Porfimer (Intravenous)

This drug can treat Barrett’s esophagus as well and it’s only given by a qualified healthcare professional under his or her direct supervision.

Overview

Porfimer is a medication available by prescription and is used in conjunction with light therapy in the treatment or relief of some cancers or precancerous medical conditions, including:

  • The symptoms of cancer of the esophagus (esophageal cancer) that is totally or almost totally blocking the esophagus
  • To treat a certain kind of lung cancer known as non-small cell cancer when your doctor and you decide that surgery and radiation shouldn't be used
  • Relieves symptoms of lung cancer (non-small cell variety) in patients whose airways are blocked

Porfimer is injected by a healthcare professional into a vein. You'll return to your doctor typically one to three days later to receive light therapy. This allows the medication to be taken into the cancerous cells.

Porfimer is in a category of medications known as antineoplastic agents. Common Porfimer side effects include mild constipation and photosensitivity.

Porfimer may be taken for other reasons. For more information, please ask your pharmacist or doctor.

Conditions Treated

  • Lung cancer

Type Of Medicine

  • Antineoplastic agent

Side Effects

Apart from its necessary effects, Porfimer may bring on some undesirable effects. While you may not experience all of these side effects, those that happen may require medical intervention.

Please see your nurse or doctor promptly should any of the side effects below occur:

More common:

  • Extreme fatigue
  • Bladder pain
  • Cough
  • Congestion
  • Confusion
  • Cloudy/bloody urine
  • Blurred vision
  • Hoarseness
  • Headache
  • Frequent desire to urinate
  • Itching
  • Fever or chills
  • Pale skin
  • Nervousness
  • Pounding in ears
  • Blue or pale lips, skin, or fingernails
  • Side or lower back pain
  • Sneezing
  • Sore throat
  • Fast, slow, shallow, or irregular breathing
  • Increased sensitivity of skin to the sun
  • Body pain or aches
  • Chest discomfort or pain
  • Troubled/difficult breathing
  • Spitting or coughing up blood
  • Soreness or dryness of the throat
  • Dilated neck veins
  • Difficulty with swallowing
  • Painful, difficult, or burning urination
  • Pounding, irregular, or fast heartbeat or pulse
  • Faintness, lightheadedness, or dizziness when suddenly standing up from a bed or chair
  • Weight gain
  • Skin rash
  • Fast or slow heartbeat
  • Runny nose
  • Severe pain in chest
  • Redness/other discoloration of skin
  • Severe sunburn
  • Sweating
  • Voice changes
  • Sudden occurrence of very serious breathing difficulty
  • Unusual tiredness/weakness
  • Unusual bleeding/bruising
  • Swelling of face, feet, lower legs, or fingers
  • Swollen, tender glands in neck
  • Tightness in chest
  • Vomiting of substance that resembles coffee grounds or blood
  • White patches along with diaper rash
  • White patches in throat, mouth, or tongue

Less common:

  • Increased heart rate
  • Wrinkled skin
  • Vomiting
  • Troubled breathing while resting
  • Shortness of breath
  • Rattling, noisy breathing
  • Decreased urination
  • Decrease in urine amount
  • Heartburn
  • Fainting
  • Dry mouth
  • Tarry, black, or bloody stools
  • Burning or pain in the throat
  • Rapid breathing
  • Thirst
  • Sunken eyes
  • White spots, ulcers, or sores on the tongue or lips or inside your mouth

Some Porfimer side effects can happen that normally don't need treatment. These side effects can disappear during treatment while you adjust to Porfimer. Consult your healthcare specialist if you've got any questions about these side effects, if they persist, or if they are bothersome.

More common:

  • Nausea
  • Constipation
  • Belching
  • Back pain
  • Sour/acid stomach
  • Diarrhea
  • Indigestion
  • Fear or nervousness
  • Loss or lack of strength
  • Pain
  • Weight loss
  • Sleeplessness
  • Trouble sleeping
  • Stomach upset, discomfort, or pain
  • Inability to sleep

Less common:

  • Full or bloated feeling
  • Increased growth of hair
  • Small lumps under skin
  • Excess gas or air in the stomach
  • Change in color of skin

Other Porfimer side effects not mentioned above may occur in some people as well. If you notice such effects, see your healthcare professional right away.

