Palivizumab: Key RSV Prevention for High-Risk Infants and Children

Summary or Key Points

Palivizumab is a prescription medication used to prevent serious lung infections caused by respiratory syncytial virus (RSV), particularly in high-risk infants and children. It is administered as an injection and works by boosting the body’s immune response to RSV. Palivizumab is not a vaccine but an antibody that helps reduce the risk of RSV-related complications. Always consult your healthcare provider before starting or adjusting any medication.

Names of Medication

US Brand Name: Synagis

Generic Name: Palivizumab

The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this case, Palivizumab is the generic name.

Pharmacologic Category

Monoclonal Antibody

Antiviral Agent

Dosing Guidelines for Palivizumab

Palivizumab is primarily used to prevent severe respiratory syncytial virus (RSV) infections in high-risk infants and children. It is not commonly used for adults but may be considered in certain high-risk populations. Below are the dosing recommendations for various conditions:

Respiratory Syncytial Virus (RSV) Infection

The recommended dose is 15 mg/kg of body weight, administered once a month during RSV season (typically fall to spring). Treatment usually lasts for 5 months, but your doctor may adjust the duration based on individual risk factors.

Bronchiolitis

The same dosing as for RSV infection (15 mg/kg monthly) is used to prevent bronchiolitis caused by RSV in high-risk infants and children.

Pneumonia

Palivizumab may be used to prevent RSV-related pneumonia in high-risk infants and children. The dosing remains 15 mg/kg, given monthly during RSV season.

Upper Respiratory Tract Infection

Palivizumab is not typically used to treat common upper respiratory infections but can help prevent RSV-related complications in high-risk individuals. The dosing is the same as for RSV infection.

Asthma Exacerbation

Palivizumab is not indicated for asthma treatment but may be used to prevent RSV-triggered asthma exacerbations in high-risk children. The dose is 15 mg/kg monthly during RSV season.

Croup

Palivizumab is not used to treat croup directly but may help prevent RSV-related complications that could lead to croup in high-risk infants. The dosing remains 15 mg/kg monthly.

Chronic Lung Disease

For infants and children with chronic lung disease, Palivizumab is given at a dose of 15 mg/kg monthly during RSV season to prevent severe RSV infections.

Congenital Heart Disease

Infants with congenital heart disease are at higher risk for severe RSV infections. The recommended dose is 15 mg/kg, administered monthly during RSV season.

Prematurity

Premature infants are at increased risk for RSV complications. Palivizumab is given at 15 mg/kg monthly during RSV season to help prevent severe infection.

Immunocompromised State

For children with weakened immune systems, Palivizumab is used to prevent RSV infections. The dosing is 15 mg/kg monthly during RSV season.

Always consult your healthcare provider before adjusting your dose or starting a new medication. If you have any questions about Palivizumab, you can schedule a telemedicine appointment with one of our providers to discuss your treatment plan.

Dosage Forms and Strengths of Palivizumab

Injection: 50 mg/0.5 mL single-dose vial

Injection: 100 mg/1 mL single-dose vial

Administration Instructions for Palivizumab Injection

Palivizumab is administered as an intramuscular injection, typically in the thigh muscle. It is usually given by a healthcare professional, such as a nurse or doctor, in a clinic or hospital setting. The injection is given once a month during RSV season, which usually lasts from fall to spring. If you miss a dose, contact your healthcare provider as soon as possible to reschedule.

Contraindications for Palivizumab

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm to the patient. It’s important to know if you have any of these conditions before starting a new medication like Palivizumab.

Severe Hypersensitivity or Allergic Reactions

Severe hypersensitivity or allergic reactions to Palivizumab or any of its components: If you have had a serious allergic reaction to Palivizumab or any of its ingredients in the past, you should not take this medication. Allergic reactions can include symptoms like rash, swelling, difficulty breathing, or anaphylaxis, which can be life-threatening.

Previous Severe Hypersensitivity to Other Monoclonal Antibodies

Previous severe hypersensitivity to other monoclonal antibodies: If you have had a severe allergic reaction to other monoclonal antibodies, this may increase your risk of reacting to Palivizumab as well.

If you are unsure whether Palivizumab is safe for you, it’s important to discuss your medical history with your healthcare provider. You can schedule a telemedicine appointment with one of our providers to review your options.

Drug-to-Drug Interactions

Palivizumab is not known to have significant interactions with other medications. However, it’s always a good idea to inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs, supplements, and herbal products. This helps ensure that there are no potential risks or interactions.

If you are concerned about drug interactions, our telemedicine providers can help you review your current medications and determine if Palivizumab is safe for you.

Palivizumab in Pregnancy

Is it Safe to Take Palivizumab During Pregnancy?

