Adakveo (crizanlizumab-ymca): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD

Quick note before we dive in: The information below is for education only and is not a substitute for medical advice. Always talk with a hematologist or your own healthcare team before starting, stopping, or changing any treatment for sickle cell disease.

What Is Adakveo (crizanlizumab-ymca)?

Adakveo (generic name crizanlizumab) is a prescription medication used in people
16 years and older with sickle cell disease to help reduce how often painful
vaso-occlusive crises (VOCs) happen.

In plain language: it’s an IV infusion that aims to cut down the number of pain crises,
not a cure for sickle cell disease and not a painkiller for crises that are already in full swing.

Adakveo is a type of treatment called a monoclonal antibody. Specifically, it targets
a molecule called P-selectin on blood vessel cells and platelets, which plays a key
role in the “traffic jam” of sickled red blood cells and white cells that causes painful blockages
in blood vessels.

How Adakveo Works (Without a PhD in Biochemistry)

In sickle cell disease, red blood cells can become stiff and “sickle” shaped. These misshapen cells
stick to each other and to the walls of blood vessels, pulling white blood cells and platelets into
the mess. The result: vaso-occlusive crises, which feel like intense, deep pain and can
damage organs over time.

P-selectin is like “Velcro” on the lining of blood vessels. When it’s turned on, cells stick more
easily and form clumps. Adakveo binds to P-selectin and blocks this stickiness, making it
harder for blood cells to pile up and block blood flow.

Clinical studies have shown that crizanlizumab can significantly reduce the median yearly rate
of VOCs compared with placebo in many patients, including those already taking hydroxyurea.

Who Is Adakveo For?

According to the U.S. prescribing information, Adakveo is approved to:

• Reduce the frequency of vaso-occlusive crises (VOCs)
• In adults and pediatric patients 16 years and older
• With sickle cell disease of any genotype

It may be used:

• With or without hydroxyurea, depending on your treatment plan
• In patients with frequent VOCs despite other therapy
• In those who cannot tolerate or cannot take hydroxyurea

Adakveo is not used to treat acute pain crises as they happen. Think of it as part of a
long-term prevention strategy, not an emergency rescue medication.

How Is Adakveo Given? Dosing & Schedule

Standard Dosing

Adakveo is given by intravenous (IV) infusion in a clinic, infusion center, or hospital.
The recommended dose for people 16 and older is:

• 5 mg per kilogram of body weight (5 mg/kg)
• First infusion at Week 0
• Second infusion at Week 2
• Then every 4 weeks (about once a month) after that

How Long Does an Infusion Take?

Each Adakveo dose is infused over about 30 minutes, plus extra time for prep, check-in,
and observation afterward.

Missed Dose

If you miss a scheduled infusion, the usual recommendation is to call your healthcare provider
as soon as possible to reschedule. They will help you figure out the best way to get back on track
with the dosing schedule.

Common Side Effects of Adakveo

Like every medication, Adakveo can cause side effects. Not everyone gets them, and many are manageable,
but you should know what to expect.

More Common Side Effects

In clinical trials and real-world use, the most commonly reported side effects include:

• Joint pain or back pain
• Fever
• Headache
• Abdominal (stomach) pain
• Nausea and vomiting
• Diarrhea
• General body pain or muscle pain
• Fatigue (feeling unusually tired)
• Mouth or throat pain, sore throat

These side effects are often mild to moderate and may improve over time, but tell your care team if
they are severe, persistent, or interfere with daily life.

Serious Side Effects

Less commonly, more serious reactions can occur. Call your care team or seek urgent medical attention
if you notice any of the following:

• Infusion-related reactions – may occur during the infusion or within 24 hours afterward.
  Symptoms can include:
  • Chest pain or tightness
  • Shortness of breath or trouble breathing
  • Feeling faint or light-headed
  • Fever, chills, flushing
  • Headache, nausea, or vomiting
• Allergic or hypersensitivity reactions – such as rash, hives, itching, swelling of the face,
  lips, tongue, or throat, or trouble breathing.
• Severe fatigue, weakness, or new chest pain – which could indicate other complications that
  need prompt evaluation.

