Lemtrada

Lemtrada is a prescription medication used to treat patients with relapsing forms of multiple sclerosis (MS). Lemtrada works because it targets the cells that are thought to cause MS.

This medication comes in a liquid form and is injected intravenously (into a vein) by your doctor or healthcare provider. 

Some of the common side effects of Lemtrada include rash, headache, and fever.

Lemtrada is a prescription medication that is used to treat patients with relapsing forms of multiple sclerosis (MS). Lemtrada is reserved for those who have not seen an adequate response to two or more medications used to treat MS. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Genzyme Corporation

Lemtrada can cause serious side effects. See "Lemtrada Precautions" section.

The most common side effects of Lemtrada include:

• rash
• headache
• thyroid problems
• fever
• feeling tired
• trouble sleeping
• infections (urinary tract infections, upper respiratory tract infections, sinus infection, herpes, fungal infection)
• hives
• itching
• joint pain
• pain in the back, arms, and legs
• diarrhea
• mouth pain or sore throat
• tingling sensation
• dizziness
• stomach pain
• sudden redness in face, neck, or chest
• vomiting

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Lemtrada. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. 

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. No official interaction studies have been performed with Lemtrada but because Lemtrada can reduce your body's ability to fight off infection tell your doctor before taking Lemtrada if you are receiving:

• Live and weakened viral vaccines including:
  • Flu vaccines
  • Mump vaccines
  • Measle vaccines
  • Rubella vaccines
  • Polio vaccines
  • Rotavirus vaccines
  • Chickenpox vaccines
  • Shingles vaccines
  • Typhoid vaccines
  • Yellow fever vaccines

This is not a complete list of Lemtrada drug interactions. Ask your doctor or pharmacist for more information.

Lemtrada can cause some serious side effects that you should know. These side effects include:

• Low blood counts (cytopenia). In some cases, Lemtrada can cause rare but serious and even fatal cases of low blood counts. The risk of low blood counts is greater when the given dose is more than recommended amount or when Lemtrada is taken for longer than recommended. Lemtrada should be stopped if certain blood counts fall into dangerously low levels. You should ask your doctor or pharmacist about the following before taking Lemtrada:
  • Low red blood cells (anemia)
  • Low platelets (thrombocytopenia) 
  • Low bone marrow activity (myelosuppression)
  • Immature cell production (aplasia)
  • Low overall blood cell production (pancytopenia)
• Serious autoimmune problems. Some people receiving this medication develop a condition where the immune cells in your body attack other cells or organs in the body (autoimmunity), which can be serious and may cause death. 
• Infusion reactions. These side effects often occur during or shortly after starting a dose of Lemtrada. These are generally worst during the first week of treatment but can occur later in treatment too. These side effects include:
  • Fever
  • Itching
  • Low blood pressure
  • Nausea
  • Vomiting
  • Difficulty breathing
  • Chills
  • Fainting
  • Swelling
  • Heart problems including irregular heartbeat and heart attack
  • Inflammation and fluid retention in the lungs
• Certain cancers. Receiving this medication may increase your chance of getting some kinds of cancers. Call your healthcare provider if you have the following symptoms that may be a sign of thyroid cancer:
  • new lump
  • swelling in your neck
  • pain in front of neck
  • hoarseness or other voice changes that do not go away
  • trouble swallowing or breathing
  • cough that is not caused by a cold

 Make sure to have your skin checked before you start receiving this medication and each year while you are receiving treatment to monitor for symptoms of skin cancer.

• Swelling of lung tissue (pneumonitis). Some people have had swelling of the lung tissue while receiving this medication. Call your healthcare provider right away if you have the following symptoms:
  • shortness of breath
  • cough
  • wheezing
• Thyroid disorders. Your healthcare provider will obtain thyroid function tests. Call your healthcare provider if you have any of these symptoms:
  • excessive sweating
  • unexplained weight loss
  • eye swelling
  • nervousness
  • fast heartbeat
  • unexplained weight gain
  • feeling cold
  • worsening tiredness
  • constipation
• Increased risk of serious infections. Lemtrada weakens the body's immune system and affects your ability to fight infections. Serious infections can happen with Lemtrada and can sometimes lead to death. Serious infections can include:
  • Viral infections. Certain viruses can live in your body and cause active infections when your immune system is weak. Viral infections that can happen with mycophenolate mofetil include:
    • Shingles, other herpes infections, and cytomegalovirus (CMV). CMV can cause serious tissue and blood infections.
    • BK virus. BK virus can affect how your kidney works and cause your transplanted kidney to fail.
  • Tuberculosis. your doctor will check you for tuberculosis before you receive this medication. 
  • Hepatitis

Do not use Lemtrada if you:

• are allergic to any of the ingredients it contains
• have HIV

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Lemtrada, there are no specific foods that you must exclude from your diet.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Lemtrada may harm your unborn baby. It is recommended to use birth control while receiving this medication and for 4 months after you stop taking Lemtrada. 

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Lemtrada passes into your breast milk. You and your doctor should decide whether you will stop breastfeeding or not take Lemtrada.

Receive this medication exactly as prescribed. 

Lemtrada is given to you through your veins and will take about 4 hours to receive a full dose. 

Your doctor will prescribe Lemtrada in an amount that is right for you. 

• You will receive Lemtrada over 2 treatment courses
• You will receive this medication for 5 days in a row for the first treatment course and then for 3 days in a row about 1 year later for your second treatment course. 

It is very important that you follow your doctor's instructions closely. 

The recommended dose of Lemtrada is 12mg/day. 

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if an overdose is suspected, seek emergency medical attention.

• It is important for you to keep all appointments. Call your doctor if you must miss an appointment. There may be special instructions for you.

Cytopenias: Serious, including fatal, pancytopenia/marrow hypoplasia, autoimmune idiopathic thrombocytopenia, and autoimmune hemolytic anemia can occur in patients receiving Lemtrada. Single doses of Lemtrada greater than 30 mg or cumulative doses greater than 90 mg per week increase the incidence of pancytopenia.

Infusion Reactions: Lemtrada administration can result in serious, including fatal, infusion reactions. Carefully monitor patients during infusions and withhold Lemtrada for Grade 3 or 4 infusion reactions.

Gradually escalate Lemtrada to the recommended dose at the initiation of therapy and after interruption of therapy for 7 or more days.

Infections: Serious, including fatal, bacterial, viral, fungal, and protozoan infections can occur in patients receiving Lemtrada. Administer prophylaxis against Pneumocystis jiroveci pneumonia (PCP) and herpes virus infections.