Lumizyme® (alglucosidase alfa) is supplied as a sterile, nonpyrogenic, white to off-white lyophilized cake or powder that must be reconstituted for intravenous administration. Certain measures, outlined below, should be followed to ensure proper product storage and preparation for infusion.
Lumizyme is available only in 50 mg units, supplied in single-dose vials. Lumizyme does not contain any preservatives and should be stored and handled according to these guidelines:
Lumizyme should be reconstituted, diluted, and administered by a health care professional using aseptic technique. Do not use filter needles during preparation. Reconstitution devices may be used to prepare successive vials of Lumizyme without the need to enter and withdraw from numerous vials of sterile water. Such devices are available from Sanofi Genzyme by contacting Medical Information at 800-745-4447, option 2.
Remove Lumizyme vials from refrigeration and allow them to reach room temperature (about 30 minutes) before starting reconstitution. Organize a clean work area and prepare the following supplies:
1. Lumizyme 50 mg vials
2. Sterile Water for Injection, USP
3. 0.9% Sodium Chloride for Injection, USP
4. Syringes for reconstitution and dilution
5. Needles (do not use filter needles during preparation)
6. Intravenous administration set
7. In-line low protein-binding 0.2 μm filter
You may need additional supplies, depending on the IV infusion protocol of your facility or practice.
The recommended dosage of Lumizyme is 20 mg per kg of body weight (administered every two weeks). For more details on calculating vials needed per dose and recommended total infusion volume based on patient weight, see the Dosing & Administration page.
Acceptable
Clear and colorless
Acceptable
Strands/fibers of alglucosidase alfa
DO NOT USE
Opaque particles or solution discoloration
LUMIZYME® (alglucosidase alfa) is a hydrolytic lysosomal glycogen-specific enzyme indicated for patients with Pompe disease (GAA deficiency).
WARNING: RISK OF ANAPHYLAXIS, HYPERSENSITIVITY AND IMMUNE-MEDIATED REACTIONS, AND RISK OF CARDIORESPIRATORY FAILURE
Anaphylaxis and Hypersensitivity Reactions: Life-threatening anaphylaxis and hypersensitivity reactions have been observed in some patients during and after treatment with alglucosidase alfa. If anaphylaxis or severe hypersensitivity reactions occur, immediately discontinue infusion and institute appropriate medical treatment. Appropriate medical support and monitoring measures should be available during infusion.
Immune-Mediated Reactions: Monitor patients for the development of systemic immune-mediated reactions involving skin and other organs. If immune-mediated reactions occur, consider discontinuation of the administration of alglucosidase alfa, and initiate appropriate medical treatment.
Risk of Acute Cardiorespiratory Failure: Patients with acute underlying respiratory illness or compromised cardiac and/or respiratory function may be at risk of serious exacerbation of their cardiac or respiratory compromise during infusions. Appropriate medical support and monitoring measures should be readily available during alglucosidase alfa infusion, and some patients may require prolonged observation times that should be individualized based on the needs of the patient.
Risk of Cardiac Arrhythmia and Sudden Cardiac Death during General Anesthesia for Central Venous Catheter Placement: Administration of general anesthesia can be complicated by the presence of severe cardiac and skeletal (including respiratory) muscle weakness. Therefore, caution should be used when administering general anesthesia. Ventricular arrhythmias and bradycardia, resulting in cardiac arrest or death, or requiring cardiac resuscitation or defibrillation have been observed in infantile-onset Pompe disease patients with cardiac hypertrophy during general anesthesia for central venous catheter placement.
Risk of Antibody Development: Patients with infantile-onset Pompe disease should have a cross-reactive immunologic material (CRIM) assessment early in their disease course and be managed by a clinical specialist knowledgeable in immune tolerance induction in Pompe disease to optimize treatment. CRIM status has been shown to be associated with immunogenicity and patients’ responses to enzyme replacement therapies. There is evidence to suggest that some patients who develop high and sustained IgG antibody titers, including CRIM-negative patients, may experience reduced clinical alglucosidase alfa treatment efficacy.
Monitoring: Laboratory Tests: Patients should be monitored for IgG antibody formation every 3 months for 2 years and then annually thereafter.
The most frequently reported adverse reactions (≥ 5%) in clinical trials were hypersensitivity reactions and included: anaphylaxis, rash, pyrexia, flushing/feeling hot, urticaria, headache, hyperhidrosis, nausea, cough, decreased oxygen saturation, tachycardia, tachypnea, chest discomfort, dizziness, muscle twitching, agitation, cyanosis, erythema, hypertension/increased blood pressure, pallor, rigors, tremor, vomiting, fatigue, and myalgia.
Please see the Full Prescribing Information for complete details, including boxed WARNING.