Select a medication above to begin.
Adcetris
brentuximab vedotin
Black Box Warnings .
Progressive Multifocal Leukoencephalopathy
John Cunningham (JC) virus infection resulting in PML and death can occur
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, and dosing incl. toxicity-related dose adjustments; for pts >100 kg, cap wt at 100 kg for dose calculations
Hodgkin lymphoma, classical
- [first-line tx]
- Dose: 1.2 mg/kg/dose IV x1 on day 1 of 14-day cycle for up to 12 cycles; Max: 120 mg/dose; 12 cycles; Info: for stage III or IV dz; part of multi-drug chemo regimen; give primary G-CSF prophylaxis starting cycle 1
- [consolidation tx]
- Dose: 1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle for up to 16 cycles; Start: 4-6wk after or upon recovery from auto-HSCT; Max: 180 mg/dose; 16 cycles; Info: for pts w/ high risk of relapse or progression
- [relapsed dz]
- Dose: 1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle; Max: 180 mg/dose; Info: for pts who have failed auto-HSCT or at least 2 lines of tx
systemic anaplastic large cell lymphoma
- [first-line tx]
- Dose: 1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle x6-8 cycles; Max: 180 mg/dose; Info: part of multi-drug chemo regimen; give primary G-CSF prophylaxis starting cycle 1
- [refractory dz]
- Dose: 1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle; Max: 180 mg/dose
peripheral T-cell lymphoma, previously untreated
- [1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle x6-8 cycles]
- Max: 180 mg/dose; Info: for pts w/ CD30-expressing peripheral T-cell lymphoma (PTCL), incl. angioimmunoblastic T-cell lymphoma and PTCL not otherwise specified; part of multi-drug chemo regimen; give primary G-CSF prophylaxis starting cycle 1
primary cutaneous anaplastic large cell lymphoma, relapsed
- [1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle for up to 16 cycles]
- Max: 180 mg/dose; 16 cycles
mycosis fungoides, relapsed
- [1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle for up to 16 cycles]
- Max: 180 mg/dose; 16 cycles; Info: for pts w/ CD30-expressing dz
large B-cell lymphoma, relapsed or refractory
- [1.2 mg/kg/dose IV x1 on day 1 of 21-day cycle]
- Max: 120 mg/dose; Info: for pts w/ diffuse large B-cell lymphoma (DLBCL) not otherwise specified, DLBCL arising from indolent lymphoma, or high-grade B-cell lymphoma who have received at least 2 lines of tx and who are ineligible for autologous HSCT or chimeric antigen receptor (CAR)-positive T-cell tx; part of multi-drug chemo regimen; give primary G-CSF prophylaxis starting cycle 1
renal dosing
- [see below]
- CrCl <30: avoid use
- HD/PD: not defined
hepatic dosing
- [Hodgkin lymphoma, first-line tx]
- Child-Pugh Class A: 0.9 mg/kg/dose q2wk, max 90 mg/dose; Child-Pugh Class B or C: avoid use
- [large B-cell lymphoma]
- bilirubin 1.1-1.5x ULN or AST >ULN: 0.9 mg/kg/dose q3wk, max 90 mg/dose; bilirubin >1.5x ULN: avoid use
- [all other indications]
- Child-Pugh Class A: 1.2 mg/kg/dose q3wk, max 120 mg/dose; Child-Pugh Class B or C: avoid use
Peds Dosing .
- Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, and dosing incl. toxicity-related dose adjustments; for pts >100 kg, cap wt at 100 kg for dose calculations
Hodgkin lymphoma, classical
- [2 yo and older]
- Dose: 1.8 mg/kg/dose IV x1 on day 1 of 21-day cycle for up to 5 cycles; Max: 180 mg/dose; 5 cycles; Info: for pts w/ previously untreated high risk dz; part of multi-drug chemo regimen; give primary G-CSF prophylaxis starting cycle 1
renal dosing
- [see below]
- CrCl <30: avoid use
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A: 1.2 mg/kg/dose q3wk, max 120 mg/dose; Child-Pugh Class B or C: avoid use
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- CrCl <30
- hepatic impairment, Child-Pugh Class B-C (except large B-cell lymphoma use)
- bilirubin >1.5x ULN (large B-cell lymphoma use)
- avoid: breastfeeding
- caution: hypersensitivity to hamster protein
- caution: hepatotoxic agent use, concurrent
- caution: female pts of reproductive potential
- caution: male pts of reproductive potential
- caution: baseline ALT or AST incr.
