[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/) › Inotuzumab ozogamicin # Inotuzumab ozogamicin ## ADCs? Antibody-drug conjugates (ADCs) ## High alert? An error with this medicine can cause serious harm: double checks and protocols are used. ## Pregnancy: avoid? Avoid in pregnancy. It may harm the fetus: a pregnancy test is done first, women and men use contraception during and for months after treatment, and breastfeeding is stopped. An anti-CD22 antibody carrying calicheamicin; used in relapsed or refractory B-cell acute lymphoblastic leukaemia. Watch the liver. Updated Nov 12, 2026 ## Quick facts **Group** [Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/) **Target** CD22 on B-lymphoblasts **Key effects** Fatigue · Nausea · Mouth sores **Monitor** Liver tests · Complete blood count **ATC** L01FB01 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action Inotuzumab ozogamicin is an antibody-drug conjugate. The antibody binds CD22 on the surface of B-lineage blasts; the complex is internalised and calicheamicin is released inside the cell, where it breaks double-stranded DNA and triggers cell death. - The antibody binds CD22 on B-lymphoblasts - It is internalised and calicheamicin is released - Double-strand DNA breaks kill the blast ## Indications - Relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukaemia in adults and children from one year of age. [Acute leukaemia (AML and ALL) →](https://durgical.com/en/conditions/acute-leukaemia/) ## Adverse effects ### Common - Fatigue, fever - Nausea, abdominal pain, diarrhoea, constipation - Mouth sores, decreased appetite - Headache, back or limb pain ### Serious (rare, important) - Hepatotoxicity, including veno-occlusive disease (boxed warning) - Higher non-relapse death after stem cell transplant (boxed warning) - Myelosuppression with infection and bleeding - Infusion reactions - QT prolongation ## Contraindications - Hypersensitivity to inotuzumab ozogamicin; earlier liver disease or a prior stem cell transplant raise the risk of veno-occlusive disease ## Key interactions **Drugs that prolong the QT interval, low potassium or magnesium** Add to QT risk; ECG and electrolytes are checked. ## What is monitored - Liver tests, bilirubin, weight and abdominal girth - Complete blood count - ECG and electrolytes - Vital signs during and for at least an hour after infusion ## Administration and safety - Hazardous drug, prepared and infused intravenously by trained staff. - Premedication before each dose. - Look-alike names: inotuzumab ozogamicin and gemtuzumab ozogamicin are different; the order is checked. ## Pregnancy and breastfeeding Avoid in pregnancy. It may harm the fetus: a pregnancy test is done first, women and men use contraception during and for months after treatment, and breastfeeding is stopped. ## Nursing care - Give premedication and watch for fever, chills, rash or breathlessness during and after infusion. - Weigh daily; teach to report rapid weight gain, right upper abdominal pain or jaundice. - Teach to report fever, bleeding or palpitations. - Contraception during and for months after treatment by women and men; breastfeeding is stopped. ## Pharmacokinetics **Absorption** Intravenous infusion over about an hour, on set days of each cycle. ## Memory aid «Ino for 22»: inotuzumab targets CD22 on B cells; gemtuzumab targets CD33 on myeloid cells; both carry calicheamicin and both threaten the liver. ## Test yourself Think of the answer, then tap the question to see it. ## Which antigen does inotuzumab ozogamicin target? CD22 on B-lymphoblasts. ## What are its two boxed warnings? Hepatic veno-occlusive disease and higher non-relapse mortality after stem cell transplant. ## Which leukaemia is it used for? Relapsed or refractory B-cell precursor acute lymphoblastic leukaemia. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/inotuzumab-ozogamicin/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High alert** An error with this medicine can cause serious harm: double checks and protocols are used. **Pregnancy: avoid** Avoid in pregnancy. It may harm the fetus: a pregnancy test is done first, women and men use contraception during and for months after treatment, and breastfeeding is stopped. ## Connections ## Related drugs 2 - [Gemtuzumab ozogamicin](https://durgical.com/en/pharmacology/gemtuzumab-ozogamicin/) - [Blinatumomab](https://durgical.com/en/pharmacology/blinatumomab/) ## Related conditions 1 - [Acute leukaemia (AML and ALL)](https://durgical.com/en/conditions/acute-leukaemia/) [← Back to the class: Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Inotuzumab Ozogamicin Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617041.html) (MedlinePlus (U.S. National Library of Medicine), 2024); [Inotuzumab Ozogamicin - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/inotuzumabozogamicin) (National Cancer Institute, 2024); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01FB01) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/inotuzumab-ozogamicin/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/inotuzumab-ozogamicin/