Biologic Medications ๐
Reference guide for biologic medications. Drug table, dosing, indications, and prescribing for autoimmune and inflammatory conditions.
๐ Overview
- Biologic medications are advanced drugs targeting specific components of the immune system.
- Used in conditions like rheumatoid arthritis, IBD, psoriasis, and more.
- Require monitoring for infections, infusion reactions, and immunosuppression.
๐ Commonly Used Biologics
- See table below for examples of commonly used biologics, dosing, and indications.
Biologic Medications
Advanced immunotherapy drugs
| Drug | Mechanism | Indications | Route | Frequency | Dosing | Notes |
|---|---|---|---|---|---|---|
| TNF-ฮฑ Inhibitors | ||||||
| Adalimumab | TNF-ฮฑ inhibitor | RA, PsA, IBD, Psoriasis | SC | Fortnightly | 40mg SC every 2 weeks | Monitor TB, LFTs, FBC |
| Infliximab | TNF-ฮฑ inhibitor | RA, IBD, Psoriasis | IV | q8w after loading | 5 mg/kg IV | Infusion reactions possible |
| IL Inhibitors | ||||||
| Tocilizumab | IL-6 receptor blocker | RA, Giant Cell Arteritis | SC / IV | Weekly or monthly | 8 mg/kg IV or fixed SC | Monitor LFTs, FBC, Lipids |
| Secukinumab | IL-17A inhibitor | Psoriasis, AS | SC | Monthly | 300mg SC monthly | Fungal infections โ |
| Ustekinumab | IL-12/23 inhibitor | IBD, Psoriasis | SC | q12w after loading | Initial weight-based IV; then 90mg SC q12w | Well tolerated |
| Other Mechanisms | ||||||
| Rituximab | Anti-CD20 (B cells) | RA, Vasculitis, Lymphoma | IV | PRN | 375 mg/mยฒ IV (note BSA dosing) | Hep B, PJP prophylaxis |
| Vedolizumab | Integrin ฮฑ4ฮฒ7 blocker | UC, Crohn's | IV | q8w after loading | 300mg IV q8w | Gut-specific, low systemic effect |
TNF-ฮฑ Inhibitors
Adalimumab
SCTNF-ฮฑ inhibitor
Indications: RA, PsA, IBD, Psoriasis
Frequency: Fortnightly
Dosing: 40mg SC every 2 weeks
Notes: Monitor TB, LFTs, FBC
Infliximab
IVTNF-ฮฑ inhibitor
Indications: RA, IBD, Psoriasis
Frequency: q8w after loading
Dosing: 5 mg/kg IV
Notes: Infusion reactions possible
IL Inhibitors
Tocilizumab
SC / IVIL-6 receptor blocker
Indications: RA, Giant Cell Arteritis
Frequency: Weekly or monthly
Dosing: 8 mg/kg IV or fixed SC
Notes: Monitor LFTs, FBC, Lipids
Secukinumab
SCIL-17A inhibitor
Indications: Psoriasis, AS
Frequency: Monthly
Dosing: 300mg SC monthly
Notes: Fungal infections โ
Ustekinumab
SCIL-12/23 inhibitor
Indications: IBD, Psoriasis
Frequency: q12w after loading
Dosing: Initial weight-based IV; then 90mg SC q12w
Notes: Well tolerated
Other Mechanisms
Rituximab
IVAnti-CD20 (B cells)
Indications: RA, Vasculitis, Lymphoma
Frequency: PRN
Dosing: 375 mg/mยฒ IV (note BSA dosing)
Notes: Hep B, PJP prophylaxis
Vedolizumab
IVIntegrin ฮฑ4ฮฒ7 blocker
Indications: UC, Crohn's
Frequency: q8w after loading
Dosing: 300mg IV q8w
Notes: Gut-specific, low systemic effect
๐ Biologic Dose Calculator
Enter patient weight and height to estimate doses for weight-based biologics. Always confirm dosing with local guidelines.
๐งด Premedications for Infusion Biologics
Rituximab: IV hydrocortisone 100mg, chlorphenamine 10mg IV, ยฑ paracetamol 1g PO
Infliximab: Chlorphenamine 10mg PO/IV ยฑ paracetamol ยฑ IV hydrocortisone if prior reaction
Tocilizumab (IV): Consider paracetamol and antihistamine in case of infusion reaction history