will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- stiripentol
stiripentol will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- tucatinib
tucatinib will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
- ublituximab
ublituximab and mirvetuximab soravtansine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered
- voriconazole
voriconazole will increase the level or effect of mirvetuximab soravtansine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 (a CYP3A4 substrate and the cytotoxic component of the antibody drug conjugate for mirvetuximab soravtansine) exposure, which may increase the risk of adverse reactions.
Minor (0)
Adverse Effects
>10%
All grades
- Vision impairment (50%)
- Increased AST (50%)
- Fatigue (49%)
- Nausea (40%)
- Increased ALT (39%)
- Keratopathy (37%)
- Abdominal pain (36%)
- Decreased lymphocytes (35%)
- Peripheral neuropathy (33%)
- Diarrhea (31%)
- Decreased albumin (31%)
- Constipation (30%)
- Increased alkaline phosphatase (30%)
- Dry eye (27%)
- Decreased magnesium (27%)
- Decreased leukocytes (26%)
- Decreased neutrophils (26%)
- Decreased hemoglobin (25%)
- Vomiting (19%)
- Cataract (18%)
- Decreased appetite (18%)
- Decreased platelets (18%)
- Photophobia (17%)
- Arthralgia (17%)
- Increased creatinine (16%)
- Decreased potassium (15%)
- Dyspnea (12%)
- Abdominal distension (11%)
1-10%
All grades
- Eye pain (10%)
- Myalgia (10%)
- Infusion related reactions/hypersensitivity (9%)
- Pneumonitis (8-9%)
- Thrombocytopenia (5%)
- Uveitis (1%)
Grades 3-4
- Keratopathy (9%)
- Vision impairment (7%)
- Abdominal pain (7%)
- Decreased lymphocytes (7%)
- Decreased potassium (4%)
- Cataract (3%)
- Fatigue (3%)
- Diarrhea (3%)
- Decreased hemoglobin (3%)
- Decreased neutrophils (3%)
- Dry eye (2%)
- Peripheral neuropathy (2%)
- Decreased magnesium (2%)
- Decreased platelets (2%)
- Increased AST/ALT (2%)
- Decreased appetite (1%)
- Constipation (1%)
- Decreased albumin (1%)
- Decreased leukocytes (1%)
- Increased alkaline phosphatase (1%)
Warnings
Black Box Warnings
Ocular toxicity
- Can cause severe ocular toxicities, including visual impairment, keratopathy, dry eye, photophobia, eye pain, and uveitis
- Conduct an ophthalmic exam, including visual acuity and slit lamp exam, before initiating every other cycle for the first 8 cycles, and as clinically indicated
- Administer prophylactic artificial tears and ophthalmic topical steroids
- Withhold for ocular toxicities until improvement and resume at the same or reduced dose
- Discontinue for Grade 4 ocular toxicities
Contraindications
None
Cautions
Severe, life-threatening, or fatal interstitial lung disease, including pneumonitis may occur; monitor for pulmonary signs and symptoms of pneumonitis, which may include hypoxia, cough, dyspnea, or interstitial infiltrates on radiologic exams; appropriately investigate to exclude infectious, neoplastic, and other causes for such symptoms
Peripheral neuropathy commonly occurs; median time to onset was 1.3 months after initiation; monitor for signs and symptoms of neuropathy (eg, paresthesia, tingling or a burning sensation, neuropathic pain, muscle weakness, dysesthesia)
Based on its mechanism of action, can cause embryo-fetal harm when administered to pregnant females
Ocular disorders
- Can cause severe ocular adverse reactions, including visual impairment, keratopathy (corneal disorders), cataract, dry eye, photophobia, eye pain, and uveitis
- Ophthalmic examinations required and premedication with lubricating and corticosteroid eye drops before administration
- Median time to onset for first ocular adverse reaction was 1.2 months (range: 0.03 to 12.9 months)
- Monitor for ocular toxicity and withhold, reduce, or permanently discontinue therapy based on severity and persistence of ocular adverse reactions
- Advise patients to avoid use of contact lenses during treatment unless directed by a healthcare provider
- Promptly refer patients to an eye care professional for any new or worsening ocular signs and symptoms
Drug interaction overview
- DM4 is a CYP3A4 substrate
-
Strong CYP3A4 inhibitors
- Closely monitor
- Coadministration with strong CYP3A4 inhibitors may increase unconjugated DM4 exposure, which may increase the risk of adverse reactions
Pregnancy & Lactation
Pregnancy
Based on its mechanism of action, can cause embryo-fetal harm when administered to pregnant females because it contains a genotoxic compound (DM4) and affects actively dividing cells
Human immunoglobulin G (IgG) is known to cross the placental barrier; therefore, mirvetuximab soravtansine has the potential to be transmitted from the mother to the developing fetus
There are no available human data regarding use in pregnant females to inform a drug-associated risk
No reproductive or developmental animal toxicity studies were conducted
Advise patients of potential risk to fetus
Verify pregnancy status in females of reproductive potential before initiating
Contraception
- Advise females of reproductive potential to use effective contraception during treatment and for 7 months after last dose
Lactation
Data are not available regarding presence in human milk or effects on breastfed children or milk production
Advise females not to breastfeed during treatment and for 1 month after last dose
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Antibody-drug conjugate comprising a folate receptor alpha (FRα)-binding antibody, cleavable linker, and the maytansinoid payload DM4, a potent tubulin-targeting agent to kill the targeted cancer cells