- caution: hepatic impairment, Child-Pugh Class A (except large B-cell lymphoma use)
- caution: bilirubin 1.1-1.5x ULN (large B-cell lymphoma use)
- caution: AST >ULN (large B-cell lymphoma use)
- caution: hepatic dz
- caution: tumor burden, high
- caution: tumor, rapidly proliferating
- caution: neutropenia
- caution: peripheral neuropathy
- caution: diabetes mellitus
- caution: lymphoma GI involvement
Drug Interactions .
Overview
brentuximab vedotin
mitosis inhibitor
- CYP3A4 substrate
- GI mucosal injury/bleeding risk
- hyperglycemic effects
- immunosuppressive oncologic agent
- myelosuppressive oncologic agent
- peripheral neuropathy
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- bleomycin
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- abrocitinib
- anifrolumab
- ceritinib
- chloramphenicol
- cladribine oral
- deferiprone
- deuruxolitinib
- dexrazoxane
- etrasimod
- fexinidazole
- ganciclovir
- palifermin
- penicillamine
- pimecrolimus topical
- primaquine
- rabies vaccine
- radium Ra 223 dichloride
- ritlecitinib
- ropeginterferon alfa-2b
- ruxolitinib topical
- valganciclovir
Monitor/Modify Tx
- acalabrutinib
- acarbose
- adagrasib
- ado-trastuzumab emtansine
- afatinib
- albendazole
- alemtuzumab
- alendronate
- allopurinol
- alogliptin
- alteplase
- anacaulase topical
- anagrelide
- anthrax vaccine
- anti-thymocyte globulin
- antithrombin
- apixaban
- argatroban
- asenapine
- asparaginase
- aspirin
- atazanavir
- atidarsagene autotemcel
- auranofin
- avapritinib
- axitinib
- azathioprine
- balsalazide
- baricitinib
- benznidazole
- betamethasone
- betibeglogene autotemcel
- bevacizumab
- bexagliflozin
- binimetinib
- bivalirudin
- bromelain
- bromocriptine
- cabazitaxel
- cabozantinib
- calaspargase
- canagliflozin
- cangrelor
- caplacizumab
- carfilzomib
- celecoxib
- chikungunya vaccine
- cidofovir
- cilostazol
- cinacalcet
- citalopram
- clarithromycin
- clopidogrel
- clozapine
- cobicistat
- colchicine
- colesevelam
- corticotropin
- cortisone
- COVID-19 vaccine
- cyclophosphamide
- cysteamine
- dabigatran
- dalteparin
- danshen
- dapagliflozin
- dapsone
- dasatinib
- deferasirox
- defibrotide
- deflazacort
- desvenlafaxine
- dexamethasone
- diclofenac
- diclofenac topical
- diflunisal
- dimethyl fumarate
- diosmin
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- dipyridamole
- diroximel fumarate
- donepezil
- dulaglutide
- duloxetine
- ebola vaccine, live
- edoxaban
- efbemalenograstim alfa
- eflapegrastim (G-CSF)
- elivaldogene autotemcel
- empagliflozin
- encorafenib
- enoxaparin
- eptifibatide
- erlotinib
- ertugliflozin
- escitalopram
- etelcalcetide
- ethanol
- etodolac
- evening primrose oil
- everolimus
- exagamglogene autotemcel
- exenatide
- fenoprofen
- fenugreek
- filgrastim (G-CSF)
- flucytosine
- fludrocortisone
- fluoxetine
- fluphenazine
- flurbiprofen
- fluvoxamine
- fondaparinux
- foscarnet
- fostamatinib
- fruquintinib
- galantamine
- garlic
- gefitinib
- gemtuzumab ozogamicin
- ginkgo
- givinostat
- glimepiride
- glipizide
- glyburide
- Haemophilus b vaccine
- heparin
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- hydrocortisone
- hydroxychloroquine
- hydroxyurea
- ibandronate
- ibrutinib
- ibuprofen
- ibuprofen lysine
- idelalisib
- iloperidone
- iloprost inhaled
- imatinib
- indomethacin
- influenza H5N1 vaccine
- influenza vaccine
- insulin
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- itraconazole
- Japanese encephalitis vaccine
