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Enspryng

satralizumab
Used for Neuromyelitis Optica Spectrum Disorder
Used for Neuromyelitis Optica Spectrum Disorder

Enspryng (satralizumab or satralizumab-nwge) is a monoclonal antibody known as an interleukin antagonist. It's FDA approved to treat certain adults with a nerve condition that affects the eye and spinal cord called neuromyelitis optica spectrum disorder (NMOSD). This medication is injected under the skin once a month after the first three starter doses. Side effects of Enspryng (satralizumab) include rash, joint pain, tiredness, and nausea.

Last reviewed on December 7, 2023
basics-icon

What is Enspryng (satralizumab)?

What is Enspryng (satralizumab) used for?

How Enspryng (satralizumab) works

Enspryng (satralizumab) is a monoclonal antibody that works as an interleukin antagonist. It's not exactly known how the medication works, but it's thought to block interleukin-6 (IL-6), a protein that's involved in inflammation. This might help treat NMOSD, a condition that happens when the immune system attacks the nerves of the eye, brain, and spinal cord and causes inflammation.

Drug Facts

Common BrandsEnspryng
Drug ClassInterleukin antagonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Enspryng (satralizumab)?

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

  • Rash (17%)
  • Joint pain (17%)
  • Pain in hands and feet (15%)
  • Tiredness (15%)
  • Nausea (15%)
  • Common cold (12%)

Other Side Effects

  • Itching
  • Depression
  • Skin infection
  • Low white blood cells
  • Fall

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Severe allergic reaction: hives, chest tightness, trouble breathing, wheezing, fast heartbeat, stomach pain, vomiting, swelling of the tongue or throat
  • Infection: fever, chills, muscle aches, constant cough, sore throat, skin redness or swelling, diarrhea, burning feeling during urination
  • Liver problems: nausea, vomiting, feeling tired, swollen belly, pain in the stomach, dark urine, yellowing of the skin or whites of the eyes

Source: DailyMed

The following side effects have also been reported

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

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

pros-and-cons

Pros and cons of Enspryng (satralizumab)

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Pros

Can inject at home after getting trained by your provider

Injected once every month (after the first 3 doses)

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Cons

Must give as an injection, so not a good option for people who don't like needles

Can raise the risk of infections

pharmacist-tips

Pharmacist tips for Enspryng (satralizumab)

pharmacist
  • Ask your provider or pharmacist if all of your vaccinations are up to date before you start Enspryng (satralizumab). This medication can change your immune system, so getting vaccinated during treatment might affect how well vaccines work or how safe they are for you. You should get any live vaccines at least a month before and any other types of vaccines at least 2 weeks before starting treatment.

    • The first three Enspryng (satralizumab) doses are given every 2 weeks. Then, the rest of your doses are given every month until your provider stops your treatment. Speak to your provider if you miss a dose; your provider will let you know how to restart the medication.

      • Before each time you use Enspryng (satralizumab), talk to your provider if you think you have an infection. Your provider can tell you whether you should take your dose or wait until your infection is treated or goes away. This medication can raise the risk for any current infections to get worse.

        Tips on how to inject Enspryng (satralizumab) at home:

        • Once you're trained by your provider, carefully review the Instructions for Use on how to prepare and inject Enspryng (satralizumab) at home. Ask your provider or pharmacist if you have any questions about using the medication at home.

          • Before you inject Enspryng (satralizumab), take the prefilled syringe out of the refrigerator and let it sit at room temperature for 30 minutes. Don't warm the medication up any other way because doing so might damage it.

            • Make sure the solution in the syringe isn't discolored, doesn't have any particles in it, and hasn't expired. Enspryng (satralizumab) should look clear and either colorless or slightly yellow in color. Injecting expired or damaged medication can lead to infections, allergic reactions, or cause the medication to not work.

              • Don't remove the needle cap until you're ready to inject the medication. Once you take off the needle cap, inject within 5 minutes or else the needle might clog.

