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Porfimer (Intravenous route)

Pronunciation:

POR-fi-mer SOE-dee-um

Brand Names:

  • Photofrin

Dosage Forms:

  • Powder for Solution

Classifications:

Therapeutic—

Antineoplastic Agent

Uses of This Medicine:

Porfimer belongs to the group of medicines known as antineoplastics. It is used, together with a special laser light, to treat cancer of the esophagus (the part of the digestive tract that carries food to the stomach) and to treat a form of lung cancer. This medicine may also treat changes in the esophagus that might lead to cancer, such as a condition called Barrett's esophagus.

This medicine is to be given only by or under the direct supervision of a doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, porfimer is used in certain patients with the following medical conditions:

  • Cancer of the biliary tract (cholangiocarcinoma), unresectable, after double stenting.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of porfimer injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of porfimer injection in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Cancer, other types of or
  • Heart or blood vessel disease or
  • Prolonged immobilization (cannot move for a long time) or
  • Surgery, recent—May increase risk for more serious side effects.
  • Esophageal ulcers or
  • Porphyria (a problem with enzymes in your body) or
  • Tracheoesophageal or bronchoesophageal fistula (opening between the esophagus and breathing airways) or
  • Tumors or lesions that obstruct blood vessels or breathing airways or
  • Varices (swollen veins) in the esophagus or stomach—Should not be used in patients with these conditions.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of this medicine from the body.
  • Radiation therapy—You will need to wait 2 to 4 weeks between phototherapy and radiation therapy.
  • Sensitivity of the skin or eyes to sunlight or bright lights—Use with caution. May make this condition worse.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Treatment with porfimer and laser light occurs in three steps. First, the porfimer is injected into your body. Second, about 2 days later, a laser light is directed at the cancer. Then, about 2 or 3 days after the light is applied, your doctor will remove the cancer cells that have been destroyed.

Precautions While Using This Medicine:

It is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by this medicine.

For at least 30 days after you receive an injection of porfimer, your eyes will be extra sensitive to light, including sunlight, bright indoor lights, and vehicle headlights. Certain types of sunglasses can help protect your eyes during this time. Check with your doctor about which sunglasses to use.

For at least 30 days after you receive an injection of porfimer, your skin will be extra sensitive to sunlight and to very bright indoor lights, such as lamps with unshaded light bulbs and lights in dental offices or operating rooms. Do not expose your skin to direct sunlight or to bright indoor lights during this time. Sunscreens will not protect your skin from a severe reaction to light (blistering, burning, and swelling of the skin). However, exposure to normal amounts of indoor light (eg, daylight or light from lamps with shades) will help use up the porfimer remaining in your skin. Therefore, do not protect your skin from normal amounts of indoor light. If you have any questions about whether the light in your home is too bright, check with your doctor or nurse. Also, ask your doctor or nurse ahead of time about what you should do if a severe reaction to light occurs.

Thirty days after receiving an injection of porfimer, test a small portion of your skin by exposing it to sunlight for 10 minutes. (Do not test skin on your face.) If the exposed part of your skin does not become blistered, red, or swollen during the next 24 hours, you can slowly increase your exposure to sunlight and bright indoor lights. If a reaction does occur, wait another 2 weeks, then test your sensitivity to sunlight again.

Even after your skin and eyes are no longer sensitive to the lights in your home or the amount of sunlight in the area where you live, you may still be sensitive to brighter levels of light. If you travel to an area where the sunlight is stronger than at home, test yourself again before exposing your skin to the stronger light.

You might have pain around your chest after your treatment. If you have pain, talk with your doctor about the best way to treat it.

If you are using this medicine to treat Barrett's esophagus, your chance of having narrowing of the esophagus may be increased. Check with your doctor right away if you start to have trouble with swallowing after you have received this medicine.

Blood clotting problems may occur in patients after receiving this medicine. Check with your doctor if you have pain in the chest, groin, or legs, especially the calves; difficulty with breathing; severe, sudden headache; slurred speech; sudden, unexplained shortness of breath; sudden loss of coordination; sudden, severe weakness or numbness in the arm or leg; or vision changes.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Bladder pain
bloody or cloudy urine
blurred vision
body aches or pain
chest pain or discomfort
confusion
congestion
cough
coughing or spitting up blood
difficult or troubled breathing
difficult, burning, or painful urination
difficulty with swallowing
dilated neck veins
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
dryness or soreness of the throat
extreme fatigue
fast, pounding, or irregular heartbeat or pulse
fever or chills
frequent urge to urinate
headache
hoarseness
increased sensitivity of the skin to sunlight
irregular, fast or slow, or shallow breathing
itching
lower back or side pain
nervousness
pale or blue lips, fingernails, or skin
pale skin
pounding in the ears
redness or other discoloration of the skin
runny nose
severe pain in the chest
severe sunburn
skin rash
slow or fast heartbeat
sneezing
sore throat
sudden onset of severe breathing difficulty
sweating
swelling of the face, fingers, feet, or lower legs
tender, swollen glands in the neck
tightness in the chest
unusual bleeding or bruising
unusual tiredness or weakness
voice changes
vomiting of blood or material that looks like coffee grounds
weight gain
white patches in the mouth or throat or on the tongue
white patches with diaper rash
Less common
Bloody, black, or tarry stools
decrease in the amount of urine
decreased urination
dry mouth
fainting
heartburn
increase in heart rate
noisy, rattling breathing
pain or burning in the throat
rapid breathing
shortness of breath
sores, ulcers, or white spots on the lips or tongue or inside the mouth
sunken eyes
thirst
troubled breathing at rest
vomiting
wrinkled skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Acid or sour stomach
back pain
belching
constipation
diarrhea
fear or nervousness
indigestion
lack or loss of strength
loss of appetite
nausea
pain
sleeplessness
stomach discomfort, upset, or pain
trouble sleeping
unable to sleep
weight loss
Less common
Bloated or full feeling
change in the color of treated skin
excess air or gas in the stomach
increased hair growth
small lumps under the skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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