- ketoconazole
- ketoprofen
- ketorolac
- leflunomide
- lenvatinib
- levoketoconazole
- levomilnacipran
- lifileucel
- linagliptin
- linezolid
- liraglutide
- lonafarnib
- lopinavir/ritonavir
- lovotibeglogene autotemcel
- lumateperone
- lymphocyte immune globulin, anti-thymocyte globulin
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- meningococcal vaccine
- mercaptopurine
- mesalamine
- mesalamine rectal
- metformin
- methotrexate
- methyl salicylate topical
- methylprednisolone
- mifepristone
- miglitol
- milnacipran
- mitotane
- monomethyl fumarate
- mycophenolate mofetil
- mycophenolic acid
- nabumetone
- naproxen
- nateglinide
- nattokinase
- nefazodone
- nelfinavir
- niacin (vitamin B3)
- nilotinib
- nintedanib
- nusinersen
- olsalazine
- oxaliplatin
- oxaprozin
- pacritinib
- paroxetine
- pazopanib
- pegaspargase
- pegfilgrastim (G-CSF)
- peginterferon alfa 2a
- peginterferon beta 1a
- penicillin G
- pentamidine
- pentosan polysulfate sodium
- pentoxifylline
- pioglitazone
- piperacillin
- piroxicam
- pirtobrutinib
- plasminogen, human
- pneumococcal vaccine
- poliovirus vaccine
- ponatinib
- porfimer
- posaconazole
- pralsetinib
- pramlintide
- prasugrel
- prednisolone
- prednisone
- proguanil
- pyridostigmine
- pyrimethamine
- ramucirumab
- regorafenib
- repaglinide
- respiratory syncytial virus vaccine
- resveratrol
- reteplase
- ribavirin
- ribociclib
- rifabutin
- risedronate
- ritonavir
- rituximab
- rivaroxaban
- rivastigmine
- rosiglitazone
- salsalate
- sargramostim (GM-CSF)
- sarilumab
- satralizumab
- saw palmetto
- saxagliptin
- selpercatinib
- selumetinib
- semaglutide
- sertraline
- sipuleucel-T
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- smallpox/mpox vaccine, live
- sorafenib
- sotatercept
- stiripentol
- succimer
- sulfasalazine
- sulindac
- sunitinib
- tenecteplase
- teplizumab
- teriflunomide
- thalidomide
- ticagrelor
- tick-borne encephalitis vaccine
- tipranavir
- tirofiban
- tirzepatide
- tisotumab vedotin
- tivozanib
- tocilizumab
- tofacitinib
- tolmetin
- tovorafenib
- trametinib
- trazodone
- treprostinil
- triamcinolone
- trimethoprim
- tucatinib
- typhoid vaccine
- upadacitinib
- vadadustat
- valproic acid
- vamorolone
- vandetanib
- venlafaxine
- vilazodone
- vinpocetine
- vorapaxar
- voriconazole
- vortioxetine
- warfarin
- willow bark
- zanubrutinib
- zidovudine
- ziv-aflibercept
- zoster vaccine, recombinant
Caution Advised
- abatacept
- adalimumab
- amiodarone
- anakinra
- apalutamide
- avacopan
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- bimekizumab
- bortezomib
- bosentan
- brodalumab
- budesonide
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- butalbital
- canakinumab
- carbamazepine
- cenobamate
- certolizumab pegol
- ciltacabtagene autoleucel
- ciprofloxacin
- cisplatin
- clobetasol ophthalmic
- crovalimab
- cyclosporine
- dabrafenib
- danicopan
- daptomycin
- delafloxacin
- deucravacitinib
- dexamethasone ophthalmic
- difluprednate ophthalmic
- dinutuximab
- disulfiram
- docetaxel
- dupilumab
- eculizumab
- efavirenz
- efgartigimod alfa
- elranatamab
- emapalumab
- enfortumab vedotin
- enzalutamide
- eribulin
- etanercept
- ethanol (in some formulations)
- etravirine
- fingolimod
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- fosphenytoin
- glofitamab
- golimumab
- guselkumab
- hydrocortisone ophthalmic
- inebilizumab
- infliximab
- iptacopan
- ivosidenib
- ixabepilone
- ixazomib
- ixekizumab
- lebrikizumab
- levofloxacin
