SYLVANT is administered by intravenous infusion once every 3 weeks until treatment failure. Preadministration tests are conducted before the treatment. See below or download the detailed Dosing and Administration Guide for specific information related to testing, infusion preparation, and more.
11 mg/kg administered over 1 hour by intravenous infusion, every 3 weeks until treatment failure
Hematology laboratory tests should be performed prior to each dose of SYLVANT therapy for the first 12 months and every 3 dosing cycles thereafter. If the treatment criteria in the table below are not met, consider delaying treatment until values improve. Do not reduce the dose.
It is not safe to administer SYLVANT to patients with severe infections.
Laboratory parameter | Requirements before first SYLVANT administration | Re-treatment criteria |
---|---|---|
Absolute neutrophil count | ≥1.0 x 109/L | ≥1.0 x 109/L |
Platelet count | ≥75 x 109/L | ≥50 x 109/L |
Hemoglobina | <17 g/dL | <17 g/dL |
Strength | 100-mg vial | 400-mg vial |
---|---|---|
Amount of Sterile Water for Injection, USP required for reconstitution | 5.2 mL | 20 mL |
Post-reconstitution concentration | 20 mg/mL | 20 mg/mL |
At EUSA Pharma, your patient’s health is our priority. That is why we are expanding access to our treatments through the new home infusion program. Home infusion is not meant to replace patients receiving treatment at a hospital, clinic, or infusion center; however, home infusion is an option that may prevent a disruption in the treatment plan.
Patients who choose to receive a home infusion must receive their first SYLVANT infusion at a clinic or hospital before transitioning to home infusion.
To start the enrollment process, or for additional information, please contact your EUSA Pharma representative or a Coram® CVS Specialty® Infusion Services representative.
Phone: 866-899-1661
Fax: 866-843-3221
Disclaimer: Insurance coverage of home infusion treatments vary by patients’ provider and plan. SYLVANT® (siltuximab) treatment must be initiated in an office or clinic setting before transitioning to home infusion.
SYLVANT [package insert]. Hertfordshire, UK: EUSA Pharma UK Ltd; 2019.
SYLVANT® (siltuximab) is indicated for the treatment of patients with multicentric Castleman’s disease (MCD) who are human immunodeficiency virus (HIV) negative and human herpesvirus-8 (HHV-8) negative.
SYLVANT was not studied in patients with MCD who are HIV positive or HHV-8 positive because SYLVANT did not bind to virally produced IL-6 in a nonclinical study.
Severe hypersensitivity reaction to siltuximab or any of the excipients in SYLVANT.
Do not administer SYLVANT to patients with severe infections until the infection resolves. SYLVANT may mask signs and symptoms of acute inflammation including suppression of fever and of acute Phase reactants such as C-reactive protein (CRP). Monitor patients receiving SYLVANT closely for infections. Institute prompt anti-infective therapy and do not administer further SYLVANT until the infection resolves.
Do not administer live vaccines to patients receiving SYLVANT because IL-6 inhibition may interfere with the normal immune response to new antigens.
Stop the infusion of SYLVANT if the patient develops signs of anaphylaxis. Discontinue further therapy with SYLVANT.
Stop the infusion if the patient develops a mild to moderate infusion reaction. If the reaction resolves, the SYLVANT infusion may be restarted at a lower infusion rate. Consider medicating with antihistamines, acetaminophen, and corticosteroids. Discontinue SYLVANT if the patient does not tolerate the infusion following these interventions.
Administer SYLVANT in a setting that provides resuscitation equipment, medication, and personnel trained to provide resuscitation.
Gastrointestinal (GI) perforation has been reported in clinical trials although not in MCD trials. Use with caution in patients who may be at increased risk for GI perforation. Promptly evaluate patients presenting with symptoms that may be associated or suggestive of GI perforation.
The most common adverse reactions (>10% compared to placebo) in the MCD clinical trial were pruritus, increased weight, rash, hyperuricemia, and upper respiratory tract infections.
Upon initiation or discontinuation of SYLVANT, in patients being treated with CYP450 substrates with a narrow therapeutic index, perform therapeutic monitoring of effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) as needed and adjust dose. The effect of SYLVANT on CYP450 enzyme activity can persist for several weeks after stopping therapy. Exercise caution when SYLVANT is co-administered with CYP3A4 substrate drugs where a decrease in effectiveness would be undesirable (e.g., oral contraceptives, lovastatin, atorvastatin).
Perform hematology laboratory tests prior to each dose of SYLVANT therapy for the first 12 months and every 3 dosing cycles thereafter. If treatment criteria outlined in the Prescribing Information are not met, consider delaying treatment with SYLVANT. Do not reduce dose.
Do not administer SYLVANT to patients with severe infections until the infection resolves.
Discontinue SYLVANT in patients with severe infusion related reactions, anaphylaxis, severe allergic reactions, or cytokine release syndromes. Do not reinstitute treatment.
Please see full Prescribing Information for additional important safety information.
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