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Zevalin
ibritumomab tiuxetan
Black Box Warnings .
Appropriate Dose
Y-90 ibritumomab dose should not exceed 32 mCi (1184 MBq)
Fatal Infusion Rxns
deaths w/in 24h of rituximab infusion, an essential component of Zevalin regimen; fatalities assoc. w/ hypoxia, pulmonary infiltrates, ARDS, MI, V Fib, or cardiogenic shock; approx. 80% fatal infusion rxns occurred w/ 1st rituximab infusion; D/C rituximab and Y-90 ibritumomab if severe infusion rxn
Severe Prolonged Cytopenias
occurred in most pts w/ Y-90 ibritumomab; do not administer Y-90 ibritumomab if >25% lymphoma marrow involvement and/or impaired bone marrow reserve
Severe Cutaneous/Mucocutaneous Rxns
can occur, incl. fatal; D/C rituximab and Y-90 ibritumomab if severe cutaneous or mucocutaneous rxns
Adult Dosing .
Dosage forms: INJ
Restricted Distribution in US
- [1-866-298-8433 or www.zevalin.com for more info]
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for XRT safety procedures, uses, premeds, and dosing incl. toxicity-related dose adjustments
non-Hodgkin lymphoma, relapsed or refractory
- [0.4 mCi/kg/dose IV x1 on days 7, 8, or 9 of regimen]
- Start: w/in 4h after rituximab tx; Max: 32 mCi/dose; Info: for low-grade or follicular NHL; use w/ rituximab; give 0.3 mCi/kg/dose IV x1 in pts w/ Plt 100,000-149,000
non-Hodgkin lymphoma, previously untreated
- [0.4 mCi/kg/dose IV x1 on days 7, 8, or 9 of regimen]
- Start: w/in 4h after rituximab tx; Max: 32 mCi/dose; Info: for follicular NHL; use w/ rituximab
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.