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Drug Guide    Z   Zevalin (In-111)

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   Zevalin (In-111)

Zevalin (In-111)
IV


This medication is combined with certain radioactive substances (Indium-111, Yttrium-90) and used along with rituximab to treat a certain type of cancer (B-cell non-Hodgkin's lymphoma) in patients whose cancer has returned or has not responded to other treatments. Ibritumomab tiuxetan and rituximab are known as monoclonal antibodies. They work by killing certain blood and cancer cells from your immune system (B cells). Yttrium-90 helps kill the cancer cells, and Indium-111 helps to show how the medication is spread throughout the body (imaging studies).

 
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 Zevalin (In-111) images:

OverviewPhotosHow To UseSide EffectsPrecautionsMissed DoseDrug Interactions
Zevalin (In-111)

Uses
This medication is combined with certain radioactive substances (Indium-111, Yttrium-90) and used along with rituximab to treat a certain type of cancer (B-cell non-Hodgkin's lymphoma) in patients whose cancer has returned or has not responded to other treatments. Ibritumomab tiuxetan and rituximab are known as monoclonal antibodies. They work by killing certain blood and cancer cells from your immune system (B cells). Yttrium-90 helps kill the cancer cells, and Indium-111 helps to show how the medication is spread throughout the body (imaging studies).
Notes
  • Laboratory and/or medical tests (e.g., complete blood count, platelets, blood pressure, imaging studies) should be performed periodically to monitor your progress or check for side effects.
  • Consult your doctor for more details.

Storage
  • Store in the refrigerator between 36-46 degrees F (2-8 degrees C) away from light.
  • The medication must be used within 12 hours when mixed with Indium-111 and within 8 hours when mixed with Yttrium-90.
  • Do not freeze.
  • Keep all medicines away from children and pets.

Overdose
  • Symptoms of overdose may include: signs of infection (e.g., fever, persistent sore throat), easy bruising/bleeding, unusual tiredness, fast/pounding heartbeat.

How To Use
  • This medication is given by injection into a vein by a health care professional.
  • Follow all instructions for the proper handling and preparation of this product (e.g., precautions for radioactive substances).
  • Do not shake the medication.
  • Before using, check this product visually for particles or discoloration.
  • Do not use the liquid if it is discolored.
  • The medication may contain a few clear particles.
  • The particles will not affect how well the medication works and will be removed by the filter.
  • If you have any questions about the preparation or use of this medication, consult the pharmacist or doctor.Dosage is based on your medical condition, weight, and response to treatment.
  • This medication is usually given as 2 doses.
  • It is always given within 4 hours after rituximab.
  • The first dose of this medication is combined with Indium-111.
  • A test is done usually 48 to 72 hours after your dose to determine how the medication has spread throughout the body.
  • If the test shows that the medication has spread properly, another dose of this medication (combined with Yttrium-90) is given 7 to 9 days after the first dose.

Side Effects
  • See also Warning section.Nausea, vomiting, diarrhea, abdominal/stomach pain, cough, dizziness, headache, flushing, or loss of appetite may occur.
  • If any of these effects persist or worsen, tell your doctor or pharmacist promptly.People using this medication may have serious side effects.
  • However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk of side effects.
  • Careful monitoring by your doctor may decrease your risk.Tell your doctor immediately if any of these unlikely but serious side effects occur: pain/swelling at injection site, swelling ankles/feet, mental/mood changes (e.g., anxiety), black stools, vomit that looks like coffee grounds, vaginal bleeding.Seek immediate medical attention if any of these rare but very serious side effects occur: weakness on one side of the body, vision problems, confusion, slurred speech.This medication is made from human blood.
  • Even though donors are carefully screened and this medication goes through a special manufacturing process, there is a very small chance that you may get infections from the medication (e.g., viruses).
  • Tell the doctor immediately if you develop any signs of infection, including fever or persistent sore throat.This medication has infrequently caused another type of cancer (acute myelogenous leukemia-AML).
  • This condition can lead to very serious blood disorders.
  • See also Warning section for symptoms.A very serious allergic reaction to this drug is rare.
  • However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions
  • Before receiving this medication, tell your doctor or pharmacist if you are allergic to it; or to mouse proteins; or to other medications in the treatment plan (rituximab, Yttrium-90, Indium-111); or if you have any other allergies.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood/bone marrow disorders (e.g., neutropenia, thrombocytopenia), recent/current infections.This drug may make you dizzy.
  • Use caution while driving, using machinery, or doing any activity that requires alertness.
  • Limit alcoholic beverages.Before having surgery, tell your doctor or dentist that you are using this medication.Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.Wash your hands well to prevent the spread of infections.To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.Since this medication may harm an unborn baby, both men and women receiving this medication should use at least 2 reliable forms of birth control (e.g., condoms, birth control pills) during treatment with this medication and for 12 months afterwards.
  • Consult with your doctor for more details.This medication is not recommended for use during pregnancy.
  • If you become pregnant or think you may be pregnant, tell your doctor immediately.It is not known whether this drug passes into breast milk.
  • Because of the possible risk to the infant, breast-feeding while using this drug is not recommended.
  • Consult your doctor before breast-feeding.

Missed Dose
  • For the best possible benefit, it is important to receive each scheduled dose of this medication as directed.
  • If you miss a dose, contact your doctor to establish a new dosing schedule.

Drug Interactions
  • Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.
  • Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: drugs that affect the immune system (e.g., azathioprine, cyclosporine, corticosteroids such as prednisone), drugs that can cause bleeding/bruising (e.g., "blood thinners" such as warfarin/heparin, anti-platelet drugs including NSAIDs such as ibuprofen/aspirin).Low-dose aspirin should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day).
  • Ask your doctor or pharmacist for more details.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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