This video provides a step-by-step guide on how to prepare and administer VYXEOS.
VYXEOS requires reconstitution and further dilution prior to intravenous infusion. For the reconstitution of one VYXEOS vial, you will need a sterile syringe, needle, Sterile Water for Injection, VYXEOS, and an IV bag containing 500 milliliters of either 0.9 percent Sodium Chloride Injection, USP or 5 percent Dextrose Injection, USP. VYXEOS vials should be refrigerated until needed for preparation. VYXEOS is a hazardous drug. Follow applicable special handling and disposal procedures.
VYXEOS contains both daunorubicin and cytarabine at a fixed molar ratio. The calculation to determine the volume of VYXEOS required per dose is based on the dose of daunorubicin. You will then use the patient’s body surface area, or BSA, to complete the calculation. To determine the volume of VYXEOS needed for the dose, multiply the patient’s BSA by the daunorubicin dose, then divide by 2.2 milligrams per milliliter. After reconstitution and prior to dilution, each vial of VYXEOS will contain 20 milliliters for administration. Each milliliter will contain 2.2 milligrams of daunorubicin and 5 milligrams of cytarabine.
Based on the volume required to prepare the dose, remove the appropriate number of VYXEOS vials from the refrigerator.
Let the vials rest for 30 minutes, allowing them to equilibrate to room temperature.
VYXEOS is supplied as a sterile, preservative-free, purple lyophilized cake.
Now that you have completed the setup, you can begin preparing VYXEOS for administration. Once the VYXEOS vials have reached room temperature, withdraw 19 milliliters of Sterile Water for Injection, using aseptic procedures.
Reconstitute VYXEOS with the 19 milliliters of Sterile Water for Injection and immediately start a 5-minute timer.
Begin gently swirling the contents of the vial for 5 minutes, while inverting every 30 seconds. Be sure to continue swirling the vial while it is inverted.
It is very important not to heat, vortex, or shake the vial at any time during this process.
After reconstitution, let the vials rest for 15 minutes.
The reconstituted product should be a purple, opaque, homogeneous dispersion, essentially free from particulates. Use the reconsistuted solution immediately. If needed, store the reconstituted product in the vial refrigerated at 2 degrees Celsius to 8 degrees Celsius, or 36 degrees Fahrenheit to 46 degrees Fahrenheit, for up to 4 hours. Note that the reconstituted product in the vial and the reconstituted product which has been diluted into an infusion solution are stable for a total of 4 hours (not 4 hours each) when stored at 2°C to 8°C.
After the 15-minute rest period, gently invert each vial 5 times for further dilution, then aseptically withdraw the calculated volume of reconstituted product from the vials with a sterile syringe.
Transfer the calculated volume into an infusion bag containing 500 milliliters of 0.9 percent Sodium Chloride Injection, USP or 5 percent Dextrose Injection, USP. Discard any unused portion or residual product remaining in the vial, and do not save any unused portions for later administration.
Gently invert the IV bag to mix the solution.
This process should result in a deep purple, translucent solution. Prior to administration, inspect the solution in the IV bag to ensure that it is a homogeneous dispersion, free from any visible particulates. Only solutions without visible particles should be used. If the diluted infusion solution is not used immediately, store in the refrigerator at 2 degrees Celsius to 8 degrees Celsius, or 36 degrees Fahrenheit to 46 degrees Fahrenheit, for up to 4 hours. If the reconstituted solution in the vial was stored for 4 hours, the diluted infusion solution must be used immediately and cannot be stored for an additional 4 hours.
Administer VYXEOS by constant IV infusion over 90 minutes via an infusion pump through a central venous catheter or a peripherally inserted central catheter. Do not mix VYXEOS with or administer it as an infusion with other drugs.
After administration, flush the line with 0.9 percent Sodium Chloride Injection, USP or 5 percent Dextrose Injection, USP.
VYXEOS is indicated for the treatment of newly-diagnosed therapy-related acute myeloid leukemia (t‑AML) or AML with myelodysplasia-related changes (AML-MRC) in adults and pediatric patients 1 year and older.
IMPORTANT SAFETY INFORMATION