Interactions - summary

CYP- 450  substrates-  formation of CYP-450 enzymes  is suppressed by increased levels of
cytokinase  during chronic inflammation

TNF blocking  agent  + Riloncept

Rilonacept + TNF blocking agent

Coadmin of rilonacept with TNF blocking agent may result in increased risk of serious
infections. Co-admin is not  recommended

Treatment of crytopyrin- associated  periodic syndrome

Most common adverse infection-

CNS - hypesthesia  8%

GI -  abdominal pain    diarrhea  3%  nausea  3%  stomach discomfort 3%

GU- urinary tract infection  3% 

Local - injection site reactions  40%

Respiratory-  cough 8%  sinusitis 7%   upper respiratory tract infection 25%

Special precautions-

Infections-  may interfere with imune response to infection.system. Taking rilonacept  with
TNF inhibitors is not recommended since this may increase risk of serious infections

Immunosuppression- treatment with immunosupressants including rilonacept may result
in an increase in the risk of malignancies

Hypersensitivity - rare. if reactions occurs discontinue administration of rilonacept

Pregnancy- use rilonacept during pregnancy only if the benefit justifies the potent risk to fetus

Lactation- excercise caution when rilonacept is administered to breast feeding woman

Children- safety and effitiveness in children younger than 12 years have not been established

Elderly-  In clinical studies,efficacy and tolerability  generally similar in elderly patients
as compared to younger adults

Indication-

Treatment of crytopyrin- associated  periodic syndrome

Dosage-

 18 years and older - initial loading dose 320mg delivered as two 2ml subcutaneous injection
 of 160mg  each given on the same day at 2 different sites.

Dosing should be continued  with once weekly injection of 160mg administerd as a single
2ml suncutaneous injection.

Rilonacept should not be gven more often than once weekly.

1. Inform patients that they may experience injection site reactions- including, pain, eryhema,
swelling, pruritus, bruising, inflammation, dermatitis, edema, urticaria

2. Caution patients that rilonacept has been associated with serious life threatening infections

3. Patients should report any symptoms of infections or allergic reactions to their doctor.

Pregnancy-
Use rilonacept during pregnancy only if the benefit justifies the potent risk to fetus

Lactation-
Excercise caution when rilonacept is administered to breast feeding woman

Children-
Safety and effitiveness in children younger than 12 years have not been established

Elderly- 
In clinical studies,efficacy and tolerability  generally similar in elderly patients
as compared to younger adults