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Patisiran

Class
Anti-amyloid agents
Subclass
RNA interference therapeutics
Generic name
Patisiran
Brand names
Onpattro®
Common formulations
Solution for injection
Safety risks
Contraindications
A known hypersensitivity to patisiran or any of its components
Warnings and precautions
Coagulopathy
•
Use caution with a history of coagulation disorders or receiving anticoagulant therapy.
Thrombocytopenia
•
Use caution with a history of bleeding disorders.
Specific populations
Renal impairment
eGFR ≥ 30 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required. Monitor for vitamin A deficiency.
eGFR < 30 mL/min/1.73 m²
•
Avoid use as much as possible. Monitor for vitamin A deficiency.
Renal replacement therapy
Continuous renal replacement
•
Use with caution.
Intermittent hemodialysis
•
Avoid use as much as possible.
Peritoneal dialysis
•
Avoid use as much as possible.
Hepatic impairment
Child-Pugh A (mild)
•
Use acceptable. No dose adjustment required.
Child-Pugh B (moderate)
•
No guidance available.
Child-Pugh C (severe)
•
No guidance available.
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals. In humans, due to the potential teratogenic risk arising from unbalanced vitamin A levels, this drug should not be used during pregnancy, unless the clinical condition of the woman requires treatment.
•
As a precautionary measure, vitamin A and thyroid stimulating hormone levels should be obtained early in pregnancy along with close monitoring of the fetus.
•
There are no controlled data in human pregnancy.
Breastfeeding
Little information available on breastfeeding safety.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Very common > 10%
•
Infusion-related reactions, upper respiratory tract infections
Common 1-10%
•
AV block, bronchitis, eye floaters, arthralgia, blurred vision, dry eyes, dyspnea, indigestion, muscle spasms, vertigo, skin erythema
Unknown frequency
•
Vitamin A deficiency
Interactions
Drug(s)
Check Interactions
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