Frequent Adverse Reactions
Amyloid-Related Imaging Abnormalities (ARIA)
ARIA-Edema (ARIA-E): Temporary brain swelling (24% incidence), often asymptomatic but may cause headaches, dizziness, or confusion[2][3][4].
ARIA-Hemosiderin Deposition (ARIA-H): Microhemorrhages (25%) and superficial siderosis (15%)[2][5].
Headache (13%)[2][4].
Infusion-related reactions (e.g., chills, sweating, nausea, chest tightness, hypotension)[1][3][7].
Serious but Less Common Effects
Hypersensitivity reactions, including anaphylaxis (swelling, hives, breathing difficulty)[1][3][6].
Symptomatic ARIA: Confusion, vision changes, seizures, or difficulty walking—requiring immediate medical attention[4][5][6].
Increased bleeding risk in patients on antithrombotics[6][8].
Monitoring & Management
Baseline and serial MRIs (before 2nd, 3rd, 4th, and 7th infusions)[2][6].
APOE ε4 testing (higher ARIA risk in homozygotes)[4][6].
Post-infusion observation for ≥30 minutes due to allergic/infusion reaction risks[3][7].
Asymptomatic ARIA often resolves spontaneously, but symptomatic cases may require treatment suspension[2][5]. Patients should carry a medication alert card[6].
Citations:
[1] https://www.rxlist.com/donanemab/generic-drug.htm
[2] https://www.drugs.com/sfx/donanemab-side-effects.html
[3] https://kisunla.lilly.com/side-effects
[4] https://www.drugs.com/donanemab.html
[5] https://medlineplus.gov/druginfo/meds/a624048.html
[6] https://www.veteranshealthlibrary.va.gov/medicationsva/203,a624048
[7] https://www.webmd.com/drugs/2/drug-388270/kisunla/details
[8] https://www.alz.org/alzheimers-dementia/treatments/donanemab
Share this post