Methoxsalen (Injection)

Methoxsalen is a medication that is used in the treatment of cutaneous T-cell lymphnoma.

Overview

Methoxsalen is a psoralens medication. It is used in conjunction with ultraviolet light for the treatment of white blood cells. The process of treatment is called photopheresis. In this process the white blood cells are removed form the body, treated and then re-injected back into the body. This treatment is used to control the skin conditions that are associated with cutaneous T-cell lymphoma. This is more commonly known as cancer of the lymph system.

Methoxsalen can only be administered by a doctor who is trained in this procedure and is only ever carried out in a hospital or cancer clinic. The medication is provided as Uvadex and is supplied as a solution or injectable.

Condition treated

  • Cutaneous T-cell lymphoma, skin conditions of

Type Of Medicine

  • Psoralens
  • Photopheresis

Side Effects

In addition to the required effects from the use of Methoxsalen, certain other side effects can also occur. While not all of these side effects will occur, when they do the patient may need to seek medical attention.

If the following side effects occur after receiving an injection of treated white blood cells then you should seek immediate medical attention:

Occurring only rarely:

  • Redness or pain at catheter site
  • Irregular heartbeat
  • Fever

It is also possible to suffer from an overdose from the use of this medication. If you believe that you or someone else has suffered an overdose of this treatment then you must seek emergency medical care. Symptoms of overdose may include the following:

  • Reddened, sore skin
  • Blistering and peeling of skin

Certain other side effects can occur from the use of Methoxsalen that would not normally necessitate that you seek medical attention. These side effects are usually mild and will abate over time. They are also not normally signs of wider medical problems developing. You should check with your medical professional if the following side effects become bothersome or are ongoing, however:

  • Reddening of the skin

This medication will usually cause a reddening of the skin that will last for 24-48 hours. This is not a cause for concern but you should check with your doctor if the skin becomes blistered.

Following treatment with Methoxsalen, there is an increased risk that you will develop skin cancer later in life. You will need to regularly check your body and skin for signs of this including sores that do not heal, new growths and changed growths or moles. You should discuss the increased risk of suffering cancer with your doctor before you begin use of Methoxsalen.

Premature aging of the skin may be suffered when you are using Methoxsalen. This effect will be permanent and will appear similar to effects of sunbathing or using sunbeds for too long or too frequently.

It is also possible that other side effects that have not been listed could also occur. If you experience any other side effects then you should inform your doctor. If you believe your health to be at immediate risk, however, then you should always seek emergency help.

Dosage

This medication will only ever be administered in a hospital or cancer clinic by a trained doctor or nurse. You should only ever use this treatment as you are directed to by your doctor.

The amount of medication that you are treated with will depend on a wide range of factors and will be specific to your personal requirements.

You must attend all appointments for treatment to get the full effect of this medication. If you are going to miss an appointment then you must inform your doctor in advance and rearrange. You should not miss appointments.

Interactions

Some medications should not ever be used in conjunction with one another. This is because they can interact with one another in the body and can cause serious side effects to occur. In the most severe cases the effects can be life-threatening. Other medications may also prevent one another from working fully or may increase the side effects experienced.

To avoid medication interactions you must inform your doctor of every medication and substance that you are taking. This includes nutritional supplements, herbal remedies, over the counter treatments and prescribed medications too. For Methoxsalen it is especially important that you make your doctor aware in the following cases.

The use of Methoxsalen with the following medications is not normally recommended. In some cases, the use of both may be required and in these situations your doctor may adjust the dosages or frequency of usage:

  • Tegafur
  • Pirfenidone
  • Clozapine
  • Anagrelide

Using Methoxsalen with the following medications can increase the risk of side effects and is not normally recommended. Both may be prescribed, however, with adjustments made to dose or use:

  • Phenytoin
  • Fosphenytoin

Other interactions may also occur that have not been listed. This list was compiled for severity of interaction and other interactions may occur. Ensure that your doctor knows of all medications you are taking before you begin use.

