Pharmacy Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.

GENERIC NAME: alefacept

BRAND NAME: Amevive

DRUG CLASS AND MECHANISM: Alefacept is an injectable drug that suppresses the immune system and is used for the treatment of psoriasis . Scientists believe that psoriasis is caused by an increase in the production of one type of immune cell, T-lymphocytes, in response to the attachment of a stimulant (antigen) to the lymphocyte. The stimulated T-lymphocytes cause skin cells to grow rapidly, and the rapid growth of the skin cells produces the skin plaques of psoriasis. Alefacept reduces the stimulation and production of T-lymphocytes by attaching to the site on the T-lymphocytes where the antigen attaches. This prevents the antigen from binding and activating the T-lymphocytes. Alefacept also decreases the life-span of T-lymphocytes that already have been produced by increasing the activity of another type of immune cell, natural killer cells, that kill T-lymphocytes. Alefacept was approved by the FDA in January, 2003.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Single use vials: 7.5 mg/0.5 ml for intravenous use and 15 mg/0.5 ml for intramuscular use.

STORAGE: Room temperature: 15-30°C (59-86°F).

PRESCRIBED FOR: Alefacept is used for the treatment of adult patients with moderate to severe chronic plaque psoriasis.

DOSING: The recommended dosing is 7.5 mg by intravenous injection or 15 mg by intramuscular injection once weekly for 12 weeks. The treatment cycle can be repeated after a twelve week interval without treatment if the patient's T-lymphocyte counts are within the normal range.

DRUG INTERACTIONS: Drug interaction studies have not been conducted. However, since alefacept suppresses the immune system, it should not be used with other drugs the also suppress the immune system.

PREGNANCY: Use of alefacept during pregnancy has not been evaluated .

NURSING MOTHERS: Use of alefacept by nursing mothers has not been adequately evaluated. It is not known whether alefacept is excreted in breast milk

SIDE EFFECTS: The most common side effects of alefacept are sore throat , dizziness, cough, nausea, itching, muscle aches, chills, injection site pain and injection site redness and swelling. The most serious side effects are a reduction in the number of immune cells, infections, cancer and allergic reactions. Alefacept should not be used by individuals whose blood lymphocyte counts are less than 250/ml.

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