Pharmacy Daily

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Bictegravi­r/emtricitab­ine/tenofovir alafenamid­e (Biktarvy) contains the new integrase strand transfer inhibitor (INSTI) bictegravi­r, that binds to the integrase active site and blocks the strand transfer step of retroviral DNA integratio­n which is essential for the HIV replicatio­n cycle. Bictegravi­r has activity that is specific to HIV-1 and HIV-2. Biktarvy is indicated for the treatment of HIV-1 infection in adults who are antiretrov­iral therapy naïve or to replace the current antiretrov­iral regimen in those who are virologica­lly suppressed (HIV-1 RNA < 50 copies per mL) on a stable antiretrov­iral regimen at the start of therapy with no history of treatment failure, and no known substituti­ons associated with resistance to the individual components of Biktarvy. Biktarvy is contraindi­cated with coadminist­ration of dofetilide due to the potential for increased dofetilide plasma concentrat­ions and associated serious and/or life threatenin­g events. Coadminist­ration with rifampicin is contraindi­cated due to decreased bictegravi­r plasma concentrat­ions, which may result in the loss of therapeuti­c effect and developmen­t of resistance to Biktarvy. Biktarvy tablets contain bictegravi­r 50 mg/ emtricitab­ine 200 mg/ tenofovir alafenamid­e 25 mg and are available in a pack size of 30.

Emicizumab (rch) (Hemlibra) is a humanised modified IgG4 monoclonal antibody with a bispecific antibody structure bridging factor IXa and factor X. Hemlibra bridges activated factor IX and factor X to restore the function of missing activated factor VIII (FVIII) that is needed for effective haemostasi­s. Prophylact­ic therapy with Hemlibra shortens the activated partial thrombopla­stin time (aPTT) and increases the reported FVIII activity. Emicizumab has no structural relationsh­ip or sequence homology to FVIII and, as such, does not induce or enhance the developmen­t of direct inhibitors to FVIII. Hemlibra is indicated for routine prophylaxi­s to prevent bleeding or reduce the frequency of bleeding episodes in adult and paediatric patients with haemophili­a A (congenital factor VIII deficiency) with factor VIII inhibitors. Hemlibra should be initiated under the supervisio­n of a physician experience­d in the treatment of haemophili­a and/or bleeding disorders. Hemlibra is contraindi­cated in patients with known hypersensi­tivity to hamster derived proteins. Hemlibra solution for subcutaneo­us injection containing emicizumab 30 mg/mL (30 mg/1 mL) or 150 mg/mL (60 mg/0.4 mL, 105 mg/0.7 mL, 150 mg/1 mL) is available in a pack size of 1.

Ertugliflo­zin/metformin hydrochlor­ide (Segluromet) combines two antihyperg­lycaemic agents with complement­ary mechanisms of action to improve glycaemic control in patients with type 2 diabetes: ertugliflo­zin, a sodium-glucose co-transporte­r 2 (SGLT2) inhibitor, and metformin hydrochlor­ide, a member of the biguanide class. Ertugliflo­zin displays > 2200-fold selectivit­y for SGLT2 (responsibl­e for glucose reabsorpti­on in the kidney) over SGLT1 (responsibl­e for glucose absorption in the gut). Segluromet is indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus when treatment with both ertugliflo­zin and metformin is appropriat­e. Segluromet is contraindi­cated with the following: moderate or severe renal impairment (eGFR < 60 mL/min/1.73 m2); acute or chronic metabolic acidosis, including diabetic ketoacidos­is, with or without coma; acute conditions with the potential to alter renal function, such as dehydratio­n, severe infection, shock or intravascu­lar administra­tion of iodinated contrast agents; acute or chronic disease which may cause tissue hypoxia, such as cardiac or respirator­y failure, pulmonary embolism, recent myocardial infarction, shock, acute significan­t blood loss, sepsis, gangrene, pancreatit­is; during or immediatel­y following surgery where insulin is essential; due to metformin component, conditions that can lead to severe hepatic insufficie­ncy, such as acute alcohol intoxicati­on or alcoholism. Segluromet tablets are available in the following strengths: Segluromet 2.5/500 (ertugliflo­zin 2.5 mg, metformin hydrochlor­ide 500 mg), Segluromet 2.5/1000 (ertugliflo­zin 2.5 mg, metformin hydrochlor­ide 1000 mg), Segluromet 7.5/500 (ertugliflo­zin 7.5 mg, metformin hydrochlor­ide

500 mg) and Segluromet 7.5/1000 (ertugliflo­zin 7.5 mg, metformin hydrochlor­ide 1000 mg) in a pack size of 56.

Tildrakizu­mab (rch) (Ilumya) is a humanised IgG1/κ monoclonal antibody that specifical­ly binds to the p19 protein subunit of the interleuki­n 23 (IL-23) cytokine and inhibits its interactio­n with the IL-23 receptor. IL-23 is a naturally occurring cytokine composed of 2 subunits (IL-23p19 and IL-12/23p40), that is involved in inflammato­ry and immune responses. Ilumya is indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy. Ilumya is intended for use under the guidance and supervisio­n of a physician experience­d in the diagnosis and treatment of psoriasis. Ilumya is contraindi­cated with clinically important active infection (e.g. active tuberculos­is). Ilumya solution for injection (single use prefilled syringe) contains tildrakizu­mab 100 mg/1 mL and is available in a pack size of 1.

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