Pegademase bovine


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Pegademase bovine
Pegademase bovine (Adagen)
Pegademase Bovine
(peg- AD-eh-mace BOH-veen)
Pregnancy Category: C Adagen (Rx)

Classification: Enzyme

Action/Kinetics: Derived from bovine intestine; is the conjugate of numerous strands of monomethoxypolyethylene glycol, which is attached covalently to the enzyme ADA. In deficiency clients, adenosine, 2'-deoxyadenosine, and their metabolites are toxic to lymphocytes. Replacement with pegademase bovine improves immune function and decreases the frequency of opportunistic infections. The time required to correct the metabolic abnormalities may range from a few weeks to 6 months. Adequate dosage may be evaluated by measuring ADA levels and by monitoring the level of dATP in erythrocytes. Peak plasma levels, after IM: 2-3 days. t 1/2: 3 to more than 6 days. After initiation of therapy, the trough level should be between 15 and 35 ümol/hr/mL before a maintenance injection is given.

Uses: Enzyme replacement for the treatment of SCID in which there is a deficiency of ADA in those who are not candidates for or who have failed bone marrow transplantation. Not intended as a replacement for HLA identical bone marrow transplant therapy or to replace continued close medical supervision and the initiation of appropriate diagnostic tests or therapy. May be used in infants from birth and in children of any age at the time of diagnosis of deficiency. The drug is ineffective in clients with immunodeficiency due to other causes.

Contraindications: Severe thrombocytopenia. IV use.

Special Concerns: Use with caution during lactation and in mild to moderate thrombocytopenia. There is no evidence to support the safety and effectiveness of pegademase bovine either before or as support therapy for bone marrow transplantation.

Side Effects: Pain at the injection site and headache.

Drug Interactions: Since vidarabine is a substrate for ADA, use of vidarabine with pegademase bovine may alter the activities of both drugs.

How Supplied: Injection: 250 U/mL

Individualized. Dose is given q 7 days. First dose: 10 units/kg. Second dose: 15 units/kg. Third dose: 20 units/kg. Maintenance doses: 20 units/kg/week. If necessary, the weekly dose may be increased by 5 units/kg but do not exceed a single dose of 30 units/kg.