Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: aldesleukin
BRAND NAME: Proleukin
DRUG CLASS AND MECHANISM: Aldesleukin is a man-made protein that has the same action as native human interleukin-2 (IL-2) that is used for treating cancer of the kidney and skin. Interleukins are the messengers by which white blood cells communicate with each other to coordinate inflammation and immunity. Among its actions, IL-2 increases the number and activities of certain types of white blood cells called lymphocytes, monocytes, and macrophages that are involved in inflammation and immunity. For example, lymphocytes fight viral infections, regulate the immune system, and fight cancers. The exact mechanism by which aldesleukin fights tumors is unknown. Aldesleukin in given only by injection. Aldesleukin was FDA approved in May 1992.
GENERIC AVAILABLE: No
PREPARATIONS: Vials containing 22 million IU (international units) of aldesleukin as a lyophilized (freeze-dried) powder, with diluent.
STORAGE: The vials should be stored in a refrigerator at 2 C to 8 C (36 F to 46 F ) before and after reconstitution with diluent. The vials should not be frozen. The solution should be brought to room temperature prior to infusion and used within 48 hours of reconstitution. Since the vials do not contain a preservative, any unused portion must be discarded.
PRESCRIBED FOR: Aldesleukin is used in treating wide-spread (metastatic) cancer of the kidney (renal cell cancer) and skin (melanoma). It also being investigated in several other diseases including acute myelogenous leukemia, non-Hodgkin's lymphoma, HIV infection, Kaposi's sarcoma, and leprosy.
DOSING: The recommended dose is 600,000 IU/kg intravenously over 15 minutes every 8 hours for 14 doses followed by 9 days of rest then another 14 doses.
DRUG INTERACTIONS: Use of aldesleukin with drugs that share similar toxicity and side effects results in shared side effects that are more severe. For example, drugs that cause damage to the heart, for example, doxorubicin (Adriamycin), can worsen the toxic effects of aldesleukin on the heart. Similarly, drugs that damage the kidneys such as aminoglycosides (Garamycin, Nebcin, Amikin) or nonsteroidal anti-inflammatory drugs, for example, ibuprofen (Motrin, Advil) can worsen the toxic effects of aldesleukin on the kidneys. Aldesleukin also affects the nervous system; therefore, combining it with narcotics, sedatives, or tranquilizers may add to its effects on the nervous system. Finally, drugs that cause liver damage such as isoniazid (INH) increase the toxic effects of aldesleukin on the liver.
Aldesleukin stimulates the immune system. Corticosteroids (for example, methylprednisolone [Medrol] or prednisone) inhibit the immune system. Therefore, aldesleukin and corticosteroids will have opposing effects if used together. Use of such combinations, in fact, may decrease the anti-tumor effect of aldesleukin. Nevertheless, when aldesleukin is used, clinicians may use dexamethasone (a very powerful corticosteroid) to decrease side effects of aldesleukin such as dyspnea, confusion, fever, nephrotoxicity, or hepatotoxicity, despite the possible decrease in benefit.
Beta blockers (for example, propranolol [Inderal, InnoPran]) and other antihypertensive drugs may increase the blood pressure reducing effect of aldesleukin. Individuals treated with interleukin-2 drugs may develop late reactions (fever, chills, nausea, vomiting, rash, hypotension, edema, and renal failure) to iodinated contrast media used for some X-rays. These reactions may occur when contrast media is administered 4 weeks to several months after receiving interleukin-2 drugs.
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