porfimer (Rx)

Brand and Other Names:Photofrin
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 75mg/vial

Esophageal Cancer, Endobronchial NSCLC

2 mg/kg IV over 3-5 minutes  

Follow by corresponding spectrum of laser light 40-50 hours after injection, then again 96-120 hours after injection; separate repeat courses by 30 days; not to exceed 3 courses

Ablation of High-grade Dysplasia in Barrett's Esophagus

2 mg/kg IV over 3-5 minutes  

Follow by corresponding spectrum of laser light 40-50 hours after injection, then again 96-120 hours after injection Barrett's esophagus patients who do not undergo esophagectomy; separate repeat courses by 30 days; not to exceed 3 courses

Bladder Carcinoma (Orphan)

Photodynamic therapy of transitional cell carcinoma in situ of the urinary bladder

Orphan sponsor

  • QLT Phototherapeutics, Inc, Lederle Laboratories; 401 North Middletown Road; Pearl River, NY 10965

Cholangiocarcinoma (Orphan)

Orphan sponsor

  • Pinnacle Biologics, Inc; 2801 lakeside Drive, Suite 209; Bannockburn, IL 60015

Mesothelioma (Orphan)

Orphan designation for malignant pleural mesothelioma

Orphan sponsor

  • Pinnacle Biologics, Inc; 2801 lakeside Drive, Suite 209; Bannockburn, IL 60015

Safety and efficacy not established

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Interactions

Interaction Checker

and porfimer

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (4)

              • aminolevulinic acid oral

                aminolevulinic acid oral, porfimer. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

              • aminolevulinic acid topical

                porfimer, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • methyl aminolevulinate

                porfimer, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • palifermin

                palifermin increases toxicity of porfimer by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hr before, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.

              Monitor Closely (41)

              • abciximab

                abciximab decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • anagrelide

                anagrelide decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • antithrombin III

                antithrombin III decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • argatroban

                argatroban decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • bivalirudin

                bivalirudin decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • chlorothiazide

                chlorothiazide, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • chlorpromazine

                chlorpromazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • chlorthalidone

                chlorthalidone, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • cholera vaccine

                porfimer decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.

              • cilostazol

                cilostazol decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • clopidogrel

                clopidogrel decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • dabigatran

                dabigatran decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • dalteparin

                dalteparin decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • demeclocycline

                demeclocycline, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • dipyridamole

                dipyridamole decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • doxycycline

                doxycycline, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • enoxaparin

                enoxaparin decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • eptifibatide

                eptifibatide decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • fluphenazine

                fluphenazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • fondaparinux

                fondaparinux decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • griseofulvin

                griseofulvin, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • heparin

                heparin decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • hydrochlorothiazide

                hydrochlorothiazide, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • indapamide

                indapamide, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • metolazone

                metolazone, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • minocycline

                minocycline, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • perphenazine

                perphenazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • prasugrel

                prasugrel decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • prochlorperazine

                prochlorperazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • promazine

                promazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • promethazine

                promethazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • siponimod

                siponimod and porfimer both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

              • sulfadiazine

                sulfadiazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • sulfamethoxazole

                sulfamethoxazole, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • tetracycline

                tetracycline, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • thioridazine

                thioridazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • ticlopidine

                ticlopidine decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • tirofiban

                tirofiban decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              • tretinoin topical

                tretinoin topical will increase the level or effect of porfimer by pharmacodynamic synergism. Use Caution/Monitor. May enhance the photosensitizing effects of porfimer

              • trifluoperazine

                trifluoperazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

              • warfarin

                warfarin decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.

              Minor (17)

              • amlodipine

                amlodipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • clevidipine

                clevidipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • cortisone

                cortisone decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • dexamethasone

                dexamethasone decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • ethanol

                ethanol decreases levels of porfimer by increasing metabolism. Minor/Significance Unknown.

              • felodipine

                felodipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • hydrocortisone

                hydrocortisone decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • isradipine

                isradipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • methyclothiazide

                methyclothiazide, porfimer. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Enhanced photosensitivity.

              • methylprednisolone

                methylprednisolone decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • nicardipine

                nicardipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • nifedipine

                nifedipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • nisoldipine

                nisoldipine decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • prednisolone

                prednisolone decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • prednisone

                prednisone decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • triamcinolone acetonide injectable suspension

                triamcinolone acetonide injectable suspension decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

              • verapamil

                verapamil decreases levels of porfimer by unspecified interaction mechanism. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Anemia (32%)

              Fever (31%)

              Pleural effusion (28%)

              Constipation (24%)

              Chest pain (22%)

              Abd pain (20%)

              Dyspnea (18%)

              Pneumonia (16%)

              Insomnia (14%)

              Back pain (11%)

              1-10%

              Atrial-fib (10%)

              Dysphagia (10%)

              Pharyngitis (10%)

              Resp distress (9%)

              Decr wt (9%)

              Hematemesis (8%)

              Dehydration (7%)

              Hypotension (7%)

              Peripheral edema (7%)

              Cardiac failure (7%)

              Tachycardia (6%)

              Asthenia (6%)

              Hypertension (6%)

              Cough (6%)

              Diarrhea (5%)

              Generalized edema (5%)

              Postmarketing Reports

              Infusion reactions including urticaria, bradycardia, hypotension, dizziness, and hypertension

