Edaravone

How it works

It acts as an antioxidant that scavenges reactive oxygen species, thereby reducing oxidative stress thought to contribute to motor neurone injury.

Prescribing in practice

• Hypersensitivity and anaphylactic reactions can occur, so administer with appropriate monitoring and resuscitation provision available for intravenous use.
• Sodium bisulfite-containing formulations may provoke reactions in susceptible individuals, including those with sulfite sensitivity.
• Treatment is given in intermittent cycles, and an oral formulation is available in some settings as an alternative to the intravenous route.

Monitoring

Monitor for hypersensitivity reactions during and after administration and assess functional status to judge ongoing benefit.

Counselling the patient

• Report any rash, breathlessness, swelling or itching during or after treatment.
• Treatment is given in repeated cycles; keep to the scheduled appointments.
• Discuss any history of sulfite sensitivity with the team.

Evidence & guidelines

A randomised placebo-controlled trial demonstrated a reduction in the rate of functional decline in a defined ALS subgroup.