Patients on immunosuppressive therapy have an increased risk of infections. Since infections have a potential to trigger acute porphyric attacks vigilance is motivated regarding signs or symptoms of infection and/or possible symptoms of a porphyric attack. Side effects like nausea and vomiting may potentially be porphyrinogenic through reduction in carbohydrate intake.

Infections are common in patients using immunosuppressants and since infections might trigger an acute porphyric attack, vigilance regarding signs and symptoms of an infection and/ or a porphyric attack is recommended. Common adverse reactions of alemtuzumab that can be confused with an acute porphyric attack are nausea and vomiting. These side effects may potentially be porphyrinogenic if leading to a decrease in carbohydrate intake.

Alemtuzumab is not metabolized by cytochrome P450 enzymes. No pharmacokinetic porphyrinogenic effects are suspected.

Alemtuzumab is a humanised derivative of campath-1G, a rat monoclonal antibody to the CD52 antigen found on lymphocytes.

Alemtuzumab is an antineoplastic and immunomodulating agent. It is indicated for treatment of adult patients with relapsing remitting multiple sclerosis. It is administered by an intravenous infusion.

Mechanisms for elimination of monoclonal antibodies are not well documented but are reported to include proteolysis by the liver and the reticuloendothelial system, target-mediated elimination and nonspecific endocytosis (Keizer 2010). Alemtuzumab is not eliminated via CYP enzymes (EMA).