If you think you’re experiencing a serious reaction, do not wait for your next appointment. Contact
emergency services or your on-call provider immediately.

Drug Interactions and Lab Considerations

Adakveo is a monoclonal antibody, and it’s not metabolized the same way as many pill-form drugs. That
means classic drug–drug interactions via liver enzymes are less of a concern. However, there are still
important points to know.

Other Sickle Cell Therapies

• Adakveo can be used with hydroxyurea and often is, especially in people who still have
  frequent VOCs despite hydroxyurea.
• It may also be used alongside pain medications (NSAIDs, opioids, or other agents) for acute crises,
  as guided by your care team.

Lab Test Interference

The prescribing information notes that crizanlizumab can affect certain lab tests, particularly
some coagulation tests such as aPTT (activated partial thromboplastin time), which are used to monitor
blood clotting. Your healthcare team and lab will account for this when interpreting your results.

Always Tell Your Healthcare Team

Make sure your doctors, nurses, and pharmacists know:

• All prescription and over-the-counter medicines you take
• Vitamins, herbal supplements, and “natural” products
• Any other infusions or biologic drugs you receive

Even when formal interaction data are limited, your team will check for overlapping side effects
(like fatigue or infection risk) and monitor you appropriately.

Important Warnings & Precautions

Infusion-Related Reactions

Infusion reactions are one of the key warnings in the Adakveo label. They can occur during the
infusion or up to 24 hours later. Your care team may monitor you closely during and after the
infusion, and may slow or stop the infusion or treat symptoms if needed.

Allergic Reactions

Because Adakveo is a monoclonal antibody (a type of protein), there is a risk of hypersensitivity
or allergic reactions. Any signs of swelling, severe rash, or breathing difficulty should be
treated as urgent.

Use in Pregnancy and Breastfeeding

Data on Adakveo in pregnancy and breastfeeding are limited. The decision to use it in these settings
is highly individualized and should be made in close consultation with a hematologist and obstetric
team.

Age Limits

Adakveo is approved for patients 16 years and older. It is not currently approved for
younger children with sickle cell disease in the United States.

What About the “Pictures” Part?

If you land on a page like WebMD, “pictures” often refers to images that help you visualize the
medication and how it’s given. For Adakveo, that may include:

• The vial and label of Adakveo (crizanlizumab) solution
• An IV bag connected to tubing, showing the infusion setup
• Illustrations of sickled red blood cells versus normal cells
• Diagrams of how blocking P-selectin reduces cell clumping and VOCs

These visuals are mainly educational. They don’t replace medical training, but they can make it easier
to understand what is going into your vein and why it might help.

Practical Tips for Patients Starting Adakveo

• Plan for infusion days. You’ll usually be at the clinic for at least an hour or two
  including check-in, infusion, and observation. Bring something to read, watch, or listen to.
• Track your crises. Keep a simple log of pain crises before and after starting Adakveo.
  This helps you and your doctor decide whether it’s working for you.
• Report new or unusual symptoms. Even if you’re not sure the symptom is from Adakveo,
  let your care team know.
• Don’t stop other treatments on your own. Many people stay on hydroxyurea and other
  supportive medications while using Adakveo. Any change should go through your specialist.
• Ask about financial assistance. Adakveo is a specialty drug. Depending on insurance
  and local programs, there may be copay support or patient assistance programs.

Is Adakveo Right for You?

That’s a question only you and your hematology team can answer. In general, Adakveo may be considered
if:

• You have sickle cell disease with recurrent VOCs
• You’re 16 or older
• You’re looking for additional ways to reduce crises beyond hydroxyurea and standard care
• You’re okay with regular IV infusions and close monitoring

Your team will also consider other approved sickle cell therapies, your past medical history, other
medications, and practical issues like access to infusion centers and coverage.