                • Inject Enspryng (satralizumab) under the skin of your thigh or stomach area (at least 2 inches away from your belly button). Inject into a different area that's at least 1 inch away from the previous site each time you take the medication. This helps prevent skin irritation around the same area.

                  • Throw away all used Enspryng (satralizumab) syringes and needle caps in a sharps container. Visit the FDA website for more information about throwing away your sharps to prevent needle-stick injuries.

                    faqs

                    Frequently asked questions about Enspryng (satralizumab)

                    Is Enspryng (satralizumab) self-administered?
                    Yes, you can administer Enspryng (satralizumab) by yourself at home, but only after a healthcare professional has properly trained you or your caregiver. Enspryng (satralizumab) comes as a prefilled syringe that you use to inject the medication under the skin. Review the Instructions for Use, and ask your provider or pharmacist if you have any questions about injecting the medication yourself.
                    Where is Enspryng (satralizumab) injected?
                    Inject Enspryng (satralizumab) under the skin in the thigh or stomach area. If you're injecting into the stomach, make sure it's at least 2 inches away from your belly button. Choose a new area that's at least 1 inch away from the previous site for each injection. This helps avoid irritation in the same area of skin. Avoid injecting the medication into moles; scars; or skin that's tender, bruised, red, hard, or broken.
                    How well does Enspryng (satralizumab) work to treat NMOSD?
                    Compared to placebo (no medication), Enspryng (satralizumab) lowered the risk of NMOSD attacks by 74% in a clinical study that lasted almost 2 years. Without medication, almost half of people with NMOSD typically have one or more attacks over about 2 years. These attacks can cause severely poor vision (including blindness), serious movement problems, and disability.
                    How often do I need blood tests while I'm taking Enspryng (satralizumab)?
                    Since Enspryng (satralizumab) can affect your liver and white blood cell levels, your provider will order blood tests to check on them and make sure the medication is safe for you. You'll need to get your liver checked every month for the first 3 months of treatment, then every 3 months for 1 year. After the first year, your provider will determine how often you'll need blood tests to check your liver. Your neutrophils (white blood cells) will be checked 1 to 2 months after you start Enspryng (satralizumab). Then, your provider will discuss with you about how often to get these levels checked during your treatment. Speak with your provider if you have any questions about these blood tests and your results.
                    Does Enspryng (satralizumab) need to be refrigerated?
                    It's best to store unopened Enspryng (satralizumab) prefilled syringes in the refrigerator in its original carton until you need to use the medication. Be careful not to freeze the syringes because that will damage the medication. If needed, you can keep Enspryng (satralizumab) out of the refrigerator at room temperature, but it's good for only up to 8 days as long as it hasn't been opened.
                    Is Enspryng (satralizumab) safe during pregnancy?
                    It's not known whether Enspryng (satralizumab) can harm mothers or their unborn babies because the medication hasn't been well studied in pregnancy. Talk with your provider if you're pregnant or planning to become pregnant before you start this medication. If you do decide to take Enspryng (satralizumab) during pregnancy or if you become pregnant while you're taking the medication, you're encouraged to join the pregnancy exposure registry by calling 1-833-277-9338. This registry monitors your health and your baby's health while you're taking Enspryng (satralizumab).
                    Can I breastfeed if I'm taking Enspryng (satralizumab)?
                    It's not known whether Enspryng (satralizumab) can pass into your breast milk and harm your baby. Discuss the risk with your provider before you decide to breastfeed your child while you're taking Enspryng (satralizumab).
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                    What are the risks and warnings for Enspryng (satralizumab)?

                    Enspryng (satralizumab) 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.

                    risk-warning

                    Risk of infection

                    Enspryng (satralizumab) can raise your risk of infections, which can sometimes be serious or life-threatening. This medication can potentially make hepatitis B infection or tuberculosis (TB) worse or come back.

                    Before you start Enspryng (satralizumab), make sure your care team knows about your medical history. Don't take this medication until any infections you might currently have are treated or have gone away. Your provider will examine you for hepatitis B because you might not be able to take Enspryng (satralizumab) if you're currently infected. Your provider will also check for TB to see whether you need additional antibiotics to prevent it from getting worse or coming back.