Dosage

Porfimer is injected through an IV into a vein. You'll receive the injection in a hospital or clinic environment.

Tell your healthcare providers if you experience any pain, swelling, or burning around the needle of the IV when you're injected with Porfimer.

You'll receive laser light therapy within 40 to 50 hours after your infusion with Porfimer. You may receive another laser light therapy within 4-5 days after your infusion.

Porfimer will increase the sensitivity of your eyes and skin to sunlight. For 30 days or so after your Porfimer treatment, you must shield your skin and eyes from natural sunlight as well as bright indoor lights (like lights in a physician's office, bright halogen lights, operating room lamps, unshaded light bulbs, or tanning beds).

To avoid being exposed to sunlight, cover all areas of your skin with clothes and put on dark sunglasses whenever you're outdoors. Sunscreen won't guard against serious sunburn in the month after you receive Porfimer treatment.

Your increased sensitivity to light can last for about 90 days or more. To find out when this problem has subsided, you can test your skin and see if it's sensitive to light still. To do this, expose a small part of your skin to bright indoor light or direct sunlight for around 10 minutes.

Don't use the skin around your eyes or on your face to determine light sensitivity. If the bare skin develops redness, blistering, or swelling within 24 hours, please wait another 14 days before you test again.

If travel or relocation will make you more exposed to sunlight within 90 days of receiving Porfimer, re-test your skin.

Being exposed to indirect sunlight (e.g. sun shining via window) isn't as hazardous and will in fact help your body get rid of Porfimer from the tissues. Please follow your doctor's orders about the right level of light exposure.

If you require surgery or you'll be on bed rest, you might need to stop taking Porfimer for a short while. Your surgeon or doctor should know you're receiving treatment with Porfimer.

While using this medication, you may require medical tests frequently or a biopsy every three months. Follow your physician's orders.

Since Porfimer is given in a medical environment by a healthcare professional, it's unlikely that you'll have an overdose.

Call up your physician if you miss a single appointment to receive laser light treatment. The time between your injection with Porfimer and your laser light treatment is vital for your treatment to be successful.

Interactions

Porfimer can interact with any of the drugs below:

  • Amiodarone
  • Adapalene
  • Acitretin
  • Celecoxib
  • Amphoteracin B
  • Fluphenazine
  • Dimethyl sulfoxide (DMSO)
  • Griseofulvin
  • Isotretinoin
  • Mannitol
  • Hydrochlorothiazide
  • Fluoroquinolone antibiotics (such as ofloxacin, ciprofloxacin, levofloxacin)
  • NSAIDs (e.g. ibuprofen, naproxen, diclofenac)
  • Nalidixic acid
  • Other cancer medications
  • Corticosteroids (such as prednisone, dexamethasone, methylprednisolone)
  • Prochlorperazine
  • Phenothiazines (e.g. chlorpromazine)
  • Thiazide diuretics (such as indapamide, hydrochlorothiazide)
  • Tetracyclines (e.g. tetracycline, minocycline, doxycycline)
  • Sulfonamide antibiotics (such as sulfisoxazole, sulfamethoxazole)
  • Sulfonylurea diabetes medicines (such as chlorpropamide, glyburide)
  • Vemurafenib
  • Tretinoin

If you're using any of the medications above, talk to your pharmacist or doctor. An interaction between two drugs doesn't always mean you must discontinue one of them. Consult your healthcare professional about how drug interactions should be controlled or how they're being controlled.

Other medications not listed above can interact with Porfimer. Let your healthcare provider know about all medications you're taking, including prescription, non-prescription, herbal, and vitamin supplements.

Warnings

Don't use Porfimer if you:

  • Have allergies to Porfimer or some of its ingredients
  • Have allergies to porphyrins
  • Have a tumor that's putting pressure on an important blood vessel
  • Have an esophageal ulcer that's more than a centimeter in diameter
  • Have a fistula between the trachea and esophagus.
  • Have porphyria, a rare condition in which your body doesn't produce sufficient enzymes to decompose chemicals known as porphyrins. When there are too many porphyrins in the body, this can cause nervous system problems. Accumulation of porphyrins can also cause skin disorders, including swelling, itching, and blisters when the skin gets exposed to light. Let your physician know if you've ever been diagnosed with porphyria.

