Drug information of Alefacept
Mechanism of effect
Recombinant dimeric fusion protein: extracellular CD2-binding portion of human leukocyte function antigen-3 (LFA-3) linked to the Fc portion of human IgG1
Inhibits LFA-3/CD2 interaction, thus inhibits T lymphocyte activation (decreases CD45RO+ T lymphs)
Interferes with lymphocyte activation by specifically binding to the lymphocyte antigen, CD2, and inhibiting LFA-3/CD2 interaction. Activation of T lymphocytes involving the interaction between LFA-3 on antigen-presenting cells and CD2 on T lymphocytes plays a role in the pathophysiology of chronic plaque psoriasis. Also causes a reduction in subsets of CD2+ T lymphocytes as well as CD4+ and CD8+ T lymphocytes.
Bioavailability: 63% (IM)
Vd: 94 mL/kg (IV)
Half-Life: 270 hr (IV)Clearance: 0.25 mL/kg/hr (IV)
Drug indicationsplaque psoriasis
Indicated for moderate-to-severe chronic plaque psoriasis
15 mg IM qWeek x 12 weeks
Regimen of 12 weekly injections recommended
Retreatment with additional 12 week course may be initiated, based on normal CD4+ T lymphocyte counts and a minimum 12 week interval
Drug contraindicationsBreast feeding , Hypersensitivity , Pts at high risk for malignancy , CD4+ T lymphocyte count below normal
InteractionsThymoglubin , Varicella-Zoster Vaccines , Golimumab , Hib vaccine , Canakinumab , Basiliximab , Azathioprine , Anti-thymocyte , Everolimus , Infliximab , Pneumovax , Tacrolimus , Japanese Encephalitis Virus Vaccine , Anthrax vaccine , Polio vaccine, inactivated , Typhoid vaccine (live), oral , Yellow fever vaccine , Rabies Vaccine , rotavirus vaccine , DIPHTHERIA & TETANUS TOXOID (Td ) , Ustekinumab , Rilonacept , Hepatitis B Vaccine , Temsirolimus , meningococcal polysaccharide vaccine , Adalimumab , Measles vaccine , Tocilizumab , Adenovirus types 4 and 7 live, oral , Anakinra , Muromonab-CD3 , Sirolimus , Cyclosporine , Glatiramer acetate , Mycophenolate mofetil , Hydroxychloroquine , Human papillomma virus vaccine , Meningococcal conjugate vaccine , sirukumab
Monitor CD4+ T lymph counts weekly; withhold dosing if CD4 <250/mcL; discontinue if CD4 <250/mcL for one month
May increase risk of malignancies
Risk of serious infection, anaphylaxis
Points of recommendation
Use alefacept as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Alefacept is given by intramuscular (IM) injection once weekly. Plan your injection on the same day each week to help you remember to administer it.
- Do not shake alefacept. This will prevent foaming of the medicine.
- Alefacept should be clear and colorless to slightly yellow. If alefacept contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
- Rotate injection sites. Each injection should be given at least 1 inch from an old site. An injection should not be given into an area of skin that is sore, bruised, red, or hard.
- Use alefacept on a regular schedule to get the most benefit from it.
- If you miss a dose of alefacept, contact your doctor immediately.
- Alefacept may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use alefacept with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not receive a live vaccine (eg, measles, mumps) while you are using alefacept. Talk with your doctor before you receive any vaccine.
- Alefacept may lower the ability of your body to fight infection. Serious infections have been reported in patients using alefacept. Avoid contact with people who have colds or infections. Tell your doctor right away if you notice signs of infection (eg, fever; chills; persistent cough or sore throat; swollen glands; blood in the phlegm; burning, difficult, frequent, or painful urination; warm, red, or painful skin; sores on the body; muscle aches; severe or persistent diarrhea or stomach pain; shortness of breath; unusual sweating; unusual tiredness).
- Alefacept may increase your risk of developing cancer. Tell your doctor if you have ever had cancer. Contact your doctor if you notice a change in the appearance or size of a mole, new skin growths, unusual lumps, night sweats, unusual tiredness or weakness, loss of appetite, or unusual weight loss. Discuss any questions or concerns with your doctor.
- Lab tests, including white blood cell counts, may be performed while you use alefacept. These tests may be used to monitor your condition or check for side effects.