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The recommended dose of casirivimab is 600 mg, along with imdevimab 600 mg. In studies, doses up to 8 g (4000 mg of each drug) have been administered without dose-limiting toxicity. In overdose situations, general supportive measures, including vital signs and clinical status monitoring, are recommended. There is no specific antidote for toxicity due to overdose. Pregnancy and Lactation [10] Casirivimab is a humanized monoclonal antibody (IgG1). Placental transfer of IgG depends on different factors, such as maternal serum IgG level and IgG subclass.[11] Further data are needed to classify risk or benefit to the fetus. Maternal IgG is present in breast milk. Casirivimab is a large protein molecule with a molecular weight of over 145,000 Da, so the amount in milk is probably low, and it is also likely partially destroyed in the infant's gastrointestinal tract. Therefore, absorption by the infant is likely low. No information is available related to using casirivimab during breastfeeding. According to the emergency use authorization, the decision to breastfeed during therapy should depend on the benefit of treatment of the mother and the benefits and risk of exposure to the infant. No dose adjustment is recommended for pregnant or lactating patients per emergency use authorization by FDA (FDA 2021).

Casirivimab is a monoclonal antibody authorized for emergency use by the FDA due to the ongoing COVID-19 pandemic. Initial results show a decrease in viral load and clinical benefit if the drug is initiated early in high-risk patients with mild to moderate disease.[9] More adverse effects related to the drug might be reported in the future. Therefore, when the drug is being used, the prescribing physician, nurses, and pharmacists need close safety monitoring. Providers should be vigilant of any potential drug-related adverse effects. Educating the patient regarding the drug is crucial. The drug combination is administered via IV infusion or SQ, and there is the possibility of infusion and injection-related side effects, including pyrexia, chills, abdominal pain, flushing, urticaria, and pruritus, along with hypersensitivity and anaphylaxis. Observation in the infusion center after transfusion for at least 60 minutes is recommended. The interprofessional team of healthcare professionals must have the necessary medications and equipment in the room to ensure safe outcomes. Proper and prompt intervention can be life-saving in cases such as anaphylaxis.[7] Pharmacists can help clinicians and nurses ensure proper dosing, monitor drug interactions, and educate patients and staff on potential side effects. Proper collaboration between interprofessional healthcare team members helps achieve optimal patient outcomes while minimizing patient risks.