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Cerezyme

imiglucerase

Used for Inherited Metabolic Diseases, Lysosomal Storage Disease

Cerezyme (imiglucerase) is a form of enzyme replacement therapy (ERT) used to treat Type 1 Gaucher disease in adults and children 2 years of age or older. It's given as an intravenous (IV) infusion by a healthcare provider. Overall, Cerezyme (imiglucerase) is well tolerated, but it can cause allergic or infusion-related reactions like hives or difficulty breathing.

Reviewed by:

Jenny Zhang, PharmD, BCOP

Daisy Chau, PharmD

Last reviewed on March 24, 2022

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Interactions Alternatives Images Prices Medicare

What is Cerezyme (imiglucerase)?

What is Cerezyme (imiglucerase) used for?

Type 1 Gaucher disease in adults and children 2 years of age or older

How Cerezyme (imiglucerase) works

Cerezyme (imiglucerase) is a modified (lab-made) version of the enzyme glucocerebrosidase that is normally found in the body. People with Gaucher disease don't have enough of this enzyme, which breaks down a fatty substance called glucosylceramide (also known as glucocerebroside or GL-1). As a result, there are higher levels of glucosylceramide in the body, and it can build up in the spleen, liver, and bones. Cerezyme (imiglucerase) works as an enzyme replacement for glucocerebrosidase and helps your body break down glucosylceramide.

Drug Facts

Common BrandsCerezyme

Drug ClassHydrolytic lysosomal glucocerebrosidase-specific enzyme

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

What are the side effects of Cerezyme (imiglucerase)?

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

Itching
Fever
Rash
Chills
Chest discomfort

Other Side Effects

Pain or burning at the IV site
Dizziness
Fatigue
Headache
Nausea
Vomiting
Stomach pain
Diarrhea
Back pain
Lung infection (pneumonia)
Lung problems

Serious Side Effects

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

Serious allergic or infusion-related reactions: throat tightness, trouble breathing, cough, itching or hives, flushing, swelling, chest pain, skin turning blue, fast heartbeat, low blood pressure, dizziness, fainting

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Abdominal discomfort

decrease in blood pressure, decrease in frequency of urination

dizziness

headache

itching

nausea

rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Pros and cons of Cerezyme (imiglucerase)

Pros

Can be used long-term, for at least 20 years, to treat Type 1 Gaucher disease

Can be used in children as young as 2 years of age

Safe to use if pregnant or breastfeeding

Fewer side effects compared to oral medications for Gaucher disease type 1

Cons

Might require frequent trips to the infusion center to receive treatment

Takes 1 to 2 hours to receive each infusion

Potential for allergic or infusion reactions with long-term use

Requires IV access, so it's not as convenient as taking a pill

Pharmacist tips for Cerezyme (imiglucerase)

It takes about 1 to 2 hours to give the full dose of Cerezyme (imiglucerase). Most commonly, you'll receive this medication at an infusion center or provider's office. In some cases, it can be given at home by a home health nurse.

You might experience an allergic or infusion-related reaction during or shortly after your Cerezyme (imiglucerase) infusion, some of which can be life-threatening. Let your provider know or get help right away if you experience any trouble breathing, hives, flushing, chest pain, skin turning blue, fast heartbeat, or dizziness.

You can feel some discomfort, pain, or burning at the IV infusion site when receiving Cerezyme (imiglucerase). Let your provider know if this is bothersome so it can be managed appropriately.

Cerezyme (imiglucerase) infusions can be shifted around travel or other plans, but it's best to stay on your regular schedule so you'll get the most benefit. If you miss an infusion, talk with your provider about rescheduling your appointment.

Talk to your provider about enrolling in a database for people with Gaucher disease. This database monitors Gaucher disease symptoms over time and the long-term effects of Cerezyme (imiglucerase).

Frequently asked questions about Cerezyme (imiglucerase)

What is Gaucher disease?

