Efalizumab, Injection

What are other names for this medicine?

Type of medicine: immunosuppressant; biologic response modifier

Generic and brand names: efalizumab, injection; Raptiva

What is this medicine used for?

This medicine is given by injection (shots) to treat moderate to severe chronic plaque psoriasis (scaly patches on the skin).

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bleeding or bone marrow problems
• cancer or significant risk factors for cancer
• kidney or liver disease
• problems with infections that keep coming back

Tell your healthcare provider if you:

• take immunosuppressants such as cyclosporine (Sandimmune, Neoral), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic) or if you are receiving phototherapy
• have an infection
• are scheduled to have any kind of vaccination such as flu shots, or pneumonia, polio, or measles vaccines

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. If you become pregnant while receiving this medicine or within 6 weeks after stopping the shots, contact your healthcare provider right away. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

The injections are usually given once a week by your healthcare provider. You may be able to give yourself these shots or have someone at home give them to you. Be sure you know how and when to have them and how much medicine to use. Your dose is based on your weight. Tell your healthcare provider if there is a change in your weight.

Use sterile, disposable syringes and needles. Use them only once and dispose of them safely, following your healthcare provider's instructions.

These shots are normally given just under the skin of the thighs, back of upper arms, abdomen, or buttocks. Your healthcare provider will determine which muscle sites you can use and the exact dosage of the medicine.

Carefully read and follow the directions that come in the package of medicine for preparing the shots. Wash your hands before using this medicine. Follow these steps to give yourself the shots:

1. Select an injection site. Each day, choose a different spot for the shot to lessen irritation. Do not give an injection close to a vein that you can see under the surface of your skin.
2. Use an alcohol swab to clean the skin where you will give yourself the shot. Let the skin dry and avoid touching the area after you clean it.
3. Gently pinch up the skin and insert the needle into the skin at a 90° angle.
4. Inject all of the solution by gently and steadily pushing down the plunger.
5. After you have given yourself the medicine, withdraw the needle quickly, at the same angle it was inserted, and press the alcohol swab on the spot where the shot was given.
6. Discard the syringe, needle, and drug vial. Use the syringes and needles ONLY ONCE. Throw them away after use. Put used needles in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. DO NOT throw needles directly into garbage cans or dumpsters.

If you are not sure of how to give yourself the shots, ask your healthcare provider or pharmacist for help.

What if I miss a dose?

Use this medicine the same day each week. If you miss a dose, contact your healthcare provider to find out when to take your next dose and what schedule to follow after that. If you take more than your regular dose of this medicine, call your healthcare provider right away.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting.

What should I watch out for?

This medicine increases the risk of progressive multifocal leukoencephalopathy (PML), a brain infection that can lead to death or severe disability. You need to have exams and blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections.

Do not have any vaccines such as for flu, pneumonia, or measles, without getting your healthcare provider's approval first.

You will need to have blood tests regularly to see how this medicine affects you. If your T-cell lymphocytes (white blood cells) drop below normal, you may not have your weekly shot. Keep all appointments for these tests.

Do not have phototherapy treatments without your healthcare provider's approval.

Adults over the age of 65 may be at greater risk of side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away): Chest pain; unexplained fever, sore throat, or cough; severe fatigue; muscle or joint pain; unusual bruising or bleeding; abdominal pain; skin growths or worsening of psoriasis; sores that don't heal; dark or bloody urine; yellowing of the skin or eyes; numbness, tingling, or weakness in face, arms, or legs; new or sudden change in thinking, balance, strength, talking, walking, or vision.

Other: Dizziness, nausea, acne, headache, irritation at the injection site.

What products might interact with this medicine?

No significant drug interactions have been reported. However, tell your healthcare provider if you take immunosuppressants such as cyclosporine (Sandimmune, Neoral), sirolimus (Rapamune), or tacrolimus (Prograf, Protopic), or are receiving phototherapy. Talk to your healthcare provider if you need to receive a vaccine while using this medicine.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store vials in the refrigerator until you are ready to prepare your injection. Do not freeze the medicine or store it at room temperature. After this medicine has been mixed with sterile water, use it right away. Do not use this medicine if it was mixed more than 8 hours earlier. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.