Injection site reactions

Several nonpeptidic, orally active vasopressin receptor antagonists have been developed. The dual V1A/V2R antagonist conivaptan is used in the treatment of hyponatraemia and could also become useful for diseases such as congestive heart failure, in which increased peripheral resistance and dilutional hyponatremia both are present [4]. Side effects of conivaptan include headache, injection site reactions, vomiting, diarrhoea, constipation and thirst. 

The most common adverse effects in adults include injection site reactions (e.g., tenderness, pain, and warmth), headaches within 5 days after vaccination, and fatigue. Local reactions may be minimized by using an appropriate needle length based on the person s age and size and by administering the injection intramuscularly in the deltoid muscle. Children may also have feeding disturbances. Hepatitis A vaccine given... 

Interferon beta 1a (Rebif) 44 meg SQ Three times per week Flu-like symptoms 28% Injection site reactions 66% Leukopenia 22% Increased aspartate aminotransferase/ alanine transaminase 1 7-27%... 

Interferon beta 1b (Betaseron) 0.25 mg SQ Every other day Flu-like symptoms 60-76% Injection site reactions 50-85% Asthenia 49% Menstrual disorder 1 7% Leukopenia 1 0-1 6% Increased aspartate aminotransferase/ alanine transaminase 4-1 9%... 

Glatiramer acetate (Copaxone) 20 mg SQ Daily Injection site reaction 90% Systemic reaction 15%... 

N, nausea D, diarrhea HA, headache SOB, shortness of breath HTN, hypertension LFTs, liver function tests CBC, complete blood count ISR, injection-site reactions IR, infusion reactions IV, intravenous MYL, myelosuppression (watch for fever, symptoms of infection, easy bruisability, and bleeding) SC, subcutaneous. 

The most common adverse effect with omalizumab is injection-site reaction, reported in 45% of patients in clinical trials. Other adverse effects include viral and upper respiratory tract infections, sinusitis, headache, and pharyngitis. Rare cases of malignant neoplasms and anaphylaxis were reported during clinical trials of omalizumab in asthma. Patients should be monitored for at least 2 hours following the injection so that anaphylaxis and/or injection-site reactions may be managed.25... 

Fusion Inhibitors Enfuvirtide (T20) Injectable, in 90 mg (1 mL) No dosage N/A Local injection site reaction Catabolism to... 

Injection site reactions Enfuvirtide Onset first new doses symptoms pain, pruritus, erythema, ecchymosis, warmth, nodules, rarely injection site infection All patients Educate regarding use of sterile technique, solution at room temperature, rotation of injection sites, avoidance of sites with little subcutaneous fat or existing reactions Massaging the area vigorously before and after injection may reduce pain wear loose clothing around injection site areas take warm shower or bath prior to injection Rarely, warm compact or analgesics may be necessary... 

Azacitidine, a cytidine analog, causes hypomethylation of DNA, which normalizes the function of genes that control cell differentiation to promote normal cell maturation. The suspension is administered as a subcutaneous injection daily for 7 days for the treatment of myelodysplastic syndrome, a preleukemia disease. The pharmacokinetics of azacitidine are best described by a two-compartment model, with a terminal half life of 3.4 to 6.2 hours, whereas peak concentrations are achieved 30 minutes after a subcutaneous injection.7 Azacitidine has been shown to be clinically active in the treatment of myelodysplastic syndromes. The side effects include myelosuppression, renal tubular acidosis, renal dysfunction, and injection-site reactions. 

SERDs Fulvestrant 250 mg IM every 28 days Hot flashes, injection site reactions, possibly thromboembolism... 

LHRH Analogs Goserelin Leuprolide Triptorelin 3.6 mg SC every 28 days 7.5 mg IM every 28 days 3.75 mg IM every 28 days Hot flashes, amenorrhea, menopausal symptoms, injection site reactions... 

The most common adverse effects reported with LHRH agonist therapy include a disease flare-up during the first week of therapy, hot flashes, erectile impotence, decreased libido, and injection-site reactions.19 The disease flare-up is thought to be caused by initial induction of LH and FSH by the LHRH agonist and manifests clinically as either increased bone pain or increased urinary symptoms.19 This flare reaction usually resolves after 2 weeks and has a similar onset and duration pattern for the depot LHRH products.33,34... 