Certain medical conditions can also impact on the use of some medications. This is because they may be worsened by the use or may increase the severity of side effects experienced. You should inform your doctor of all medical problems from which you suffer before you begin use of any treatment. In the case of Methoxsalen it is particularly important that you inform your doctor if you are suffering from any of the following conditions:

These conditions may be worsened by use:

  • Albinism
  • Erythropoietic protoporphyria
  • Lupus erythematosus
  • Porphyria cutanea tarda
  • Skin cancer
  • Variegate porphyria
  • Xeroderma
  • Cataracts
  • Loss of lens of eye
  • Other eye problems

This list may not be all-inclusive so you must ensure that your doctor is fully aware of your entire medical history before you begin treatment.

Warnings

Before you begin use of Methoxsalen it is important that you understand the risks of use. The most severe risk is the increased risk of suffering cancer that you will face following treatment. You should consider this carefully with your doctor and weigh it against the benefits of use. You should also ensure all of the following factors have been taken into account in making your decision:

Allergies ' You must inform your doctor if you suffer from any allergies. This is especially important if you have ever suffered from any allergies to medications or to dyes. Such allergies may prohibit the use of this treatment in some cases.

Pediatric' This medication has only been tested in adults and there is no information pertaining to the risks that are posed to children from use.

Geriatric ' This medication has not been tested on elderly patients but no limitations are expected. Elderly patients are more likely to be suffering from conditions that will limit the use of Methoxsalen, however, so caution should be exercised.

Pregnancy ' There is a risk to the use of this medication when pregnant. It has been registered as a category C risk. You must inform your doctor before use of this medication if you are pregnant and should avoid becoming pregnant during use.

Breastfeeding'There is no information pertaining to the risks of breastfeeding while taking Methoxsalen. You should consider the potential risks with your doctor and weigh them against the benefits before beginning use of Methoxsalen.

The consumption of certain foods while you are being treated with Methoxsalen can increase your sensitivity to it and to light. Patients should avoid eating the following foods while they are undergoing treatment with Methoxsalen:

  • Limes
  • Figs
  • Parsley
  • Parsnips
  • Mustard
  • Carrots
  • Celery

Your doctor will need to make regular checks on your condition while you are undergoing this treatment. You will also need to have regular eye checks carried out. The doctor will check for progress with treatment and also for any unwanted side effects that could be occurring.

Methoxsalen will increase the sensitivity of skin to the sun so extra caution will need to be taken when in direct light. Sunlight will also increase premature aging of the skin while you are using this treatment. You may even become burned through a window or on a cloudy day. You should cover your skin when you are in light and use a sunblock to protect yourself. You should do so for at least 24 hours.

In the 24 hours following treatment, you should also wear polarized sunglasses to protect your eyes from UV light. Your eyes may be very sensitive to damage at this time.

Storage

This medication should be stored at a controlled room temperature. It should be stored in a hospital environment only.

Summary

Methoxsalen is a treatment that is used to help control skin conditions related to cutaneous T-cell lymphoma. This type of cancer is very serious and the symptoms of skin conditions can be very painful. In this treatment white blood cells are removed from the body, treated with Methoxsalen and UV light and then re-injected back into the body. The purpose of this treatment is to help control the skin conditions being suffered and improve comfort for the patient.

Methoxsalen can have the very serious side effects of increasing the likelihood of cancer occurring in the future. This side effect and other side effects should be clearly understood and considered before beginning use of this treatment. Discuss this risk with your doctor if you have any concerns.

Patients being treated with Methoxsalen will have a reddening of the skin that will last for 24-48 hours. This is normal and is nothing to be concerned about. Patients will be more sensitive to the sun for 24 hours following treatment, however, and should be very careful not to get burned by the sun. Severe sunburn can occur even on a cloudy day or through a window following this treatment.

This medication should be avoided when you are pregnant. Inform your doctor if you are pregnant before you begin use.