How does this medication work? What will it do for me?
Daratumumab is a monoclonal antibody that belongs specifically to the class of medications called antineoplastic agents. It is used to treat multiple myeloma, when at least 3 other types of chemotherapy have not successfully treated the cancer.
Multiple myeloma is a type of blood cancer that affects plasma cells, a type of white blood cell. Daratumumab works by recognizing and attaching to these cancer cells. This may slow down or stop the cancer from growing and dividing.
Daratumumab has been granted a notice of compliance with conditions (NOC/c) by Health Canada. This means that Health Canada has approved this medication to be marketed based on promising evidence of effectiveness, but additional results of studies are needed to verify its effectiveness. An NOC/c is used to allow access to products that are used to treat or prevent serious, life-threatening, or severely debilitating illness.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each 1 mL of sterile, colourless to yellow, preservative-free, liquid concentrate contains 20 mg daratumumab. Nonmedicinal ingredients: glacial acetic acid, sodium acetate trihydrate, sodium chloride, mannitol, polysorbate 20, and water for injection.
How should I use this medication?
The initial dose of daratumumab depends on body size and is usually 16 mg per kilogram of body weight. Daratumumab is usually injected into a vein through a specially prepared site on your skin. It is usually given once a week for the first 8 weeks, then once every 2 weeks for 16 weeks, then once every 4 weeks after that.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, discuss any concerns with your doctor.
It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive daratumumab, contact your doctor as soon as possible to reschedule your appointment.
Very careful handling of this medication is required. Daratumumab should only be given by health care professionals familiar with the use of chemotherapy medications used to treat cancer. It is always given under the supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you are allergic to daratumumab or any ingredients of the medication.
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- back pain
- joint, arm or leg pain
- loss of appetite
- muscle spasms
- stomach ache
- throat irritation
- weight loss
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- blurred vision
- feeling very tired, weak or dizzy
- increased blood pressure
- mild infusion reaction (e.g., chills, nasal congestion, cough, headache, nausea, difficulty breathing)
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of electrolyte imbalance (e.g., muscle pain or cramps, weakness, irregular heart beat, lack of coordination, thirst, confusion)
- signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
- signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, change of urine colour)
- signs of pneumonia (e.g., fever, chills, shortness of breath, cough)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- wheezing or shortness of breath
- symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- severe infusion reaction (e.g., wheezing, throat tightness, difficulty breathing, high blood pressure)
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY
March 25, 2019
Health Canada has issued information concerning the use of daratumumab. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Anemia: Daratumumab may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.
Bleeding: Daratumumab may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.
Infection: As well as killing cancer cells, daratumumab can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people with contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.
Infusion reactions: This medication can cause a hypersensitivity or infusion reaction. Your doctor will prescribe a corticosteroid, an antihistamine, and a fever-reducing medication to help reduce the risk of this type of reaction. People who have breathing problems such as asthma or chronic obstructive pulmonary disease (COPD) may require inhalers if breathing problems develop after the infusion. Infusion reactions generally appear during the infusion of the medication and may include flushing, chest pain, shortness of breath, and a dramatic drop in blood pressure. In rare instances, these reactions can cause death, so it is important to let your nurse or doctor know immediately if you notice any unusual reactions.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Women who may become pregnant who are taking daratumumab should use an effective method of birth control such as condoms during treatment and for 3 months after the last dose of this medication.
Breast-feeding: It is not known if daratumumab passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
What other drugs could interact with this medication?
Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
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