What are the side effects and mitigation methods of Amivantamab from Janssen Pharmaceuticals in the United States? Is there anything to pay attention to when storing?
Common side effects of Amivantamab include immune related reactions, infusion reactions, and skin toxicity, which require targeted pre-treatment and intervention measures.
1. Immune mediated adverse reactions
(1) Pneumonia
Symptoms include coughing or difficulty breathing, medication should be temporarily suspended and corticosteroid treatment should be used. In severe cases, medication should be permanently discontinued. Imaging monitoring of changes in lung infiltration shadows.
(2) Hepatitis
Jaundice or elevated transaminase levels indicate possible occurrence and immediate liver function testing is required. Grade 3 or higher liver toxicity requires permanent discontinuation of medication and administration of immunosuppressive agents.
(3) Colitis
When there is bloody stool or abdominal pain, colonoscopy should be performed. Mild cases can adjust the dosage, while severe cases require permanent discontinuation of medication and intravenous injection of glucocorticoids.
2. Infusion related reactions
(1) Acute reaction
The incidence of chills and fever is about 30%, and pre-treatment with diphenhydramine and dexamethasone is required before the first infusion. Suspend infusion immediately when symptoms appear.
(2) Delayed reaction
If chest tightness or hypotension occurs within 24 hours after infusion, the monitoring time should be extended. Patients who experience severe reactions repeatedly are prohibited from further treatment.
3. Skin toxicity management
(1) Rash
Mild papules can be relieved with moisturizers, and oral antihistamines can be added when accompanied by itching. If the range is greater than 30% of the body surface area, medication should be suspended.
(2) Bullous dermatitis
If skin peeling or positive Nissl sign occurs, permanent discontinuation of medication is required, and systemic use of glucocorticoids and anti infective treatment is necessary.
4. Treatment of eye symptoms
(1) Dry eye syndrome
Artificial tears should be dripped 4-6 times a day, and in severe cases, cyclosporine eye drops should be added. Avoid prolonged eye fatigue.
(2) Keratitis
Corneal ulcers require immediate discontinuation of medication and ophthalmic consultation, with local use of antibiotics and repair factor eye drops for treatment.
5. Storage precautions
(1) Unopened storage
The original vial needs to be refrigerated vertically at 2-8 ℃ to avoid freezing or exposure to light. Special cold chain packaging is required for transportation, and if the temperature exceeds the standard, it must be scrapped.
(2) Post dissolution treatment
The reconstitution solution is stable at room temperature for 4 hours and refrigerated for no more than 24 hours. Diluted infusion bags should be refrigerated for ≤ 7 days, but it is recommended to use them within 6 hours.
(3) Preparation before infusion
Refrigerated drugs should be equilibrated at room temperature for 15-30 minutes, and gently rotated and mixed during reconstitution. Do not shake or freeze storage.
Disclaimer：《What are the side effects and mitigation methods of Amivantamab from Janssen Pharmaceuticals in the United States? Is there anything to pay attention to when storing?》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！