Antisense oligonucleotide (SMN2 splicing modifier)
Nusinersen
Brand names: Spinraza
Adult dose
Dose: 12mg intrathecal: loading on days 0, 14, 28, 63, then maintenance every 4 months
Route: Intrathecal
Frequency: per protocol
Clinical pearls
- Spinal muscular atrophy (SMA) — specialist neuromuscular MDT
- Coag and platelet check before each dose
Contraindications
- Hypersensitivity
Side effects
- Post-LP syndrome
- Thrombocytopenia / coagulopathy
- Renal toxicity
- Hydrocephalus (rare)
- Headache
Monitoring
- Platelets
- Coag
- Urinary protein
- Neurodevelopment
Reference: BNF; NICE TA588; SmPC; https://bnf.nice.org.uk/drugs/nusinersen/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Acute Stroke Management · NICE NG128 / RCP 2023
- TIA Assessment (ABCD2) · NICE NG128 / NICE CG68
- Bacterial Meningitis (Adults) · NICE CG102 / BIA 2016
- Parkinson's Disease Management · NICE NG71 2017