The following factors can affect how you use Porfimer.

Infection - apart from destroying cancer cells, Porfimer can reduce your white blood cells (the cells that fight off infections in the body). If possible, don't come into contact with people carrying contagious infections. Let your physician know immediately if you start to have signs of infection, including fever or chills, shortness of breath, severe diarrhea, headache, prolonged dizziness, weight loss, listlessness, or stiff neck. Your physician will regularly perform blood tests to track the amount of certain kinds of blood cells in the body.

Chest pain - some individuals may suffer chest pain while being given Porfimer due to how the medicine works. If this happens, notify your doctor.

Breathing “ Porfimer may lead to shortness of breath as well as troubled breathing in the interval between receiving the injection and laser therapy. Get in touch with your doctor promptly if these symptoms occur.

Pregnancy - Porfimer shouldn't be taken during pregnancy unless its benefits outweigh the risks. If you may get pregnant while using Porfimer, make sure to use effective contraception. If you get pregnant while using Porfimer, contact your physician immediately.

Breastfeeding - it's unknown whether Porfimer gets into human milk. If you're taking Porfimer and are breastfeeding, it may harm your little one. Talk to your physician about whether it's wise to continue breastfeeding.

Children - the efficacy and safety of using Porfimer haven't been determined in children.

Sun sensitivity - you should avoid exposing your skin and eyes to bright indoor light or direct sunlight for at least a month and up to 3 months after using Porfimer.

When you go outside within this timeframe, make sure to wear dark sunglasses and protective clothing. Consult your physician about the right sunglasses to wear to shield your eyes. Using sunscreens regularly won't protect your eyes and skin from a reaction. Speak to your physician about how to know when it's okay to resume your usual routine with regard to bright light and sun exposure.

Don't stay in a dark room within this time frame, because normal indoor light breaks down the medicine safely.

Some severe side effects can occur with Porfimer use, including:

Liver/kidney impairment - you could be at a greater risk of developing certain side effects if you've got kidney or liver disease.

Blood clots - blood clots occur when blood thickens within a blood vessel, normally in the legs. You could have a serious problem if the blood clot takes off and moves to your lungs.

Bleeding - patients who have esophageal varices (expanded blood cells surrounding the esophagus that may rip open and bleed without medical care) may have a higher risk of bleeding. This can rarely cause coughing up of blood, which may be fatal sometimes. For this reason, your healthcare professional shouldn't administer light directly to an area with esophageal varices.

Gastrointestinal perforation - this can happen when the stomach or intestine lining becomes really irritated that a hole develops in the lining. Therefore, this may cause serious issues and be life-threatening.

Airway obstruction - tumor inflammation may occur after treatment, causing problems with breathing. This can be particularly serious for people suffering from lung cancer and who already have issues with breathing.

Ocular sensitivity - a patient's eyes can become more susceptible to light. Make sure to put on dark sunglasses for a month when you're outdoors after therapy, or until the sensitivity subsides.

Tracheoesophageal or bronchoesophageal fistula - a fistula refers to an opening that projects through two different body tissues that lie near one another. An opening may develop between the swallowing tube (esophagus) and windpipe (trachea) depending on the location of the tumor and where the light therapy is used. An opening may also develop between the bronchi (airways) and the esophagus.

Storage

Porfimer will be kept at the clinic or hospital where you get treatment. Therefore, you don't need to keep it at home.

Summary

You shouldn't receive Porfimer if you're allergic to it or any of its ingredients, or if you've got porphyria (a hereditary enzyme problem that leads to symptoms affecting the nervous system or skin).

Before you're given Porfimer, let your healthcare professional know if you've got kidney or liver disease.

Porfimer may make your eyes and skin more sensitive to bright light, sunlight, or vehicle headlights. Avoid exposing your skin and eyes to bright lights indoors and natural sunlight for 1 to 3 months after you receive Porfimer treatment.

This medicine may make your eyes more susceptible to oncoming car headlights when you are driving. Please don't drive at night until you are sure that this effect has worn off.

Your physician may have recommended Porfimer for other disorders not listed in this medication guide. If you've not talked about this with your physician or are unsure why you're receiving Porfimer, be sure to talk to your physician.