Ibritumomab

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Zevalin; Belgium: Zevalin; Bulgaria: Zevalin; Cyprus: Zevalin; Czech Republic: Zevalin; Estonia: Zevalin; Finland: Zevalin; France: Zevalin; Germany: Zevalin; Hungary: Zevalin; Ireland: Zevalin; Italy: Zevalin; Latvia: Zevalin; Malta: Zevalin; Netherlands: Zevalin; Poland: Zevalin; Portugal: Zevalin; Romania: Zevalin; Slovakia: Zevalin; Slovenia: Zevalin; Spain: Zevalin; Sweden: Zevalin; UK: Zevalin.

North America

USA: Zevalin.

Latin America

Argentina: Zevamab.

Asia

Japan: Zevalin.

Drug combinations

Chemistry

Ibritumomab Tiuxetan: Mw: approx. 1500.01. (1) Immunoglobulin G~1~, anti-(human CD20 (antigen))(mouse monoclonal IDEC-Y2B8 γ~1~-chain), disulfide with mouse monoclonal IDEC-Y2B8 κ-chain, dimer, N-[2-[bis(carboxymethyl)amino]-3-(4-isothiocyanatophenyl)propyl]-N-[2-[bis(carboxymethyl)amino]propyl]glycine conjugate; (2) Immunoglobulin G~1~ (mouse monoclonal IDEC-Y2B8 γ~1~-chain anti-human antigen CD20), disulfide with mouse monoclonal IDEC-Y2B8 κ-chain, dimer, N-[2-[bis(carboxymethyl)amino]-3-(p-isothiocyanatophenyl)propyl]-N-[2-[bis(carboxymethyl)amino]propyl]glycine conjugate. CAS-206181-63-7 (1998).

Pharmacologic Category

Other Antineoplastic Agents; Monoclonal Antibodies. Radiopharmaceutical. (ATC-Code: V10XX02).

Mechanism of action

Ibritumomab is a monoclonal antibody directed against CD20 antigen found on B lymphocytes (normal and malignant). Ibritumomab binding induces apoptosis in B lymphocytes in vitro. Combined with chelator tiuxetan, which acts as specific chelation site for either Indium-111 (^111^In) or Yttrium-90 (^90^Y). The monoclonal antibody acts as a delivery system to direct the radioactive isotope to the targeted cells, however, binding has been observed in lymphoid cells throughout the body and in lymphoid nodules in organs such as the large and small intestines.

Therapeutic use

Treatment of relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin lymphoma.

Pregnancy and lactiation implications

Unlabeled use

Contraindications

Known type I hypersensitivity or anaphylactic reactions to ibritumomab, indium chloride, yttrium chloride, any component of the formulation. Murine proteins, or rituximab.

Warnings and precautions

Hazardous agent. Cutaneous and mucocutaneous reactions reported (erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous dermatitis, and exfoliative dermatitis). Delayed, prolonged, and severe cytopenias (thrombocytopenia and neutropenia) common. Severe and potentially fatal infusion reactions (angioedema, bronchospasm, hypotension, hypoxia) reported. Radiation injury occurred in or near areas of lymphomatous involvement. Secondary malignancies (acute myelogenous leukemia and/or myelodysplastic syndrome) reported. Product contains albumin (theoretical risk of transmission of viral disease or Creutzfeldt-Jakob disease). Infusion site erythema and ulceration reported following extravasation. Do not administer live viral vaccines to patients who have recently received ibritumomab treatment. Do not exceed the ^90^Y ibritumomab maximum allowable dose of 32 mCi, and do not administer to patients with altered biodistribution.

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