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Gamifant is administered by intravenous infusion over 1 hour twice a week (every 3-4 days) until the patient no longer requires therapy for the treatment of HLH, until HSCT is performed, or if unacceptable toxicity is reached. Gamifant should be given concomitantly with dexamethasone at a starting daily dose (for the steroid) of at least 5 to 10 mg/m2.1

During Gamifant treatment, monitor for tuberculosis, adenovirus, Epstein-Barr virus (EBV), and cytomegalovirus (CMV) every 2 weeks and as clinically indicated.1

Gamifant offers flexibility of dosing1

Gamifant can be incrementally titrated upward or downward according to the clinician's assessment of patient response.

After the patient’s clinical condition is stabilized, decrease the dose to the previous level to maintain clinical response until HSCT.

Dexamethasone can also be tapered according to the judgment of the treating physician.


Response criteria for dose increase1

Gamifant can be increased after 3 days, based on the clinician’s assessment of unsatisfactory improvement in clinical condition, AND at least one of the following:

Fever Persistence or recurrence
Platelet Count
  • If baseline <50,000/mm3 and no improvement to >50,000/mm3
  • If baseline >50,000/mm3 and <30% improvement
  • If baseline >100,000/mm3 and decrease to <100,000/mm3
Neutrophil Count
  • If baseline <500/mm3 and no improvement to >500/mm3
  • If baseline >500-1000/mm3 and decrease to <500/mm3
  • If baseline 1000-1500/mm3 and decrease to <1000/mm3
  • If baseline ≥3000 ng/mL and <20% decrease
  • If baseline <3000 ng/mL and any increase to >3000 ng/mL
Splenomegaly Any worsening
Coagulopathy Both D-dimer and fibrinogen must apply
  • D-dimer: if abnormal at baseline and no improvement
  • Fibrinogen (mg/dL): if baseline levels ≤100 mg/dL and no improvement or if baseline levels >100 mg/dL and any decrease to <100 mg/dL
dosing & Administration guide


Target-mediated clearance

Gamifant exhibits target-mediated clearance dependent on IFNγ production, which can vary between and within patients as a function of time and can affect the recommended dosage.1

  • The pharmacokinetics of emapalumab-lzsg were evaluated in healthy adult subjects and in patients with primary HLH1
  • Gamifant steady-state is achieved by the seventh infusion when the IFNγ production is moderate. At high IFNγ production, steady-state is reached earlier due to a shorter half-life1

Dosing flexibility is especially important given this variability, and dose adjustments may be needed to neutralize IFNγ concentrations in each patient.

Identify the right dose of Gamifant with our Dosing Calculator.