There is limited data on the use of Palivizumab during pregnancy. Animal studies have not shown any harm to the fetus, but there are no well-controlled studies in pregnant women. Palivizumab is generally not used in pregnant women because it is primarily prescribed for infants and young children to prevent respiratory syncytial virus (RSV) infection. If you are pregnant and considering Palivizumab, it’s important to discuss the risks and benefits with your healthcare provider.

html

Palivizumab While Breastfeeding

Is it safe to take Palivizumab while breastfeeding?

There is no specific data on whether Palivizumab passes into human breast milk. However, because Palivizumab is a large protein molecule, it is unlikely to transfer into breast milk in significant amounts or be absorbed by the infant’s digestive system. If you are breastfeeding and have concerns about Palivizumab, it’s important to consult your healthcare provider to discuss any potential risks and benefits.

Estimated Cost of Palivizumab

The cost of Palivizumab can vary depending on the pharmacy and your location. Without insurance, a single dose of Palivizumab (Synagis) using a GoodRx coupon is estimated to cost between $1,500 and $2,500. Since Palivizumab is typically administered as a monthly injection during RSV season, the total cost can add up over several months. Be sure to check with your insurance provider to confirm if Palivizumab is covered under your plan.

Possible Alternatives to Palivizumab

While Palivizumab is specifically used to prevent RSV infection in high-risk infants and children, other treatments and lifestyle adjustments may help manage or reduce the risk of respiratory infections. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these alternatives.

Respiratory Syncytial Virus (RSV) Infection

Supportive care: For mild RSV cases, supportive care such as ensuring proper hydration, rest, and managing fever with acetaminophen (Tylenol) or ibuprofen (Advil) may be sufficient.

Preventive measures: Regular handwashing, avoiding close contact with sick individuals, and keeping infants away from crowded places during RSV season can help reduce the risk of infection.

Bronchiolitis

Oxygen therapy: In severe cases of bronchiolitis, oxygen therapy may be necessary to help your child breathe more comfortably.

Hydration: Keeping your child well-hydrated is essential, especially if they are having difficulty feeding due to respiratory distress.

Pneumonia

Antibiotics: If pneumonia is caused by a bacterial infection, antibiotics such as amoxicillin or azithromycin may be prescribed.

Vaccination: The pneumococcal vaccine can help prevent certain types of bacterial pneumonia.

Upper Respiratory Tract Infection

Rest and hydration: Most upper respiratory tract infections are viral and will resolve on their own with adequate rest and fluids.

Over-the-counter medications: Decongestants, cough suppressants, and pain relievers can help alleviate symptoms.

Asthma Exacerbation

Inhaled bronchodilators: Medications like albuterol (ProAir, Ventolin) can help open the airways during an asthma attack.

Inhaled corticosteroids: These medications reduce lung inflammation and help prevent future asthma flare-ups.

Croup

Humidified air: Breathing in moist air from a humidifier or steam from a hot shower can help soothe the airways.

Steroids: In more severe cases, a single dose of oral corticosteroids like dexamethasone may be prescribed to reduce airway swelling.

Chronic Lung Disease

Oxygen therapy: Some children with chronic lung disease may require supplemental oxygen to assist with breathing.

Regular monitoring: Close follow-up with a healthcare provider is crucial to manage symptoms and prevent complications.

Congenital Heart Disease

Medications: Depending on the specific heart defect, medications such as diuretics or ACE inhibitors may be prescribed to manage symptoms.

Surgery: In some cases, surgery may be necessary to correct the heart defect.

Prematurity

Preventive care: Premature infants are at higher risk for infections, so preventive measures like proper hand hygiene and avoiding contact with sick individuals are essential.

Nutritional support: Ensuring adequate nutrition, either through breastfeeding or formula, is vital for the growth and development of premature infants.

Immunocompromised State

Infection prevention: Immunocompromised individuals should take extra precautions to avoid infections, including staying up to date on vaccinations and avoiding contact with sick individuals.

Antiviral medications: In some cases, antiviral medications may be prescribed to prevent or treat infections in immunocompromised patients.

Recent Updates on Palivizumab Research

Recent studies have focused on Palivizumab’s effectiveness in preventing severe RSV infections in high-risk infants. Researchers are also exploring extended dosing schedules to provide longer protection throughout the RSV season. Additionally, new research is investigating alternative monoclonal antibodies that may offer broader protection against various RSV strains. While Palivizumab remains the standard of care for preventing RSV in high-risk infants, ongoing research may lead to new and improved options in the future.

If you have questions about Palivizumab or emerging treatment options, our telemedicine providers are available to discuss the latest research and help you make informed decisions about your child’s care.

James Kingsley

Learn More