Can I continue to take hydroxyurea with Adakveo (crizanlizumab)?

[Hydroxyurea](https://www.goodrx.com/hydroxyurea/what-is) is a common medication used to [help keep your red blood cells from turning into a sickle shape](https://www.hematology.org/-/media/Hematology/Files/Education/Hydroxyurea-Booklet.pdf), which helps manage pain crises in people with sickle cell disease. As long as your provider recommends it, you may continue to take __hydroxyurea__ while getting monthly Adakveo (crizanlizumab) infusions.

Can I take Adakveo (crizanlizumab) if I'm pregnant?

There isn't much research done in human pregnancies. But based on information from studies done on animals, Adakveo (crizanlizumab) can cause harm to your unborn baby including death. If you're pregnant or planning to become pregnant, talk with your provider about the risks and benefits of this medication.

Adakveo

crizanlizumab

Used for Sickle Cell Disease

Adakveo (crizanlizumab) is the first and only FDA-approved intravenous (IV) infusion used to lower the number of pain crises in people with sickle cell disease. After your first month of treatment, you only need to get the infusions once a month. But you have to receive it at your provider's office. This medication is brand name only and can be expensive.

Reviewed by:

Allison Gourley, PharmD

Kristianne Hannemann, PharmD

Last reviewed on March 28, 2022

What is Adakveo (crizanlizumab)?

What is Adakveo (crizanlizumab) used for?

Lessen the number of vaso-occlusive crises (pain crises) in people aged 16 years and older with sickle cell disease (SCD)

How Adakveo (crizanlizumab) works

Adakveo (crizanlizumab) is a monoclonal antibody that binds to P-selectin, which is a sticky protein that normally plays a role in blocking blood flow.

In people with sickle cell anemia, P-selectin gets activated when blood vessels are damaged by the sickled red blood cells. This causes your red blood cells, white blood cells, and platelets to stick together and block blood flow, which results in pain crises.

By binding to P-selectin, Adakveo (crizanlizumab) stops your blood cells from sticking together. This means your blood can flow better, which lowers the amount of pain crises.

Are you looking for information on adalimumab (Humira) instead?

Drug facts

Common Brands	Adakveo
Drug Class	Monoclonal antibody
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Adakveo

Drug Class

Monoclonal antibody

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Adakveo (crizanlizumab)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Nausea (18%)
Joint pain (18%)
Back pain (15%)
Stomach pain (12%)
Fever (11%)

Less Common Side Effects

Throat pain
Diarrhea
Vomiting
Itchy skin or vaginal itching
Chest pain
Muscle aches and pain

Adakveo (crizanlizumab) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Infusion-related reactions: pain in different parts of your body, fever, chills, nausea, vomiting, dizziness, hives, difficulty breathing

Source: DailyMed

The following Adakveo (crizanlizumab) side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

Back pain
Fever
Headache
Joint pain
Nausea
Stomach pain

Pros and cons of Adakveo (crizanlizumab)

Pros

Given once a month (after your first 2 doses at Week 0 and Week 2)
Infusion only takes about half an hour
Can lessen the number of pain crises by nearly half (after 1 year)

Cons

Not approved for children younger than 16 years old
Can cause infusion-related reactions
Must get infusion regularly; not meant to treat pain crises on an as-needed basis

Pharmacist tips for Adakveo (crizanlizumab)

It's possible to experience a infusion-related reaction up to 24 hours after your infusion of Adakveo (crizanlizumab). Monitor yourself for symptoms even after you go home. Get medical help right away if you experience symptoms such as fever, difficulty breathing, and hives.
Use a calendar to help stay on track for your Adakveo (crizanlizumab) infusion appointments. Missing an appointment or rescheduling often can affect how well the medication works for you. If you miss your infusion appointment, contact your provider as soon as you can to reschedule.
Adakveo (crizanlizumab) is meant to be a long-term treatment. Keep appointments with your healthcare provider while you're receiving treatments so they can monitor your progress and pain crises. Don't stop receiving these infusions unless your provider tells you to stop.
Tell your provider and pharmacist about all of the medications you take, including prescription and over-the-counter medications, vitamins, and herbal supplements, to make sure they're safe to take with Adakveo (crizanlizumab).
While receiving Adakveo (crizanlizumab), try to also follow these general tips for staying healthy with sickle cell disease.

Common questions about Adakveo

If you miss your Adakveo infusion appointment, contact your provider right away to reschedule. If you can get rescheduled within 2 weeks, you should be able to get back on track with your usual dosing schedule. If you get rescheduled more than 2 weeks after your missed dose, then your monthly dosing schedule will need to be adjusted according to the rescheduled dose.

Hydroxyurea is a common medication used to help keep your red blood cells from turning into a sickle shape, which helps manage pain crises in people with sickle cell disease. As long as your provider recommends it, you may continue to take hydroxyurea while getting monthly Adakveo infusions.

It's not known if Adakveo is safe or works well in children 15 years of age and younger. Talk with your child's provider about other treatment options for them.

There isn't much research done in human pregnancies. But based on information from studies done on animals, Adakveo can cause harm to your unborn baby including death. If you're pregnant or planning to become pregnant, talk with your provider about the risks and benefits of this medication.

Your Adakveo infusion should take about 30 minutes. It's given through your vein in your healthcare provider's office.

Risks and warnings for Adakveo (crizanlizumab)

Adakveo (crizanlizumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Infusion-related reactions

Risk factors: First or second Adakveo (crizanlizumab) infusion

Adakveo (crizanlizumab) can cause you to have a reaction either during the infusion or even up to 24 hours after you've received the infusion. This is most likely to happen after your first or second infusion. In many cases, your provider can slow down the rate of your infusion, or give you medication to manage your infusion-related symptoms. If the reaction is severe enough (e.g., hives, shortness of breath), your provider might stop the infusion altogether. Let your provider know right away if you develop pain in your body, headache, fever, chills or shivering, feeling sick to your stomach, diarrhea, difficulty breathing, or dizziness.

Interferes with certain blood tests

Make sure to tell all of your healthcare providers that you're receiving Adakveo (crizanlizumab) before getting certain blood tests drawn. Adakveo (crizanlizumab) can interfere with the results of a laboratory test commonly used to measure your platelet counts.

Adakveo (crizanlizumab) dosage

Typical dosage for Adakveo (crizanlizumab)

Adakveo (crizanlizumab) is only available as an intravenous (IV) infusion that's administered by a healthcare provider.

Your dose of Adakveo (crizanlizumab) depends on your weight. In general, the typical dose is 5 mg/kg, given as an IV infusion over a period of 30 minutes, at Week 0, Week 2, and then every 4 weeks thereafter.