                    Let your provider know right away if you have signs and symptoms of an infection, such as fever, chills, muscle aches, constant cough, sore throat, skin redness or swelling, diarrhea, or burning feeling during urination.

                    risk-warning

                    Liver problems

                    Some people who took Enspryng (satralizumab) had abnormal liver lab results on their blood tests, which can suggest liver problems. To be safe, your provider will order blood tests during treatment to check your liver. If your liver is affected by this medication, your provider might ask you to pause treatment until your lab results show your liver is getting back to normal. Your provider might also consider switching you to a different medication. Tell your provider if you have symptoms of liver problems, such as stomach pain and yellowing of the skin or whites of the eyes.

                    risk-warning

                    Low white blood cells

                    Some people who took Enspryng (satralizumab) had lower levels of white blood cells. Having a low white blood cell count can put you at risk for infections. Your provider will order blood tests throughout your treatment to check your white blood cell count. Let your provider know right away if you have any signs of infection, such as fever, chills, muscle aches, cough that doesn't go away, sore throat, stomach pain, or pain while urinating.

                    risk-warning

                    Allergic reactions

                    Medications like Enspryng (satralizumab) can cause serious and sometimes life-threatening allergic reactions. Let your provider know if you have a rash, hives, chest tightness, trouble breathing, wheezing, swelling of the tongue or throat, or other symptoms of an anaphylactic reaction.

                    dosage

                    Enspryng (satralizumab) dosage forms

                    Typical dosing for Enspryng (satralizumab)

                    The typical starting dose is 120 mg injected under the skin every 2 weeks for the first 3 doses (at week 0, 2, and 4). After that, you'll continue at a maintenance dose of 120 mg injected under the skin every 4 weeks.

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                    contraindications-icon

                    Enspryng (satralizumab) contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Enspryng (satralizumab) will not be safe for you to take.
                    alternatives

                    What are alternatives to Enspryng (satralizumab)?

                    There are a number of medications that your doctor can prescribe in place of Enspryng (satralizumab). Compare a few possible alternatives below.
                    Enspryng (satralizumab)
                    $17626.73 Lowest GoodRx priceView Prices
                    Used for:
                    • Paroxysmal nocturnal hemoglobinuria (PNH)

                    • Atypical hemolytic uremic syndrome (aHUS)

                    • Certain people with generalized myasthenia gravis (gMG)

                    • Certain people with neuromyelitis optica spectrum disorder (NMOSD)

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                    References

                    Best studies we found
                    View All References (9)

                    Genentech USA, Inc. (n.d.). What is neuromyelitis optica spectrum disorder (NMOSD)?

                    Huda, S., et al. (2019). Neuromyelitis optica spectrum disorders. Clinical Medicine.

                    Ma, X., et al. (2020). Risk of relapse in patients with neuromyelitis optica spectrum disorder: Recognition and preventive strategy. Multiple Sclerosis and Related Disorders.

                    National Organization for Rare Disorders. (2022). Neuromyelitis optica spectrum disorder.

                    Papadopoulos, M. C. et al. (2012). Aquaporin 4 and neuromyelitis optica. The Lancet Neurology.

                    Royston, M., et al. (2021). Neuromyelitis optica spectrum disorder: clinical burden and cost of relapses and disease-related care in US clinical practice. Neurology and Therapy.

                    Tanaka, T., et al. (2014). IL-6 in inflammation, immunity, and disease. Cold Spring Harbor Perspectives in Biology.

                    Traboulsee, A., et al. (2020). Safety and efficacy of satralizumab monotherapy in neuromyelitis optica spectrum disorder: A randomised, double-blind, multicentre, placebo-controlled phase 3 trial. The Lancet Neurology.

                    U.S. Food and Drug Administration. (2021). Safely using sharps (needles and syringes) at home, at work and on travel.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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