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              Warnings

              Contraindications

              Hypersensitivity to porphyrins

              Porphyria

              Emergency treatment of severe acute respiratory distress when caused by endobronchial lesion

              Esophageal or gastric varices

              Esophageal ulcers

              Tracheoesophageal or bronchoesophageal fistula; tumor erosion into major blood vessel

              Cautions

              Separate from radiotherapy by 2-4 wk

              Avoid sunlight following injection

              Esophageal stricture reported within 6 months of initiating treatment (usually within 6 months of treatment)

              Inflammation resulting from treatment may obstruct airway (not for use in patients with esophageal tumors eroding into the trachea or bronchial tree

              Potentially fatal gastrointestinal and esophageal necrosis and perforation may occur following treatment

              May experience substernal chest pain from inflammatory responses within the treatment area

              Ocular discomfort reported

              Photosensitivity reactions reported in patients exposed to direct sunlight or bright indoor light

              Thromboembolism reported, particularly in patients with other risk factors (eg, advanced cancer, postsurgery, prolonged immobilization, CV disease)

              Hepatic or renal impairment will likely prolong the elimination of porfimer sodium leading to higher rates of toxicity; inform patients with severe renal impairment or mild to severe hepatic impairment that the period requiring precautionary measures for photosensitivity may be longer than 90 days

              Risk of hemorrhage increased in patients esophageal varices or tumors eroding into pulmonary blood vessels; patients with large, centrally located tumors, cavitating tumors, or extensive tumors extrinsic to bronchus are at high risk for fatal massive hemoptysis; assess patients for tumors eroding into a pulmonary blood vessel and esophageal varices; do not administer light directly to an area with esophageal varices because of high risk of hemorrhage

              Long-term effect of PDT on high grade dysplasia (HGD) in Barrett’s Esophagus (BE) is unknown; there is always a risk of cancer or abnormal epithelium that is invisible to endoscopist beneath the new squamous cell epithelium; these facts emphasize the risk of overlooking cancer in such patients and the need for rigorous continuing surveillance despite endoscopic appearance of complete squamous cell reepithelialization

              Conduct endoscopic biopsy surveillance every 3 months, until 4 consecutive negative evaluations for HGD have been recorded; further follow-up may be scheduled every 6 to 12 months, as per judgment of healthcare providers; the follow-up period of randomized study at time of analysis was a minimum of 2 years (range 2 to 5.6 years)

              If PDT is to be used before or after radiotherapy, allot sufficient time between the two therapies to ensure that the inflammatory response produced by the first treatment has subsided before commencing the second treatment

              The inflammatory response from PDT will depend on tumor size and extent of surrounding normal tissue that receives light; allow 2-4 weeks after PDT before commencing radiotherapy; the acute inflammatory reaction from radiotherapy usually subsides within 4 weeks after completing radiotherapy; allow 4 weeks after completing radiotherapy before commencing PDT

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              Pregnancy & Lactation

              Pregnancy

              Based on animal studies, drug may cause embryo-fetal toxicity when administered to a pregnant woman; there are no available data on use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes

              Verify pregnancy status in females of reproductive potential prior to initiation of therapy

              Contraception

              • Drug may cause fetal harm when administered to a pregnant woman
              • Females: Advise females of reproductive potential to use effective contraception during treatment and for 5 months after final dose
              • Males: Advise male patients with female partners of reproductive potential to use condoms during treatment and for 5 months following final dose

              Animal data

              • Intravenous administration of drug to pregnant rats and rabbits during period of organogenesis at dose levels approximately 0.64 times recommended human dose based on body surface area (BSA) resulted in increased fetal resorptions, decreased litter size, and reduced fetal weight, but did not cause fetal malformations

              Lactation

              There are no data on presence of drug in human or animal milk, effects on breastfed infant, or on milk production; because of potential for serious adverse reactions in breastfed infant, advise patients that breastfeeding is not recommended during treatment and for 5 months after last dose

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Cytotoxic activity dependent on light and oxygen; activated by laser light to produce oxygen free radicals and vascular necrosis via thromboxane A2 release

              Pharmacokinetics

              Half-Life: 17 days (first dose); 30 days (second dose); retained longest in tumors, skin, and reticuloendothelial organs

              Peak Plasma Concentration: 15 mcg/mL

              Protein Bound: 90%

              Vd: 0.49 L/kg

              Clearance: 0.051 mL/min/kg

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              Administration

              IV Incompatibilities

              Do not mix with other drugs in the same solution

              IV Preparation

              Reconstitute with 31.8 mL of either D5W or NS resulting in a final concentration of 2.5 mcg/mL & pH of 7-8

              Shake well until dissolved

              Protect the reconstituted product from bright light & use immediately

              Reconstituted porfimer is an opaque solution in which detection of particulate matter by visual inspection is extremely difficult

              IV Administration

              Administer slow IVP over 3-5 min

              Use of gloves & eye protection is recommended

              Storage

              Store intact vials at controlled room temp 20-25°C (68-77°F)

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              Images

              No images available for this drug.
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              Patient Handout

              Patient Education
              porfimer intravenous

              NO MONOGRAPH AVAILABLE AT THIS TIME

              USES: Consult your pharmacist.

              HOW TO USE: Consult your pharmacist.

              SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Consult your pharmacist.

              DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: No monograph available at this time.

              MISSED DOSE: Consult your pharmacist.

              STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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              • View the formulary and any restrictions for each plan.
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              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.