How does this medication work? What will it do for me?

Brodalumab belongs to the class of medications called biological response modifiers ("biologics").

It is used to treat moderate-to-severe plaque psoriasis in adults whose specialists have determined that systemic or phototherapy may be beneficial. For people with plaque psoriasis, the body overproduces a protein called interleukin-17A (IL-17A). Increased levels of this protein can result in skin itching, pain, and scaling. Brodalumab recognizes this protein and blocks the action of IL-17A, reducing the symptoms of plaque psoriasis.

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 mL of clear-to-slightly-opalescent, colourless-to-slightly-yellow liquid that is practically free from particles, contains 140 mg of brodalumab. Nonmedicinal ingredients: proline, glutamate, polysorbate 20, and water for injection. The resulting pH is 4.8.

Each single-use prefilled syringe contains 210 mg of brodalumab and is supplied in 1.5 mL solution (140 mg/mL brodalumab) in a single-use syringe made from type 1 glass with a stainless steel 27G x 1⁄2" needle.

How should I use this medication?

The recommended starting dose of brodalumab is 210 mg injected subcutaneously (under the skin) once a week for 3 weeks. After 3 doses, the recommended dose is 210 mg injected every 2 weeks. Each dose is given as a single injection of 210 mg (1.5 mL). Each syringe is single-use only and should be safely discarded after injecting the dose.

Brodalumab is administered by subcutaneous injection in the thigh, abdomen, or outer upper arm. It is important to rotate the site of injection. Avoid injecting into areas that are tender, bruised, red, hard, or affected by psoriasis.

Do not shake this medication before using it. The solution for injection should be clear to slightly opalescent, and colourless-to-slightly-yellow. If it is cloudy or you can see lumps, flakes, or coloured particles in the solution, do not use it. To minimize discomfort, allow this medication to warm to room temperature for 30 minutes before injecting.

If you are using this medication at home, your doctor will ensure that you understand exactly how to use it. Make sure you ask any and all questions necessary to ensure that you use it exactly as prescribed. It is important to visit your doctor regularly during therapy to ensure that the medication is working safely and effectively.

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, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, inject it as soon as possible. Then talk to your doctor about when you should inject the next dose. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication in the refrigerator, protect it from light and moisture, and keep it out of the reach of children. Do not allow this medication to freeze. Brodalumab may also be kept at room temperature in its original carton for up to 14 days.

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 brodalumab or any ingredients of the medication
  • have Crohn's disease

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.

  • diarrhea
  • fatigue
  • headache
  • joint pain

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:

  • mouth or throat pain
  • signs of bowel inflammation (e.g., fever that appears after starting the medication, watery and severe diarrhea [may also be bloody])

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • 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.

Allergic reactions: In rare cases, some people may develop an allergic reaction to this medication. Signs of an allergic reaction include a severe rash, hives, swollen face or throat, or difficulty breathing. If these occur, seek medical attention immediately.

Crohn's Disease: If you have Crohn's disease, (a form of inflammatory bowel disease) brodalumab may make symptoms of this condition worse. During medication testing, some people with no history of Crohn's disease developed bowel symptoms. If you develop symptoms of inflammation in the digestive system, such as diarrhea, fatigue, fever, and abdominal pain or cramping, contact your doctor as soon as possible. People who have Crohn's disease should not use this medication.

Infections: This medication can increase the risk of developing an infection, including serious infections such as sepsis, pneumonia, and tuberculosis. Before starting brodalumab treatment, your doctor may test to see if you have tuberculosis. If you notice signs of an infection such as fever, chills, pain, swelling, coughing, or pus, contact your doctor as soon as possible. This medication should also not be started while you have an active infection.

Tell your doctor if you have a history of infections that keep coming back, or other conditions that might increase your risk of infections such as diabetes. While you are taking brodalumab, your doctor will monitor you for signs of infection.

Suicidal or agitated behaviour: People with psoriasis appear to be at an increased risk of suicidal behaviour. If you have depression or other mental illness, you may be at an increased risk of mood changes, feeling agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or wanting to hurt yourself or others. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately.

Vaccines: Live vaccines (e.g., BCG, yellow fever) are not recommended for people taking this medication. Talk to your doctor if you need any vaccinations while taking this medication.

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.

Breast-feeding: It is not known if brodalumab 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?

There may be an interaction between brodalumab and any of the following:

  • medications that suppress the immune system:
    • corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
    • medications used to treat conditions such as cancer, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, or medications used after a transplant
  • vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. 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.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications 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.

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