Crizanlizumab

Indication: sickle cell disease (reduction of vaso-occlusive crises); may be given with or without hydroxyurea. Dilute in 0.9% sodium chloride or 5% dextrose to a total volume of 100 mL (volume of crizanlizumab added must not exceed 96 mL); one 100 mg/10 mL vial per 10 mL required. Do not mix or co-administer other drugs through the same line; flush the line with at least 25 mL of 0.9% sodium chloride or 5% dextrose after the infusion. Diluted solution: give as soon as possible - no more than 4.5 hours at room temperature (up to 25 degrees C) or 24 hours refrigerated at 2-8 degrees C from first vial puncture to end of infusion. Missed dose: give as soon as possible; if given within 2 weeks of the missed dose continue the original schedule, if more than 2 weeks later continue every 4 weeks from then. Re-evaluate treatment at least yearly and consider discontinuing if no perceived benefit. Infusion-related reactions: interrupt or slow the infusion for mild/moderate reactions, discontinue for severe reactions; use caution with corticosteroids in sickle cell disease unless clinically indicated. No UK SPC was retrieved for this bundle; the entry derives from US labelling (ADAKVEO, label date 2026-06-04) and must be verified against the UK SPC.

Safety and effectiveness established only in paediatric patients aged 16 years and older, at the same 5 mg/kg dose as adults (one 16-year-old patient was treated with 5 mg/kg in the SUSTAIN trial). Safety and efficacy below 16 years of age have NOT been established - do not extrapolate this dose to younger children.