Defibrotide (intravenous)

Patients who most commonly require defibrotide treatment are those undergoing chemotherapy or stem cell transplants, wherein the liver's blood vessels can become blocked.

Overview

Defibrotide is a prescription medication used as an anti-clotting agent to relieve blockages which occur in various locations around the body. One of the primary locations, however, is in the liver, where blood vessels often become blocked for patients being treated with stem cell therapy, or for those undergoing chemotherapy treatment.

If the blood vessel blockages were not relieved by an anti-clotting agent such as defibrotide, there could be serious damage to the liver or other organs of the body. There is also the possibility that an untreated blockage could break free of its original location and be carried by the circulatory system elsewhere in the body, where other major damage could occur as a result.

Condition Treated

  • Breaks down blood clots
  • Treats veno-occlusive disease

Type Of Medicine

  • Thrombolytic (breaks down blood clots)

Side Effects

While defibrotide can deliver some useful health benefits with regular usage, there may also be some undesirable side effects which are experienced by any given user, although it should be understood that any side effects experienced will generally be different for every person.

One of the most important reactions that you should be alert for is an allergic reaction to the medication. This will be identifiable by some of the following symptoms:

  • Hives or rashes appearing on the skin
  • Possible tightening of the chest and/or difficulty breathing
  • Dizziness or disorientation all of a sudden
  • Swelling in the area of the face, especially around the tongue, throat, and lips.

If any of these symptoms appear after you have taken defibrotide, you should immediately seek medical attention, because there is a potential for the symptoms to become much worse. There are some other severe side effects which you should alert your doctor to immediately if you experience them, and these are as follows:

  • Lightheadedness, as though you are about to pass out
  • Problems with your vision
  • Speech which is slurred or difficult to understand
  • Confusion or disorientation
  • Persistent headaches
  • Blood in the urine or in your stools
  • Unexplained bruising or spontaneous bleeding
  • Nausea and/or vomiting
  • Severe and/or persistent diarrhea
  • Constant dizziness
  • Nosebleeds with no apparent cause.

Dosage

A dosage of defibrotide must be injected directly into a vein via an intravenous drip and must be delivered slowly to be done correctly. It generally takes a period of approximately two hours to complete a dosage, and this is true whether it's handled in a hospital setting or at home. If you are administering a dosage of defibrotide to yourself at home, make sure that you understand the procedure exactly, and that you have all your questions answered by your doctor prior to attempting this at home. This means you must understand the usage of needles, tubing and any other materials used in the process, as well as the proper disposal of the same materials.

It is normally necessary to continue the treatment program of defibrotide for about three weeks, but if there is no improvement in symptoms, treatment can continue up to a maximum of 60 days. If self-administering in a home setting, be sure to follow your doctor's instructions precisely as well as those printed on the label of the bottle containing the medicine, and always use only the amount prescribed by your doctor, even if that means some is left over in the container bottle.

This is a medication which must be combined with a diluent before it can be used, so it's essential that you understand the mixing process, as well as how the medication should be stored prior to usage. You should not mix up a dosage of defibrotide until you are ready to administer the IV drip.

If you are using an intravenous method of taking other medications, be sure that you don't mix your IVs between medications ' each medication must have a dedicated IV line. Before self-administering, inspect the medication in the bottle to be sure that it has not changed color since you got it. Also look for particles which may be floating in the medication, and if either of these conditions is true, you should discard the medication without using it.

Once you have mixed up a dosage of defibrotide, it must be used within 24 hours even if you have stored it properly in a refrigerator. After mixing a dosage of defibrotide, if you keep it at room temperature, the medication must be used within four hours, otherwise, it will have to be discarded.

Each vial of defibrotide is intended for a single use, and the file should be properly disposed of after that usage whether or not all of my medication has been used up. If you miss a dosage of defibrotide, it is allowable to catch up on that dose as soon as you remember it, unless you are nearing the scheduled time of your next dosage, in which case it should be skipped entirely. Do not double up on dosages in order to get yourself back on schedule.

Interactions

There are approximately 736 brand-name and generic name drugs which are known to interact in some way with defibrotide, and these interactions can range from the very mild to quite severe, so that makes it important to identify any other drugs you might be taking, to see if they fall in this category of interaction.

The best way to accomplish this is to prepare a list of all other prescription medications which you are currently taking, including over-the-counter drugs, herbal supplements, and vitamins so that your doctor can carefully review this list to see if any of them are drugs which are known to interact with defibrotide. It will be very useful to have this list on hand when you need to make a trip to the emergency room or to a healthcare clinic where your primary care doctor is not in residence. By reviewing your medication list, any doctor treating you will be able to determine what kinds of medications can be used in your treatment without interacting with your defibrotide medication.

To be on the safe side, you should consult with your doctor to see if there are any foods or drinks which he advises against while you are being treated with defibrotide. For instance, it is likely that your doctor will recommend that you avoid consuming alcohol during the period you are being treated with defibrotide. If you are scheduling surgery of any type, even if it's oral surgery, you should advise your doctors or dentists that you are being treated with defibrotide, so that they can be sure not to administer any medications which might conflict with your medication.

Warnings

There are a few precautions which should be considered when you are thinking of initiating a program of treatment that calls for defibrotide usage. First of all, you should not use defibrotide if you know that you are allergic to it or any of the ingredients which are used in making it. You should also not use this drug if you have active bleeding somewhere in the body, or if you are taking a blood thinner such as Jantoven, Coumadin, or warfarin.

Along these same lines, any medications you might be taking that are used for the dissolution of blood clots may cause serious conflict with defibrotide, so you should make sure your doctor is aware of this. Any kind of blood clotting disorder or fairly persistent bleeding is a condition which could be exacerbated by taking defibrotide and is therefore generally considered a disqualifying factor.

There is only a small body of research which has been conducted on animals and almost none on humans which definitively shows any impact or relationship between using defibrotide and pregnancy. Since this is a largely unknown area, it is best that you consult with your doctor if you are pregnant or plan to become pregnant during the period you are being treated with defibrotide. It is likewise unknown whether there is any impact on a nursing infant who is breastfeeding, so to be on the safe side, it is advisable to avoid breast-feeding while you are being treated with defibrotide.

Storage

If you always have your defibrotide dosages being administered in a clinical setting or hospital setting, you don't have to worry about any storage procedures, because that will all be handled by medical professionals. If you are storing the medication at home, it should always be kept in unopened vials at a temperature between 68 and 77°F, although brief periods between 59° and 86°F are permissible.

Each vial of defibrotide is intended for single usage, and should be discarded immediately after a dosage has been delivered, so that none is left lying around to be picked up by non-patients. As many as four doses may be mixed at one time, as long as they are kept refrigerated, but it is more advisable to mix single dosages and use them immediately. Once a dosage has been mixed, it will need to be administered within four hours if it's kept at room temperature, and within 24 hours if it has been kept refrigerated.

Summary

Defibrotide is a medication which is delivered by intravenous method, and it generally takes about two hours to undergo a single treatment. It is used to break down harmful blood clots in the body, often for patients who are undergoing chemotherapy, and are susceptible to this kind of clotting. It can be dangerous to use this medication in conjunction with any other kinds of blood thinners, because that has the potential to significantly increase the de-clotting capability in the body, to a dangerous level.

In some cases, patients can self-administer this medication at home, as long as they are cautious about all the usage and disposal of all the materials used in conducting an IV drip, and are thoroughly educated about proper procedures.

Defibrotide is known to interact with literally hundreds of other medications, so it is very important that your doctor knows about all other drugs you are currently taking, to avoid any unpleasant conflicts.