Octreotide -synthetic peptide analogue of somatostatin -abdominal pain, nausea, vomiting, diarrhea -local injection site reactions -cholelithiasis -sweating, flushing -hyperglycemia (many patients will require insulin therapy)... 

Common side effects noted include injection site reactions, weakness, dizziness, weight loss and flu-like symptoms, with depression being the most common reason for treatment discontinuation. ViraferonPeg is manufactured and marketed by Schering Plough. 

The most common side effects noted included injection site reactions and flu-like symptoms with serious potential side effects including depression, as well as liver and blood abnormalities. Rebif is manufactured and marketed by Serono Inc. 

Clinical evaluation entailed administration to 45 MPS I patients in a randomized, placebo-controlled clinical trial. The primary efficacy outcomes assessed were forced vital capacity and distance walked in 6 min, both of which were statistically higher relative to placebo after 26 weeks of treatment. The most serious adverse reaction noted was that of a severe anaphylactic reaction in one patient. The most common adverse effects reported were respiratory tract infection, rash and injection-site reactions. The product is manufactured by BioMarin Inc. and is distributed by Genzyme Corporation. 

The most common bisphosphonate adverse effects are nausea, abdominal pain, and dyspepsia. Esophageal, gastric, or duodenal irritation, perforation, ulceration, or bleeding may occur when administration directions are not followed or when bisphosphonates are prescribed for patients with contraindications. The most common adverse effects of IV bisphosphonates include fever, flu-like symptoms, and local injection-site reactions. Osteonecrosis of the jaw occurs rarely if it develops, oral chlorhexidine washes, systemic antibiotics, and systemic analgesics are used based on severity. 

Etanercept adali- Local injection-site reactions, Symptoms of infection... 

Adalimumab (Humira) is a human immunoglobulin Gj monoclonal TNF-a antibody. The binding of adalimumab results in inactivation of the proinflammatory cytokine TNF-a. It is indicated for psoriatic arthritis and treatment of adults with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy. The recommended dose for psoriatic arthritis is 40 mg subcutaneously every other week. The recommended dose for adults with plaque psoriasis is an initial dose of 80 mg, followed by 40 mg every other week starting 1 week after the initial dose. The most common adverse reactions are infections (e.g., upper respiratory, sinusitis), injection site reactions, headache, and rash. 

Entry inhibitors Enfuvirtide 84 3.8 90 mg (2) 1.1/0.73 nial hemorrhage Injection-site reactions... 

The vaccine is well tolerated with injection site reactions and headache and fatigue occurring as commonly as in placebo groups. 

Side effects of triptans include paresthesias, fatigue, dizziness, flushing, warm sensations, and somnolence. Minor injection site reactions are reported with SC use, and taste perversion and nasal discomfort may occur with intranasal administration. Up to 15% of patients report chest tightness, pressure, heaviness, or pain in the chest, neck, or throat. Although the mechanism of these symptoms is unknown, a cardiac source is unlikely in most patients. Isolated cases of myocardial infarction and coronary vasospasm with ischemia have been reported. 

The most common adverse effects of LHRH agonists are disease flare-up during the first week of therapy (e.g., increased bone pain, urinary symptoms), hot flashes, erectile impotence, decreased libido, and injection-site reactions. 

Specific (local tissue tolerance) toxicity studies may be necessary due to special characteristics of the product or the clinical indication. Adjuvanted vaccines are routinely evaluated for local (injection site) reactions, and cellular therapies are routinely screened for tumorigenic potential. Research is also needed to better predict the sensitizing potential of biological products and to determine the relevance of serum antibody levels following repeat dosing in animals and humans. 

Adults - Adverse reactions experienced by at least 5% of patients receiving sodium ferric gluconate complex include the following abdominal pain, abnormal erythrocytes, asthenia, chest pain, cramps, diarrhea, dizziness, dyspnea, fatigue, fever, generalized edema, headache, hyperkalemia, hypertension, hypotension, injection-site reaction, leg cramps, nausea, pain, paresthesias, pruritus, syncope, tachycardia, upper respiratory tract infection, vomiting. 

Dermatologic- Injection-site reaction, lipodystrophy, pruritus, rash. 

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