Skip to Main Content

INTRODUCTION

palifermin (pa-lif-er-min)

Kepivance

Classification

Therapeutic: cytoprotective agents

Pharmacologic: keratinocyte growth factors (rDNA)

Indications

To decrease incidence/duration of severe oral mucositis associated with myelotoxic therapy requiring stem cell support for hematologic malignancies.

Action

Enhances proliferation of epithelial cells. Therapeutic Effects: Decreased incidence/duration of mucositis.

Adverse Reactions/Side Effects

Derm: skin toxicity. GI: oral toxicity. Metab: ↑ amylase, ↑ lipase. MS: arthralgia. Neuro: dysesthesia.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

  • Monitor any skin reactions, including rash, itching, irritation, and exfoliation. Report any suspicious or toxic skin reactions to the physician or nursing staff.

  • Assess any joint pain to rule out musculoskeletal pathology; that is, try to determine if pain is drug induced rather than caused by anatomic or biomechanical problems.

  • Monitor and report any changes in taste or other unusual sensations such as burning, tingling, or painful responses to touch (dysesthesia).

Patient/Client-Related Instruction

  • Instruct patient to report any increase in oral lesions.

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Distributes into extravascular space.

Metabolism and Excretion: Unknown.

Half-life: 4.5 hr.

Favorite Table | Download (.pdf) | Print

TIME/ACTION PROFILE (levels)

ROUTE ONSET PEAK DURATION
IV unknown end of dose unknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to palifermin or other Escherichia coli–derived proteins.

Use Cautiously in: OB: Pregnancy (use only if maternal benefit outweighs fetal risk); Pedi: Children, lactation (safety not established).

Interactions

Drug-Drug: Binds to and inactivates heparin (flush tubing between use). Administration within 24 hr after myelotoxic therapy (chemotherapy/radiation) ↑ severity and duration of mucositis.

Route/Dosage

IV (Adults): 60 mcg/kg/day for 3 days before and 3 days after myelotoxic therapy.

Availability

Powder for injection: 6.25 mg/vial.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.