Porfimer

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics

Brand Names

Europe

Austria: Photobarr; Czech Republic: Photobarr; Estonia: Photobarr; France: Photobarr, Photofrin; Germany: Photobarr, Photofrin; Greece: Photobarr, Photofrin; Hungary: Photobarr, Photofrin; Italy: Photobarr; Latvia: Photobarr; Lithuania: Photobarr; Malta: Photobarr; Netherlands: Photobarr; Poland: Photobarr; Portugal: Photobarr, Photofrin; Romania: Photobarr; Slovakia: Photobarr; Slovenia: Photobarr; Sweden: Photobarr, Photofrin.

North America

Canada: Photofrin; USA: Photofrin.

Asia

Japan: Photofrin.

Drug combinations

Chemistry

Porfimer Sodium: C~34~H~38~N~4~NaO~5~ Mw: 605.6785. Polyporphrin oligomer containing ester and ether linkage. Photofrin II. CAS-87806-31-3 (1990).

Pharmacologic Category

Other Antineoplastic Agents; Sensitizers used in Photodynamic/Radiation Therapy. (ATC-Code: L01XD01).

Mechanism of action

Cytotoxic activity of porfimer dependent on light and oxygen. Following administration, drug is selectively retained in neoplastic tissues. Release of thromboxane A~2~, leading to vascular occlusion and ischemic necrosis, may also occur.

Therapeutic use

Palliation in obstructing (partial or complete) esophageal cancer. Treatment of microinvasive endobronchial non-small cell lung cancer. Reduction of obstruction and palliation in obstructing (partial or complete) non-small cell lung cancer. Ablation of high-grade dysplasia in Barrett’s esophagus.

Pregnancy and lactiation implications

Animal studies show maternal and fetal toxicity, but no major malformations. Not recommended during lactation.

Unlabeled use

Treatment of gastric cancer (obstruction). Treatment of actinic keratoses and low-risk basal and squamous cell skin cancers.

Contraindications

Porphyria. Photodynamic therapy contraindicated in tracheoesophageal or bronchoesophageal fistula. Tumors eroding into major blood vessel. Severe acute respiratory distress when caused by endobronchial lesion. Esophageal or gastric varices. Esophageal ulcers >1 cm in diameter.

Warnings and precautions

Hazardous agent. Inflammatory responses within treatment area may result in substernal chest pain. Ocular discomfort reported. Photosensitivity reactions common in patients exposed to direct sunlight or bright indoor light (e.g. fluorescent lights, unshaded light bulbs, examination/operating lights). Esophageal strictures are common adverse events associated with photodynamic therapy of Barrett’s esophagus. Fistula formation may occur after resolution of tumors with deep bronchial wall invasion. Generally not suited for treatment of esophageal or gastric varices (caution if used at all). Porfimer treatment for tumors which erode into trachea or bronchial tree likely to cause fistula (use not recommended). Use contraindicated in existing tracheoesophageal or bronchoesophageal fistula. Elimination may be prolonged in hepatic or renal impairment (toxicities may be increased). Photosensitivity may be increased beyond 90 days in mild-to-severe hepatic impairment or severe renal impairment. Concurrent use with other photosensitizing agents may increase risk for photosensitivity reactions. Avoid extravasation.

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