Lanadelumab
Hereditary angioedema agents
Hereditary angioedema agents
A human antibody that blocks plasma kallikrein; injected under the skin at intervals, it prevents hereditary angioedema attacks.
Also called: lanadelumab-flyo
Quick facts
- Group
- Hereditary angioedema agents
- Target
- Plasma kallikrein
- Key effects
- Injection-site pain · Headache · Muscle pain
- Monitor
- Attack diary to judge prevention
- ATC
- B06AC05
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows human plasma kallikrein with the binding fragment (Fab) of DX-2930, the development code of lanadelumab, covering the active site; as an antibody it has no small-molecule ligand.
Lanadelumab is a fully human IgG1 monoclonal antibody that binds active plasma kallikrein and blocks its active site. The enzyme can no longer cut high-molecular-weight kininogen, so less bradykinin is produced and attacks become rarer.
- Lanadelumab binds active plasma kallikrein
- Kallikrein cannot cleave high-molecular-weight kininogen
- Less bradykinin is released and fewer attacks occur
Indications
- Prevention of hereditary angioedema attacks (adults and children from 2 years) Urticaria and angioedema →
Adverse effects
Common
- Injection-site pain, bruising or redness
- Headache, dizziness
- Muscle pain
- Diarrhoea
- Cold-like symptoms (cough, runny nose, sore throat)
Contraindications
- Hypersensitivity to lanadelumab
Key interactions
- Other medicines
- No specific interactions are listed; acute-attack treatment is still kept at hand
What is monitored
- Attack diary to judge prevention
- Allergic reactions after injections
Administration and safety
- Subcutaneous injection into the thigh or abdomen, avoiding the navel, sites rotated; home injection after training
- Brought to room temperature without heating; not shaken; not used if cloudy or with particles
- Stored refrigerated, protected from light, never frozen
- It does not treat an acute attack
Pregnancy and breastfeeding
Pregnancy, plans for pregnancy or breastfeeding are discussed with the treating team before use.
Nursing care
- Teach injection technique and sharps disposal
- Make sure the patient still has an acute-attack plan
- Teach signs of allergy that need urgent care
- Remind not to stop without speaking to the doctor
Pharmacokinetics
- Absorption
- Subcutaneous injection
- Elimination
- Broken down like other antibodies; long-acting, so doses are spaced
Test yourself
Think of the answer, then tap the question to see it.
What does lanadelumab bind?
Active plasma kallikrein.
Does it treat acute attacks?
No, it prevents attacks.
Which oral drug shares its target?
Berotralstat.
Connections
← Back to the class: Hereditary angioedema agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Lanadelumab-flyo injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2025); 4OGY: Crystal structure of Fab DX-2930 in complex with human plasma kallikrein at 2.1 Angstrom resolution (RCSB Protein Data Bank, 2014).
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Representative model, for educational purposes only.