- lorlatinib
- loteprednol ophthalmic
- lumacaftor/ivacaftor
- mavacamten
- metronidazole
- miglustat
- mirikizumab
- mirvetuximab soravtansine
- mitapivat
- mitoxantrone
- modafinil
- mometasone implant
- mometasone inhaled
- mometasone nasal
- mosunetuzumab
- moxifloxacin
- nadofaragene firadenovec intravesical
- nafcillin
- natalizumab
- naxitamab
- nelarabine
- ocrelizumab
- ofatumumab
- ofloxacin
- ozanimod
- paclitaxel
- pegcetacoplan
- pentobarbital
- pexidartinib
- phenobarbital
- phenytoin
- polatuzumab vedotin
- pomalidomide
- ponesimod
- pozelimab
- prednisolone ophthalmic
- primidone
- ravulizumab
- repotrectinib
- rifampin
- rifapentine
- rilonacept
- risankizumab
- rozanolixizumab
- secukinumab
- siltuximab
- siponimod
- sotorasib
- spesolimab
- St. John's wort
- sutimlimab
- tacrolimus
- talquetamab
- teclistamab
- tezepelumab
- tildrakizumab
- tinidazole
- tisagenlecleucel
- tralokinumab
- tuberculin purified protein derivative
- ublituximab
- ustekinumab
- vedolizumab
- vigabatrin
- vilobelimab
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- zilucoplan
Adverse Reactions .
Serious Reactions
- infusion rxn, severe
- anaphylaxis
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- peripheral neuropathy
- anemia
- neutropenia
- thrombocytopenia
- infection, severe
- febrile neutropenia
- septic shock
- opportunistic infection
- PML
- tumor lysis syndrome
- pulmonary embolism
- pulmonary toxicity
- pneumonitis, non-infectious
- interstitial lung dz
- ARDS
- supraventricular arrhythmia
- hepatotoxicity
- GI toxicity, severe
- GI perforation
- GI hemorrhage
- GI obstruction
- pancreatitis
- hyperglycemia
- ketoacidosis
- female infertility (animal studies)
Common Reactions
- neutropenia
- peripheral neuropathy
- anemia
- fatigue
- nausea
- thrombocytopenia
- diarrhea
- URI
- fever
- cough
- vomiting
- pruritus
- arthralgia
- dyspnea
- myalgia
- rash
- infusion rxn
- appetite decr.
- constipation
- abdominal pain
- headache
- weight decr.
- rigors
- hyperglycemia
- alopecia
- muscle spasms
- insomnia
- dizziness
- back pain
- lymphadenopathy
- edema
- pain
- extremity pain
- night sweats
- anxiety
- oropharyngeal pain
- stomatitis
- ALT incr.
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline; Cr at baseline; LFTs at baseline, then periodically; CBC w/ diff prior to each dose; glucose; s/sx neuropathy
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available, though risk of teratogenicity and embryo-fetal toxicity and death based on animal data at recommended human dose and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x2mo after D/C in female pts and x4mo after D/C in male pts
Lactation
Clinical Summary
avoid breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: for brentuximab vedotin: catabolism; CYP450: unknown; Info: antibody-drug conjugate releases active drug monomethyl auristatin E (MMAE); for MMAE: unknown; CYP450: 3A4/5 substrate
Excretion: feces 72% (primarily unchanged); Half-life: 4-6 days (antibody-conjugated MMAE), 3-4 days (unconjugated MMAE)
Subclass: Immunotherapy, Antibody-Drug Conjugates ; Immunotherapy, CD30 Inhibitors ; Mitosis Inhibitors, Antimicrotubule Agents
Mechanism of Action
binds CD30-expressing cells, forming internalized complex which releases monomethyl auristatin E (MMAE) intracellularly; MMAE binds to microtubules, inhibiting mitosis and inducing apoptosis (antibody-drug conjugate)
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.