Efalizumab Injection

Conditions Treated

Efalizumab is used to treat chronic (long-term) plaque psoriasis (a skin disease in which red scaly patches form on some areas of the body) in patients who cannot be treated with medications that are applied to the skin. Efalizumab is in a class of medications called immunosuppressants. It works by stopping the action of cells in the body that cause the symptoms of psoriasis.

Possible Side Effects

What Side Effects Can This Cause?

Efalizumab may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache, fever, chills, nausea, vomiting, and muscle pain within 48 hours of injecting the first 2 doses
• back pain
• acne

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• easy bruising or bleeding
• bleeding gums
• tiny red spots under surface of skin
• weakness
• lightheadedness
• dark or red urine
• yellowing of the skin or eyes
• red, stiff, swollen, or painful joints
• hives
• itching
• difficulty breathing or swallowing
• wheezing
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• rash or blisters
• unusual skin changes or sores on the skin
• new lumps or masses anywhere in your body
• sudden numbness, tingling, or weakness in the arms or legs

Efalizumab may increase the risk that you will develop cancer. Talk to your doctor about the risks of using this medication.Efalizumab may cause other side effects. Call your doctor if you have any unusual problems while using this medication.If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

Usage Instructions

How Should This Medication Be Used

Efalizumab comes as a powder to mix with sterile water and inject subcutaneously (under the skin). It is usually injected once a week. You should inject efalizumab on the same day every week. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use efalizumab exactly as directed. Do not use more or less of it or use it more often or for a longer period of time than prescribed by your doctor. Your doctor will probably start you on a low dose of efalizumab and increase your dose after one week. You can inject efalizumab yourself or have a friend or relative give the injections. Your doctor will train the person who will be injecting the medication, and will test him or her to be sure that person can give the injections correctly. Be sure that you and the person who will be giving the injections read the manufacturer's information for the patient that comes with efalizumab before you use it for the first time at home. If you are injecting efalizumab yourself, you can inject it anywhere on your thighs or stomach. If someone else will be giving you your injections, he or she can also inject the medication anywhere on the back of your upper arms or buttocks. To reduce the chances of soreness or redness, choose a different area for each injection. If your doctor has told you to use two injections for each dose, choose two spots that are at least 1 inch apart. Do not inject efalizumab near a vein that you can see through the surface of the skin. Try to inject efalizumab in skin that is free of symptoms of psoriasis. Never mix efalizumab powder with any liquid other than the sterile water provided. Never add any other medications to the syringe you will use to inject efalizumab. Never reuse needles, syringes, vials of efalizumab, or syringes of sterile water. You can throw away used alcohol pads, needle caps, and vials in the trash. Throw away used needles and syringes in a puncture-resistant container out of the reach of children. Talk to your doctor or pharmacist about what to do with the puncture-resistant container when it is full. Efalizumab controls chronic plaque psoriasis but does not cure it. It may take several weeks before you feel the full benefit of efalizumab. Do not stop taking efalizumab without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What Dietary Instructions Should I Follow

Unless your doctor tells you otherwise, continue your normal diet.

Are There Any Special Instructions

Before using efalizumab, tell your doctor and pharmacist if you are allergic to efalizumab or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any other medications for psoriasis. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you are being treated with phototherapy (a treatment for psoriasis that involves exposing the skin to ultraviolet light) and if you or any family members have or have ever had cancer or any condition that affects your nervous system. if you are having surgery, including dental surgery, tell the doctor or dentist that you are using efalizumab. talk to your doctor about whether you should receive any vaccinations before you begin your treatment with efalizumab. It is important to have all vaccines appropriate for your age before beginning your treatment with efalizumab. Do not have any vaccinations while you are using efalizumab without talking to your doctor. Also talk to your doctor if anyone in your household needs to receive a vaccine during your treatment with efalizumab. you should know that your psoriasis may worsen or you may develop a new type of psoriasis during or after your treatment with efalizumab. Call your doctor if you notice a new or worsening rash during or after your treatment. tell your doctor if you gain or lose weight while you are using efalizumab. Your doctor may have to change the dose of your medication if your weight changes. Do not change the dose of your medication without talking to your doctor.