Palifermin (Intravenous)

Palifermin is used both as a preventative measure and to aid in the healing of severe sores of the mouth and throat that may be caused by chemotherapy or radiation treatments of cancer patients.

Overview

In injection of palifermin is normally intended to treat or prevent painful side effects that are caused by chemotherapy in cancer patients. Such symptoms that can be treated with this medication include swelling, sores, irritation, and ulcers on or in the mouth. The palifermin injection is administered to patients who are suffering from cancers that affect the blood and bone marrow and act as a chemoprotective agent. The medication consists of a man-made form or a protein that affects the growth of cells and tissues of the mouth and digestive tract to include the esophagus, stomach, and intestines. It is used for patients who require hematopoietic stem cell support. Palifermin is marketed under the brand name Kepivance and is only prescribed and administered under the direct supervision of the prescribing physician. It is packaged as a powder that needs to be diluted into a solution for intervenous injection. It is a very effective treatment for the side effects caused by chemotherapy medications but there are many symptoms that it will have no impact on and it is important to note that it is not a treatment for cancer itself or any of its symptoms.

Condition treated

  • Medication side effects
  • Sores
  • Ulcers

Type Of Medicine

  • Chemoprotective Agent

Side Effects

As with most medications, there is a certain risk of side effects from palifermin even though its purpose is to treat the side effects of other medications. While these side effects may not necessarily occur for all patients, any patient taking palifermin should be aware of the possibility that they may be swapping one set of side effects for another. Some of the side effects associated with palifermin may be serious enough to merit medical attention on their own. Inform a medical professional if a fever or severe skin rash is noticed while using this medication to treat mouth sores and ulcers.

Some of the side effects associated with Palifermin will not necessarily need medical attention as they are considered routine and temporary in nature. The cause of these side effects is the body adjusting to the palifermin injection. These symptoms are expected to subside as the body gets used to the medication, and the prescribing physician may know some remedies for these temporary side effects. If they are more severe than normal or last longer than expected a doctor should be informed as this may be an indication that there is a more serious medical condition to consider.

Some of the more common temporary side effects include blurred vision, difficulty moving, dizziness, headache, nervousness, and Some patients experience an unusual taste in the mouth while receiving the injection that is described as bad or unpleasant that may include discoloration or thickening of the tongue. Other common side effects that are not expected to last is a tingling of the skin, flushing or redness of the skin, sensitive skin, itching, rashes, or unusually warm skin. Those taking the injection can temporarily experience muscle pain, stiffness, joint pain, swelling, tingling in the extremities, pounding in the ears, or a slower or faster heartbeat.

While their exact instance is not known, certain temporary side effects have been reported when using palifermin. Some patients have experienced redness or swelling of the skin or vagina. Others have experienced scaling of the skin or ulcers, especially on the hands and feet when first receiving the injection. It is important to report any other side effects not listed as this medication may affect a patient differently based on a number of factors and these side effects may not be a complete list of what is possible.

Dosage

Palifermin is a potent prescription-only medication that can only be administered under the direct supervision of a physician. and is normally conducted in a hospital. A nurse or other trained medical professional will be tasked with administering the injection in the form of a needle placed in the vein and fed with an intravenous drip. The Palifermin will be given for 3 consecutive days after a cancer treatment or chemotherapy and will consist of 6 total doses. If for any reason this dose must be given in the home ensure that it is performed by a certified caregiver who has been trained in the administration of palifermin injections.

Interactions

Palifermin has a certain risk of drug interactions when used at the same time as other medications. Some of these should not be used together in any circumstances, while others may be used together because they represent the best course of treatment despite the risks involved. In the case that a drug combination is necessary there may be other precautions that can mitigate the risk such as changing dosing schedules or the amount of dosage of one or both medications. When receiving palifermin it is important to ensure that the prescribing physician is aware of all medication that is being currently taken to include both prescription and nonprescription medication, vitamins, and supplements. While this guide does not include all potential drugs which may interact with palifermin they are some of the more notable examples. Using Heparin at the same time as palifermin may result in an increased risk of side effects of one or both medications, but the drugs may need to be used together to treat their respective maladies.

There may be a certain risk of other interactions caused by consumption of food, drink, alcohol, or tobacco while using palifermin. Patients and doctors should communicate regarding the safety of these activities prior to beginning the palifermin regimen. Other medical problems that the patient has may also be exacerbated by palifermin, and the conditions may affect the way palifermin works. The prescribing physician should be made aware of all conditions that a patient is currently suffering from as well as any history of these medical conditions. If a patient is currently suffering from a type of cancer or tumor other than the type specifically designated to be treated by palifermin then it may not have a benefit for patients with these conditions.

Warnings

Palifermin is a medication that requires very close supervision by the prescribing physician and the patient will need to have their progress checked at regular visits to the doctor's office. During these regular visits, the progress of the treatment will be evaluated and the doctor will conduct exams to ensure that the medication is working as intended before the regimen continues. It is important to regularly check the patient's general condition as palifermin may cause some tumors in the body to grow if they are not related to cancer palifermin is intended for. Any other tumor or cancer may disqualify a patient from being treated with palifermin for the side effects of chemotherapy. The prescribing physician should be informed immediately if there are any of the following symptoms after taking palfemin as they may indicate a potentially life-threatening allergy to the mediation:

  • Rash,
  • Itching,
  • Reddening of the skin,
  • Swelling of the tongue
  • Unusual taste in your mouth.

Storage

Palifermin will normally be maintained and stored by medical personnel in a hospital and will be required to be refrigerated under precise conditions when in the form of a solution. If a patient needs to store palifermin at home then someone in the home needs to be trained in its storage, maintenance, and use before sending it home with the patient. It should not be maintained in the home longer than needed and should be disposed of when it is expired in accordance with local guidelines regarding the disposal of medical waste.

Summary

Painful oral sores and ulcers are an unfortunate side effect of many forms of chemotherapy. It can be one of the most unbearable forms of myriad side effects that this aggressive form of therapy has on the physical well-being of the patient. Palifermin is an intravenous method of aiding patients in preventing and healing this painful affliction while undergoing treatment for bone and blood cancers. It functions by aiding in healing by helping the body to generate the naturally-occurring cells in the mouth and digestive tract at a rate that exceeds the rate at which they are damaged by the chemotherapy. While the medication does not treat cancer itself and can be very counter-productive when used by patients with other forms of cancer, it remains an effective way to reduce suffering in patients who have these side effects. If used properly and for the specific causes that it is approved for, palifermin may significantly improve the quality of life for patients who are fighting for their lives against a life-threatening form of cancer.