 INDICATIONS/ROUTES/DOSAGE

Alzheimer's Disease

**PO:** **ADULTS, ELDERLY:** Initially 5 mg/day at bedtime. May increase at 4- to 6-wk intervals to 10 mg/day at bedtime. For moderate to severe Alzheimer's, a dose of 23 mg once daily can be administered once pt has been taking 10 mg once daily for at least 3 mos.

Dosage in Renal/Hepatic Impairment

No dose adjustment.

#####  SIDE EFFECTS

**Frequent (11%–8%):** Nausea, diarrhea, headache, insomnia, nonspecific pain, dizziness. **Occasional (6%–3%):** Mild muscle cramps, fatigue, vomiting, anorexia, ecchymosis. **Rare (3%–2%):** Depression, abnormal dreams, weight loss, arthritis, drowsiness, syncope, frequent urination.

#####  ADVERSE EFFECTS/TOXIC REACTIONS

Overdose may result in cholinergic crisis (severe nausea, increased salivation, diaphoresis, bradycardia, hypotension, flushed skin, abdominal pain, respiratory depression, seizures, cardiorespiratory collapse). Increasing muscle weakness may occur, resulting in death if muscles of respiration become involved. **Antidote:** AVAILABILITY (Rx)

**Injection, Solution:** 10 mg/ml (30-ml vial).

#####  ADMINISTRATION/HANDLING

**◀ ALERT ▶** Vaccination with a meningococcal vaccine must be given at least 2 wks prior to receiving first dose of eculizumab. Must be given by IV infusion; do not give by bolus or IV push.

  IV

**Reconstitution** • Withdraw required amount of eculizumab from vial and dilute with equal volume of 0.9% NaCl, D5W, or lactated Ringer's to provide final concentration of 5 mg/ml. • Final admixture is 120 ml for 600-mg dose or 180 ml for 900-mg dose. • Gently invert bag to ensure thorough mixing. • Prior to administration, allow admixture to adjust to room temperature.

**Rate of Administration** • Administer over 35 min. • Total infusion time should not exceed 2 hrs.

**Storage** • Refrigerate vials. •