Upon binding to FRα, mirvetuximab soravtansine is internalized followed by intracellular release of DM4 via proteolytic cleavage
DM4 disrupts the microtubule network within the cell, resulting in cell cycle arrest and apoptotic cell death
Absorption
Steady-state reached at ~24 days
Peak plasma concentration
- Mirvetuximab soravtansine: 137.3 mcg/mL
- Unconjugated DM4: 4.11 ng/mL
- S-methyl-DM4: 6.98 ng/mL
AUC
- Mirvetuximab soravtansine: 20.65 h⋅mg/mL
- Unconjugated DM4: 530 h⋅ng/mL
- S-methyl-DM4: 1848 h⋅ng/mL
Distribution
Protein bound: >99% (DM4 and S-methyl DM4)
Vd: 2.63 L (mirvetuximab soravtansine)
Metabolism
Monoclonal antibody portion of mirvetuximab soravtansine is expected to be metabolized into small peptides by catabolic pathways
Unconjugated DM4 and S-methyl-DM4 undergo metabolism by CYP3A4
Elimination
Excretion: S-methyl DM4 and DM4-sulfo-SPDB-lysine were detected in urine within 24 hr of infusion as the main metabolites
Half-life
- Mirvetuximab soravtansine: 4.8 days
- Unconjugated DM4: 2.8 days
- S-methyl-DM4: 5 days
Total plasma clearance
- Mirvetuximab soravtansine: 18.9 mL/hr
- Unconjugated DM4: 13.8 L/hr
- S-methyl-DM4: 4.3 L/hr
Administration
IV Incompatibilities
NaCl 0.9%
IV Compatibilities
D5W
IV Preparation
Follow applicable special handling and disposal procedures
Calculate dose (mg) based on patient’s AIBW, total volume (mL) of solution required, and the number of vials needed for any dosage modifications
More than 1 vial will be needed for a full dose
Remove vials from refrigerator and allow to warm to room temperature
Inspect visually for particulate matter and discoloration before administering; solution should appear clear to slightly opalescent to colorless
Gently swirl and inspect each vial before withdrawing dose volume for subsequent further dilution
Do not shake vial
Using aseptic technique, withdraw dose volume for subsequent further dilution
Contains no preservatives and is intended for single-dose only; discard any unused drug remaining in vial
Dilution
- Must dilute with D5W to final concentration of 1-2 mg/mL; incompatible with saline solutions
- Do not mix with any other drugs or IV fluids
- Determine D5W volume required to achieve final diluted concentration; either remove excess D5W from prefilled IV bag or add calculated volume to a sterile empty IV bag
- Then add calculated dose volume to IV bag and gently mix by slowly inverting the bag several times to assure uniform mixing
- Do not shake or agitate
- If diluted solution if not used immediately, store appropriately (see Storage)
Premedication
Premedicate with IV corticosteroid and IV/PO antihistamine, antipyretic, and antiemetic
Consider additional premedications including corticosteroids the day before administration for patients who experienced infusion-related reactions
Example (or equivalent) premedication regimen
- Dexamethasone 10 mg IV, diphenhydramine 25-50 mg PO/IV, and acetaminophen 325-650 mg PO/IV at least 30 min before mirvetuximab soravtansine
- Antiemetic (5-HT3 serotonin receptor antagonist or appropriate alternative) PO/IV before each dose and thereafter as needed
Ophthalmic exams and premedication
-
Ophthalmic exam
- Conduct ophthalmic exam, including visual acuity and slit lamp exam, before initiation every other cycle for the first 8 cycles, and as clinically indicated
-
Ophthalmic topical steroids
- Ophthalmic topical steroid recommended after slit lamp examination
- Instill 1 drop in each eye 6 times daily starting the day before each infusion until day 4, THEN
- Instill 1 drop in each eye 4 times daily for days 5-8 of each cycle
-
Lubricating eye drops
- Use eye drops at least 4 times daily and as needed during treatment
- Instruct patient to use lubricating eye drops and advise to wait at least 10 minutes after ophthalmic topical steroid administration before instilling lubricating eye drops
IV Administration
Administer premedication
Administer as IV infusion only, using a 0.2 or 0.22 μm polyethersulfone (PES) in-line filter; do not substitute other membrane materials
Initial dose: Initiate at rate of 1 mg/min; if well tolerated after 30 min, my increase to 3 mg/min; if 3 mg/min well tolerated after 30 min, may increase to 5 mg/min
If no infusion-related reactions occur with previous dose, subsequent infusions may be started at maximally tolerated rate and be increased up to maximum of 5 mg/min as tolerated
Flush IV line with D5W after infusion completed to ensure delivery of full dose
Do not use any other IV fluids for flushing
Storage
Hazardous drug; follow applicable special handling and disposal procedures
Unopened vials
- Store vials upright
- Refrigerate at 2-8ºC (36-46ºF) until time of preparation
- Keep in original carton to protect from light
- Do not freeze or shake
Diluted solution
- If not used immediately, store at 18-25ºC (64.4-77ºF) for no more than 8 hr (including infusion time), OR
- Refrigerate at 2-8ºC (36-46ºF) for no more than 12 hr
- If refrigerated, allow infusion bag to reach room temperature before administration
- After refrigeration, administer diluted infusion solution within 8 hr (including infusion time)
- Do not freeze prepared infusion solution
Images
Formulary
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To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
