Sample of a possible Lemtrada Protocol

1. Sample Lemtrada Protocol
1-7 Days Prior to starting Lemtrada:
Preventive Treatment:
Motrin 600-800mg oral 2-3 times a day- 1-2 days in advance is fine
Diphenhydramine 25-50 mg oral at bedtime
Ranitidine 150-300 mg orally
Valcyclovir 200mg twice daily- continue as prescribed
Day 1:
Treatment:
Solumedrol 1gm given over 1 hour infusion
Motrin 600-800mg oral initially and prn
Acetaminophen 550+mg orally initially and prn discomfort
Diphenhydramine 50 mg IV or oral
Ranitidine 150-300 mg orally
After other infusions above, Alemtuzumab must be mixed, used immediately and not
combined with any other drugs in the IV line
Alemtuzumab 12mg IV given over 4 hours, may extend time if patient is not doing well.
Supportive measures such as pain medication may be needed
Consider 2nd
dose of IV Benadryl 50mg prior to discharge
Day 2:
Solumedrol 1gm given over 1 hour infusion
Motrin 600-800mg oral initially and prn
Acetaminophen 550+mg orally initially and prn discomfort
Diphenhydramine 50 mg IV or oral
Ranitidine 150-300 mg orally
After other infusions above, Alemtuzumab must be mixed, used immediately and not
combined with any other drugs in the IV line
Alemtuzumab 12mg IV may shorten infusion time to 2 hours if patient tolerated day 1
well, may extend time if Alemtuzumab was not tolerated well.
Supportive measures such as pain medication may be needed
Consider 2nd
dose of IV Benadryl 50mg prior to discharge for rash
Day 3:
Solumedrol 1gm given over 1 hour infusion
Motrin 600-800mg oral initially and prn

2. Acetaminophen 550+mg orally initially and prn discomfort
Diphenhydramine 50 mg IV or oral
Ranitidine 150-300 mg orally
After other infusions above, Alemtuzumab must be mixed, used immediately and not
combined with any other drugs in the IV line
Alemtuzumab 12mg IV may shorten infusion time to 2 hours if patient tolerated day 1
well, may extend time if Alemtuzumab was not tolerated well.
Supportive measures such as pain medication may be needed
Consider 2nd
dose of IV Benadryl 50mg prior to discharge for rash
Day 4:
Solumedrol 500mg given over 30 minute infusion* patient preference, not part of
official protocol. Patient requests a step down from high dose steroid treatment
Motrin 600-800mg oral initially and prn
Acetaminophen 550+mg orally initially and prn discomfort
Diphenhydramine 50 mg IV or oral
Ranitidine 150-300 mg orally
After other infusions above, Alemtuzumab must be mixed, used immediately and not
combined with any other drugs in the IV line
Alemtuzumab 12mg IV may shorten infusion time to 2 hours if patient tolerated day 1
well, may extend time if Alemtuzumab was not tolerated well.
Supportive measures such as pain medication may be needed
Consider 2nd
dose of IV Benadryl 50mg prior to discharge for rash
Day 5:
Solumedrol 250mg given over 30 minute infusion* patient preference, not part of
official protocol. Patient requests a step down from high dose steroid treatment
Motrin 600-800mg oral initially and prn
Acetaminophen 550+mg orally initially and prn discomfort
Diphenhydramine 50 mg IV or oral
Ranitidine 150-300 mg orally
After other infusions above, Alemtuzumab must be mixed, used immediately and not
combined with any other drugs in the IV line
Alemtuzumab 12mg IV may shorten infusion time to 2 hours if patient tolerated day 1
well, may extend time if Alemtuzumab was not tolerated well.
Supportive measures such as pain medication may be needed
Consider 2nd
dose of IV Benadryl 50mg prior to discharge for rash