Gaucher disease is a rare, genetic condition where your body has lower levels of an enzyme, a specific protein, that breaks down a type of fatty substance called glucosylceramide. As a result, glucosylceramide can build up in certain organs, like your spleen, liver, and bones. A buildup in the liver or spleen can lead to these organs getting abnormally large and causing a swollen belly. And a buildup in the bones and bone marrow can cause serious bleeding, bruising, and bone pain or weakness. Cerezyme (imiglucerase) helps to replace this enzyme that you're missing so that your body can break down glucosylceramide.

How likely am I to have an allergic or infusion-related reaction?

There's a risk of developing allergic or infusion-related reactions with protein-based therapies like Cerezyme (imiglucerase). This is due to your body developing an immune response (antibodies) to Cerezyme (imiglucerase). About 15% of people who were treated and tested have developed antibodies to Cerezyme (imiglucerase) within the first year of treatment. Most did so within 6 months of treatment and some rarely after 1 year of treatment. Your risk of an allergic or infusion-related reaction is higher if you develop antibodies to Cerezyme (imiglucerase). Your provider might occasionally monitor your antibody levels during the first year of treatment to see if you'll have a higher chance for reactions.

Can I receive Cerezyme (imiglucerase) again if I've had an allergic or infusion-related reaction before?

Possibly, it depends on how severe your reaction was. Your provider should discuss with you the risks and benefits of treatment with Cerezyme (imiglucerase) again following an allergic or infusion-related reaction. People who experience such reactions to Cerezyme (imiglucerase) can be given antihistamines or corticosteroids before future infusions. The rate of infusion can also be slowed down to try and prevent reactions. Talk to your provider if you’re concerned about receiving this treatment.

Is Cerezyme (imiglucerase) safe in pregnancy?

Yes, studies have shown that Cerezyme (imiglucerase) is safe to use in pregnant females. Your provider can enroll you in a pregnancy exposure database that monitors outcomes in people who are pregannt who received Cerezyme (imiglucerase). It's known that people with Gaucher disease have a higher risk of miscarriage, especially if symptoms aren't controlled before and during pregnancy. Pregnancy can also worsen symptoms. If you're pregnant or think you might become pregnant, talk to your provider before starting Cerezyme (imiglucerase).

Is Cerezyme (imiglucerase) safe while breastfeeding?

Studies have shown that a small amount of Cerezyme (imiglucerase) is found in breastmilk immediately following an infusion of the medication. Fortunately, there haven't been reports of any side effects in breastfed babies exposed to Cerezyme (imiglucerase). It's not known how Cerezyme (imiglucerase) can affect your milk supply. If you’re breastfeeding, discuss with your provider about the risks and benefits of taking Cerezyme (imiglucerase).

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What are the risks and warnings for Cerezyme (imiglucerase)?

Cerezyme (imiglucerase) 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.

Allergic or infusion-related reactions

Risk factors: Having antibodies to Cerezyme (imiglucerase) after repeated treatments

Cerezyme (imiglucerase) can cause allergic or infusion-related reactions, which can be serious. These reactions can happen during or shortly after infusions. Your risk for reactions is higher with the more Cerezyme (imiglucerase) treatments you get. This is due to your body developing antibodies to Cerezyme (imiglucerase). Most people who develop antibodies do so within 6 to 12 months of starting treatment. Your provider might check your antibody levels occasionally during the first year of treatment.

Let your provider know right away if you experience any throat tightness, trouble breathing, cough, itching, hives, flushing, swelling, chest pain, skin turning blue, fast heartbeat, low blood pressure, dizziness, or fainting.

Cerezyme (imiglucerase) dosage forms

Typical dosing for Cerezyme (imiglucerase)

Cerezyme (imiglucerase) is an intravenous (IV) infusion that is administered by a healthcare provider. The dose depends on your weight and how severe your Type 1 Gaucher disease symptoms are. Your healthcare provider will determine the appropriate dose for you each time.

In general, the dose ranges from 2.5 units/kg three times a week to 60 units/kg once every two weeks.

Interactions between Cerezyme (imiglucerase) and other drugs

Cerezyme (imiglucerase) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Cerezyme (imiglucerase). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.