Table 3e. Dosing Regimens for the Drugs Recommended for the Treatment of MIS-C
Last Updated: February 24, 2022
Table 3e. Dosing Regimens for the Drugs Recommended for the Treatment of MIS-C | Drug Name | Dosing Regimens For infants, children, and adolescents unless otherwise specified. The doses listed are for FDA-approved indications for other diseases or from reported experiences or clinical trials. | Adverse Events | Monitoring Parameters |
|---|
| Intravenous Immunoglobulin | - IVIG 2 g/kg IBW/dose (up to a maximum total dose of 100 g) IV for 1 dose
- In the event of cardiac dysfunction or fluid overload, consider administering IVIG in divided doses (1 g/kg IBW/dose IV every 24 hours for 2 doses).
| - Hypersensitivity
- Fever
- Chills
- Flushing
- Hemolytic anemia
| - Renal function
- Urine output
- CBC with differential
- Infusion or injection-related AE
- Anaphylaxis
- Signs and symptoms of hemolysis
|
| Methylprednisolone | - Methylprednisolone 1 to 2 mg/kg/dose IV every 12 hours
- If the patient with MIS-C does not respond to 1–2 mg/kg/dose IV every 12 hours, increase the dose to 10–30 mg/kg/day (up to maximum of 1,000 mg/day) IV for 1 to 3 days.
| - Adrenal suppression
- Hyperglycemia
- Sodium retention
- Fluid retention
- Leukocytosis
- Immune suppression
| - Blood pressure
- CBC with differential
- BMP
|
| Anakinra | Anakinra 5–10 mg/kg/day IV (preferred) or SUBQ in 1 to 4 divided doses | - Headache
- Fever
- Hypersensitivity
- Immune suppression
- Transaminitis
| - CBC with differential
- LFTs
- Scr
|
| Infliximab | Infliximab 5–10 mg/kg/dose IV for 1 dose | - Infusion-related reaction
- Headache
- Immune suppression
| - Monitor vital signs every 2–10 minutes during infusion
- CBC with differential
|
| Aspirin | Aspirin 3–5 mg/kg/dose (up to maximum of 81 mg/dose) PO once daily | - Gastrointestinal ulcers
- Hypersensitivity
- Renal dysfunction
| - Signs or symptoms of bleeding
- Renal function
|
| Enoxaparin | Enoxaparin Prophylaxis
Aged >2 Months to <18 Years- 0.5 mg/kg/dose (up to maximum of 30 mg/dose) SUBQ every 12 hours
Enoxaparin Treatment
Aged >2 Months to <18 Years - 1 mg/kg/dose SUBQ every 12 hours
- Monitor antifactor Xa activity (treatment goal: 0.5 to 1).
| - Increased risk of bleeding
- Thrombocytopenia
| - CBC with differential
- Renal function
|
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