What you Should Tell the Doctor before Starting Alefacept
Alefacept can both affect your normal immune response and make you more susceptible to infections. You should tell your doctor about any other health problems you have now or have had in the past. If any of the following conditions apply, tell your doctor before you start alefacept therapy:
- are pregnant or are planning to become pregnant
- are breast-feeding
- have had a recent severe infection or are prone to chronic or recurring infections
- have, have had, or have been exposed to tuberculosis
- have a history of immune suppression (such as HIV/AIDS)
- have a history of cancer
- have a history of allergy to alefacept
- are taking any other medications, especially immunosuppressive agents or herbal supplements
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| Alefacept for Psoriasis |
Who Should Not Take Alefacept
- those with a T-cell count lower than 250 cells/microliter
- those who are pregnant or breast-feeding
- those who have a serious infection, or frequent recurrence of serious infections
- those who have HIV/AIDS
- those who have cancer (with the exception of certain types of skin cancer that have been treated)
- those who are allergic to alefacept or any of its components
As always, it is important to follow your doctor's instructions, keep your appointments for injections, and obtain all blood work as directed by your doctor. If you develop any of the following conditions while taking alefacept, immediately contact your doctor.
You experience a decrease in your T-lymphocyte number:
A decrease in the number of T-lymphocytes (one of the types of white blood cells measured during a complete blood count) is called lymphopenia. If your T-lymphocytes drop below a certain number while on alefacept, your doctor will stop your treatment until they increase (levels of CD4+ T-lymphocyte cells should be greater than 250 cells/microliter). If these levels are below normal prior to starting alefacept treatment, you should not start until your cell count is normal or above normal. Your doctor will determine this before starting therapy. It is important to get your blood work done regularly while on alefacept as directed by your doctor.
You develop an infection:
If you develop an infection or symptoms of an infection, you should contact your doctor. If the infection is mild, it may not be necessary for you to stop treatment. However, certain infections may require you to do so.
Symptoms can include fever, fatigue, and/or a cough. Other symptoms could include a raised, hot, red area of skin that is spreading. If you feel unwell but do not have a fever, it is still important to tell your doctor. Since alefacept can suppress your immune system, your body may not respond to an infection with a fever as it would normally. If you develop a serious infection alefacept should be stopped until it is fully treated. Any medication that your doctor prescribes for the treatment of infections should be taken immediately.
You develop cancer (malignancies):
If you develop cancer while taking alefacept, tell your doctor right away. Alefacept is an immunosuppressant and has a potential to increase your risk of cancer. Alefacept reduces the number of T-cells, which are important in fighting and preventing serious infections and cancer. The role of alefacept in the development of cancer is unknown. In clinical trials, the incidence of cancer in patients treated with alefacept was low and similar to those taking a placebo. Long-term follow-up studies are required to determine the safety of this medication.
You become pregnant:
If you become pregnant while taking alefacept, contact your doctor immediately. In the United States, there is a pregnancy registry that you can enroll in by calling 1-866-263-8483.
You need to receive a vaccine:
The efficacy and safety of live vaccines administered while a patient is taking alefacept is not known.
What Side Effects Can Alefacept Cause?
Side effects are possible with any medication, including biologic agents; however, clinical studies have shown that alefacept is well tolerated. There is no evidence of psoriasis rapidly recurring (rebound) after stopping therapy. The most common side effects, experienced by more than 5 percent of patients, were:
- sore throat
- runny nose
- nausea
- fatigue
- diarrhea
- itch
- headaches
- pain, swelling, and redness at the site of injection
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| Alefacept for Psoriasis |
How Do You Store Alefacept?
When alefacept is administered at your doctor's office, it will usually be provided when you come to the clinic. If a nurse comes to your home and administers the injection, you may have to store the medication.
- Do not use the medicine after the expiry date on either the vial of alefacept or the water used for injection. Do not use after the last day of the last month stamped on either vial.
- The dose pack should be stored in the refrigerator between 36°- 45°F (2°- 8°c).
- If there is not enough room in the refrigerator for the entire dose pack (a vial of dilutant, syringe, needles, bandage, alcohol pack, and gauze pads), it is important that the vial of alefacept is refrigerated. Other parts of the dose pack can be stored at room temperature.
- You might want to take the alefacept out of the refrigerator 30 minutes before you inject, which will allow the medication to warm to room temperature and will be more comfortable for you to inject.
- Once you mix the dilutant with the alefacept, use it immediately.
- If necessary, you can keep the mixed solution in the refrigerator for up to 4 hours. If you don't use it within 4 hours, dispose of the solution.