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Deepika vegiraju at 05:52, 21 August 2022

2022-08-21T05:52:43Z

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== '''What is Palifermin?''' ==

* Palifermin ('''Kepivance''') is '''a truncated recombinant [[keratinocyte growth factor]]''' (KGF) produced by [[recombinant DNA]] technology in [[E coli]] used to treat Oral [[mucositis]] that is severe.

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'''Limitations of Use:'''
* The safety and efficacy of Kepivance have not been established in patients with non-hematologic [[malignancies]].
* Kepivance was not effective in decreasing the incidence of severe [[mucositis]] in patients with [[Hematologic malignancy|hematologic malignancies]] receiving myelotoxic therapy in the setting of [[allogeneic]] [[hematopoietic stem cell]] support.
* Kepivance is not recommended for use with [[melphalan]] 200 mg/m 2 as a conditioning regimen.

== '''What are the uses of this medicine?''' ==

* Palifermin ('''Kepivance''') to decrease the incidence and duration of severe oral [[mucositis]] in patients with blood cancers ([[leukemia]] and [[lymphoma]]) receive high dose [[chemotherapy]] and [[radiation therapy]] to undergo [[bone marrow transplantation]].
* They usually get severe oral [[mucositis]].
* Palifermin reduces the incidence and duration of severe oral mucositis by protecting those cells and stimulating the growth of new [[epithelial cells]] to build up the mucosal barrier.

== '''How does this medicine work?''' ==

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* Keratinocyte growth factor (KGF) resides in the family of [[fibroblast growth factor]] (FGF).
* The drug’s '''target is the KGF receptor'''.
* Through the binding of this drug to the aforementioned receptor, '''Palifermin stimulates [[epithelial cell]] [[proliferation]], [[differentiation]], and upregulation of [[Cytoprotective Agent|cytoprotective]] mechanisms to reduce the symptoms of oral mucositis'''.

== '''Who Should Not Use this medicine ?''' ==

'''Limitations of Use:'''
* The safety and efficacy of Kepivance have not been established in patients with non-hematologic malignancies.
* Kepivance was not effective in decreasing the incidence of severe [[mucositis]] in patients with hematologic malignancies receiving myelotoxic therapy in the setting of [[allogeneic]] [[hematopoietic stem cell]] support.
* Kepivance is not recommended for use with [[melphalan]] 200 mg/m 2 as a conditioning regimen.

== '''What drug interactions can this medicine cause?''' ==

* Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take.
Be sure to mention any of the following:
* [[dalteparin]] (Fragmin)
* [[enoxaparin]] (Lovenox)
* [[heparin]]
* [[tinzaparin]] (Innohep)

* Drug interactions with Heparin include a significantly increased systemic exposure to [[Palifermin]].
* Avoid administration of Palifermin within 24 hours of myeltoxic [[chemotherapy]], as this could result in increased oral [[mucositis]].

== '''Is this medicine FDA approved?''' ==

* '''Initial U.S. Approval:''' 2004

== '''How should this medicine be used?''' ==

'''Recommended dosage:'''
* The recommended dose of Kepivance is 60 mcg/kg/day, administered as an intravenous [[bolus]] injection for 3 consecutive days before and 3 consecutive days after myelotoxic therapy, for a total of 6 doses.
* The recommended dose of Kepivance is 60 mcg/kg/day, administered as an intravenous bolus injection for 3 consecutive days before and 3 consecutive days after myelotoxic therapy, for a total of 6 doses.
* Administer the first 3 doses prior to myelotoxic therapy. Administer the third dose 24 to 48 hours prior to beginning myelotoxic therapy.
* Administer the last 3 doses after myelotoxic therapy is complete with the first of these doses on the day of [[hematopoietic]] stem cell infusion after the infusion is completed, and at least 7 days after the most recent administration of Kepivance.

'''Administration:'''
* Palifermin comes as a powder to be mixed with liquid to be injected [[intravenously]] (into a vein).
* It is usually given once a day for 3 days in a row before you receive your chemotherapy treatment and then once a day for 3 days in a row after you receive your [[chemotherapy]] for a total of 6 doses.
* You will not be given palifermin on the same day that you are given your cancer chemotherapy treatment.
* Palifermin must be given at least 24 hours before and at least 24 hours after you receive your chemotherapy treatment.

== '''What are the dosage forms and brand names of this medicine?''' ==

This medicine is available in fallowing doasage form:
* '''As injection:''' 6.25 mg [[lyophilized]] powder in single-dose vials

This medicine is available in fallowing brand namesː
* '''Kepivance'''

=='''What side effects can this medication cause?'''==

The most common side effects of this medicine include:
* rash
* fever
* elevated serum [[amylase]]
* [[pruritus]]
* [[erythema]]
* [[edema]]

Kepivance may cause some of the serious side effects:
* Difficulty breathing
* Changes in cutaneous or [[mucous membrane]] appearance/feel (redness/rash, swelling, itching, change in color or thickness of tongue, changes in taste)
* Fever

==''' What special precautions should I follow?''' ==

That the safety and efficacy of Kepivance have not been established in patients with non-hematologic malignancies.
Advise patients to report the following to healthcare providers:
* Rashes and reddening of skin
* Itchiness
* Swelling of tongue
* Changes in mouth and tongue sensation
* Alteration in taste

== '''What to do in case of emergency/overdose?''' ==

Symptoms of overdosage may include:
* thick tongue
* change in color of tongue
* change in ability to taste food
* increased or decreased feelings when touched, especially in and around the mouth
* burning or [[tingling]], especially in and around the mouth
* [[joint pain]]
* rash
* red or itching skin
* swelling of the hands, feet, ankles, or lower legs
* fever

'''Management of overdosage:'''
* {{overdose}}

== '''Can this medicine be used in pregnancy?''' ==

* Based on findings in animal studies, Kepivance may cause fetal harm when administered to pregnant women.
* There are no data available on Kepivance use in pregnant women to inform a drug-associated risk of major birth defects and miscarriage or adverse maternal or fetal outcomes.

=='''Can this medicine be used in children?'''==

* Information on the dosing and safety of Kepivance in the pediatric population is limited.
* However, use of Kepivance in pediatric patients ages 1 to 16 years is supported by evidence from adequate and well-controlled studies of Kepivance in adults and a phase 1 study that included 27 pediatric patients with acute leukemia undergoing [[hematopoietic stem cell]] transplant.

== '''What are the active and inactive ingredients in this medicine?''' ==

'''Active ingredient:'''
* PALIFERMIN

'''Inactive ingredients:'''
* MANNITOL
* SUCROSE
* HISTIDINE
* POLYSORBATE 20

== '''Who manufactures and distributes this medicine?''' ==

'''Manufactured by:'''
* [[Swedish Orphan Biovitrum Ab|Swedish Orphan Biovitrum AB]] (publ)
* SE-112 76 Stockholm, Sweden

== '''What should I know about storage and disposal of this medication?''' ==

* Store Kepivance vials in the dispensing pack in its carton refrigerated at 2° to 8°C (36° to 46°F) until time of use.
* Protect from light.

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{{Detoxifying agents for antineoplastic treatment}}
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{{cancer}} {{health}} {{links}} [[Category:Cancer]]
[[Category:Growth factors]]

Palifermin - Revision history

Prab: CSV import

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Deepika vegiraju at 05:52, 21 August 2022