【藥品庫存】 單株抗體本院備有庫存，請參閱說明書，本品需先下載檢核表及病人同意書，填寫完畢後交給感染控制部，經諮詢區管指揮官同意後，藥劑部將開檔供醫師醫囑。

Coronavirus disease 2019 (COVID-19), mild to moderate: Reserve for patients with positive SARS-CoV-2 direct viral testing who are at high risk for progression to severe disease or hospitalization

Antiviral Agent; Monoclonal Antibody
Bamlanivimab and etesevimab are both recombinant neutralizing human IgG1k monoclonal antibodies to the spike protein of SARS-CoV-2. They bind to different, but overlapping receptors, thus blocking the spike protein attachment to the human ACE2 receptor. Use of the combination is expected to reduce the risk of viral resistance.

Absorption:
Cmax:
Bamlanivimab (700 mg): 196 mg/L
Etesevimab (1.4 g): 504 mg/L
Distribution:
Vd:
Bamlanivimab: 2.87 L (central); 2.71 L (peripheral)
Etesevimab: 2.38 L (central); 1.98 L (peripheral)
Metabolism:
Bamlanivimab and etesevimab are expected to be degraded into small peptides and component amino acids via catabolic pathways in the same manner as endogenous IgG antibodies.
Half-life elimination:
Bamlanivimab: 17.6 days
Etesevimab: 25.1 days

There are no contraindications listed in the FDA emergency use authorization (EUA) fact sheet for health care providers.

The potential benefits or risks of in utero exposure to bamlanivimab and etesevimab to the fetus are not known
Use may be considered in pregnant patients, particularly those with over 1 additional risk factor. According to the EUA (emergency use authorization), dose adjustments are not recommended for patients who are pregnant.

It is not known if bamlanivimab or etesevimab are present in breast milk; however, bamlanivimab and etesevimab are humanized monoclonal antibodies (IgG1); maternal IgG is present in breast milk

>10%:
Pruritus, hypersensitivity reaction (including type 1 hypersensitivity reaction, flushing, facial swelling, rash at injection site, skin rash), fever
Frequency not defined:
Anaphylaxis, infusion related reaction

COVID-19, weight over 40kg: (IV) administer Bamlanivimab 700 mg and etesevimab 1.4 g together as a single IV infusion; administer as soon as possible after a positive SARS-CoV-2 test and within 10 days of symptom onset

Emergency use authorization from the FDA is based on likelihood of similar exposures in patients >12 years of age weighing >40 kg

No dosage adjustment recommended

Mild impairment: No dosage adjustment recommended
Moderate or severe impairment: There are no dosage adjustments provided (has not been studied)