Kisunla (donanemab-azbt) is a prescription drug that’s used to treat Alzheimer’s disease in adults. Kisunla is given as an intravenous (IV) infusion by a doctor or other healthcare professional.

Note: As a person’s condition progresses, they may need help reading or understanding certain information about their treatment plan. This article contains details that may help caregivers learn more about key aspects of Kisunla.

Kisunla basics

Kisunla contains the active ingredient donanemab-azbt.

Kisunla is a biologic medication. A biologic is made from parts of living organisms. It’s available only as a brand-name drug. It isn’t available in a biosimilar form.

Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.

Biosimilars will have the same active ingredient core name as the brand-name drug. But they’ll have unique suffixes. This is why “-azbt” appears at the end of the name of the active ingredient. This is to show that it’s distinct from biosimilars that may be created in the future.

Kisunla has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should be considered before taking Kisunla?” section below.

Kisunla is used to treat Alzheimer’s disease (AD) in adults. It’s typically prescribed for people with mild AD.

AD is a form of dementia that’s progressive (meaning it gets worse over time). Dementia refers to changes in the brain that can negatively affect your decision making, memory, and ability to use language.

AD may cause symptoms such as:

  • memory loss
  • changes in behavior, mood, and personality
  • disorientation with respect to time and place
  • trouble with familiar tasks or problem-solving

One key feature of AD is the presence of beta-amyloid plaques in the brain. Beta-amyloid is a protein normally found in the brain. If these proteins clump together, such as what happens in many cases of AD, they can form plaques. These plaques disrupt the brain’s ability to communicate with nerve cells. Kisunla works to treat Alzheimer’s disease by reducing the number of amyloid beta plaques in the brain.

Before prescribing Kisunla, your doctor will likely order tests to confirm the presence of beta-amyloid plaques in your brain. They can provide more information on how they’ll test whether you’re a good candidate to receive Kisunla.

Like most drugs, Kisunla may cause mild to serious side effects. The lists below contain some of the more common side effects Kisunla may cause, but they don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Kisunla. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Kisunla can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Kisunla’s prescribing information.

Mild side effects of Kisunla that have been reported include:

  • headache
  • mild infusion reactions

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Kisunla can occur, but they aren’t common. If you have serious side effects from Kisunla, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Kisunla that have been reported include:

  • obstruction or perforation (holes) in your digestive tract
  • severe infusion reactions
  • boxed warning: risk of amyloid-related imaging abnormalities (ARIA)*

* For more information, see the “What should be considered before taking Kisunla?” section.

Allergic reaction

For some people, Kisunla can cause an allergic reaction. In general, symptoms of allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Kisunla.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Kisunla, they may have you switch to a different treatment.

Your doctor will recommend the dosage of Kisunla that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.

Form and strength

Kisunla comes as a liquid solution that’s given as an intravenous (IV) infusion (an injection into your vein over a period of time). It comes in one strength of 350 milligrams in 20 milliliters of solution (mg/mL).

Recommended dosage

The recommended starting dose of Kisunla for treating Alzheimer’s disease (AD) is 700 mg every 4 weeks for three doses. After that, the dose is typically increased to 1,400 mg every 4 weeks.

How it’s given

Your doctor will explain how Kisunla will be given to you. They’ll also explain how much you’ll be given and how often.

Kisunla comes as a liquid solution that’s given as an IV infusion. You’ll receive infusions at your doctor’s office or a clinic.

Questions about using Kisunla

Below are some common questions about using Kisunla.

  • What if I miss a dose of Kisunla? If you miss an appointment to receive an infusion of Kisunla, call your doctor’s office as soon as possible to reschedule.
  • Will I need to use Kisunla long term? Kisunla is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
  • How long does Kisunla take to work? Kisunla begins to work after you take your first dose. But you likely won’t feel the drug working in your body. Your doctor will order tests throughout your treatment to check whether Kisunla is working to treat your condition.

Below is important information you should consider before starting Kisunla treatment.

Interactions

Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

There are no reports of Kisunla interacting with other medications, herbs, supplements, foods, or alcohol. But this doesn’t mean that such interactions won’t be recognized in the future.

Before starting Kisunla treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Kisunla and alcohol

Alcohol is not known to interact with Kisunla. But alcohol may make your Alzheimer’s disease worse. Because of this, your doctor may recommend that you limit the amount of alcohol you drink.

If you have questions about consuming alcohol with your condition or treatment plan, talk with your doctor or pharmacist.

Pregnancy and breastfeeding

It’s not known whether it’s safe to use Kisunla during pregnancy or while breastfeeding. If you’re pregnant or breastfeeding, or planning to become pregnant or to breastfeed, talk with your doctor before starting Kisunla treatment.

Boxed warning

Kisunla has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Risk of amyloid-related imaging abnormalities (ARIA): Treatment with Kisunla can cause amyloid-related imaging abnormalities (ARIA). This refers to abnormalities that may appear on imaging such as MRI scans.

This side effect was uncommon in studies of Kisunla. ARIA is more likely when you first begin treatment with Kisunla, but can happen at any time you’re using the medication.

ARIA can appear as either swelling or bleeding spots in different parts of your brain.

ARIA can be detected using MRI scans. In most cases, this side effect doesn’t cause symptoms. However, some people may experience symptoms including:

  • confusion
  • difficulty walking
  • dizziness
  • headache
  • nausea
  • vision changes

Mild ARIA symptoms may go away on their own with time. In rare cases, ARIA can cause serious complications including seizure and status epilepticus.

A certain genetic risk factor can increase your risk of developing ARIA if you use Kisunla. Your doctor will likely order a test to check for this genetic risk factor (homozygous apolipoprotein E ε4 gene carriers) before prescribing Kisunla for you. In addition, your doctor will likely order MRI scans before and during your Kisunla treatment.

It can be difficult to distinguish ARIA symptoms from symptoms of a stroke. If you develop symptoms of ARIA described above, immediately call your doctor or go to the closest emergency room.

Other warnings

Kisunla can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Kisunla is a good treatment option for you.

Talk with your doctor about your health history before you take Kisunla. Be sure to tell them if any of the following factors apply to you:

Whether you have health insurance or not, cost may be a factor when you’re considering Kisunla. What you’ll pay for Kisunla may depend on several things, such as your treatment plan and the pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called Lilly Support Services may also be available.

You can also check out this article to learn more about saving money on prescriptions.

Other drugs are available that can treat your condition. If you’d like to explore an alternative to Kisunla, talk with your doctor. They can tell you about other medications that might work well for you.

The following drugs are similar to Kisunla:

  • lecanemab-irmb (Leqembi)
  • donepezil (Aricept, Adlarity)
  • rivastigmine (Exelon)
  • galantamine
  • memantine (Namenda)
  • donepezil/memantine (Namzaric)

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.