palifermin

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: 4.5 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	end of dose	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to palifermin or other E. coli–derived proteins;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Allogeneic hematopoietic stem cell support (↑ risk of exacerbated mucositis);
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: erythema, pruritus, rash

GI: tongue thickening/discoloration

GU: ↓fertility

Metab: ↑amylase, ↑lipase

MS: arthralgia

Neuro: dysesthesia, dysgeusia

Interactions ⬆ ⬇

Drug-drug:

Unfractionated heparin and low-molecular weight heparin↑ levels (flush tubing with saline between use).
Administration within 24 hr after myelotoxic therapy (chemotherapy/radiation)↑ severity and duration of mucositis.

Route/Dosage ⬆ ⬇

IV (Adults ): 60 mcg/kg/day for 3 days before and 3 days after myelotoxic therapy.

Availability ⬆ ⬇

Powder for injection: 6.25 mg/vial

Assessment ⬆ ⬇

Assess level of oral mucositis prior to and periodically during therapy.

Lab Test Considerations:

May cause ↑ serum lipase and amylase; usually reversible.
- May cause proteinuria.

Implementation ⬆ ⬇

Do not administer palifermin within 24 hr before, during infusion, or 24 hr after infusion of myelotoxic chemotherapy.
- Administer doses for 3 consecutive days before (3rd dose 24–48 hr prior to chemotherapy) and 3 consecutive days after myelotoxic chemotherapy (4th dose on same day as hematopoietic stem cells infusion after infusion is completed and at least 4 days after most recent palifermin administration) for a total of 7 doses.

IV Administration:

IV Push: Reconstitution: Reconstitute palifermin powder by slowly injecting 1.2 mL of sterile water for injection aseptically.Concentration: 5 mg/mL. Swirl gently; do not shake or vigorously agitate. Solution should be clear and colorless; do not administer solution that is discolored or contains particulate matter. Dissolution usually takes less than 3 min. Administer immediately after reconstitution or refrigerate and administer within 24 hr. Do not freeze. Allow to reach room temperature for up to 1 hr. Protect from light. Discard palifermin after expiration date or if left at room temperature for more than 1 hr.
Rate: Administer via bolus injection. Do not use a filter.
Y-Site Incompatibility: heparin. If heparin solution is used to maintain IV line, flush with 0.9% NaCl prior to and after use of palifermin.

Patient/Family Teaching ⬆ ⬇

Explain the purpose of palifermin to patient.
Inform patient of evidence of tumor growth and stimulation in cell culture and animal models.
Advise patient to notify health care professional if rash, erythema, edema, pruritus, oral/perioral dysesthesia (tongue discoloration, tongue thickening, alteration of taste) occur.
Rep: May cause fetal harm. Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding during therapy and for at least 2 wk after last dose. May impair female and male fertility.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