Real-World Experiences with Adakveo (Illustrative Examples)

While clinical trial data give us charts and p-values, real life is messier and more human. The
following scenarios are composite examples based on the kinds of experiences reported in
clinics and patient communities. They’re not individual case reports and are not predictions of what
will happen to you, but they can help you imagine what Adakveo might feel like in practice.

Case 1: Fewer Crises, More “Normal” Days

Imagine a 24-year-old college student with HbSS sickle cell disease who has four or five VOCs a year,
often requiring hospital stays. She’s been on hydroxyurea for years, takes her medication faithfully,
and still misses exams and social events because of pain. After a long talk with her hematologist, she
adds Adakveo to her regimen.

The first few infusions are a little nerve-racking. She’s not thrilled about more needles, and after
the first infusion she has mild back pain and a headache that last a day. Over the next 6–12 months,
though, she notices she’s had only one hospital-level crisis. She still has bad days, but they’re less
frequent, and she feels more comfortable planning trips and internships that used to feel risky.

Is this everyone’s story? No. But it reflects what some patients describe when Adakveo works well for
them: not a miracle cure, but a noticeable reduction in crises that opens up more room for “regular
life.”

Case 2: Side Effects and Tough Trade-Offs

Now consider a 35-year-old father with frequent VOCs and chronic pain. He starts Adakveo hoping to cut
down on ER visits. After the first two infusions, he experiences significant fatigue, headaches, and
episodic chest tightness during infusion. His team slows the infusion, premedicates him, and monitors
him more closely.

Over time, his VOC rate drops slightly, but the side effects remain bothersome. After six months, he
and his hematologist sit down and do what every chronic illness patient knows too well: a risk–benefit
analysis. For him, the modest reduction in crises doesn’t outweigh the feeling that he loses a day
or two every month to side effects. Together, they decide to stop Adakveo and focus on other approaches.

This scenario highlights an important reality: even effective medications are not a universal fit. Side
effects, logistics, lifestyle, and personal priorities all matter.

Case 3: The Clinician’s Perspective

From a hematologist’s point of view, Adakveo is one of several newer disease-modifying options for
sickle cell disease. It adds a tool to the toolbox, particularly for patients who:

• Have frequent VOCs despite hydroxyurea
• Cannot tolerate high-dose hydroxyurea
• Need additional VOC prevention but are not candidates for bone marrow transplant or gene therapy

The clinician must weigh questions like:

• How severe and frequent are the patient’s crises now?
• Is there access to an infusion center that can reliably provide monthly treatments?
• What is the patient’s insurance situation and out-of-pocket cost?
• Does the patient have support for transportation, time off work or school, and follow-up visits?

Many clinicians report that some patients do extremely well on Adakveo, while others see minimal
benefit or cannot tolerate side effects or the logistics of infusion-based therapy. Ongoing studies
continue to refine where this medication fits best among the growing number of sickle cell treatments.

Taking Charge of Your Treatment Story

Perhaps the most important “experience” to keep in mind is your own. Living with sickle cell disease
often means juggling pain control, preventive treatments, work or school, family life, and mental
health. If you’re considering Adakveo, think about:

• What would count as a “win” for you? Fewer crises? Shorter hospital stays? More stable energy?
• How do you feel about monthly infusions versus daily pills?
• What supports (transport, childcare, schedule flexibility) are available to you?

Bring these questions to your hematology visit. The goal isn’t just to add another medication; it’s to
choose a treatment plan that actually fits your life.

Conclusion

Adakveo (crizanlizumab-ymca) is an IV monoclonal antibody that targets P-selectin to help reduce
painful vaso-occlusive crises in people 16 and older with sickle cell disease. It’s given as a 30-minute
infusion at Week 0, Week 2, and then every 4 weeks. For some, it significantly cuts down on crises and
opens up space for school, work, and life. For others, side effects, logistics, or cost may limit its
usefulness.

As with any serious medication, the decision to start Adakveo should be made with a specialist who
knows your full medical history, treatment goals, and everyday realities. If you’re curious about
whether it might help you, the best next step is a frank, unhurried conversation with your hematology
team.