Porfimer Sodium

Porfimer sodium is a prescription medication used in combination with light therapy to treat or relieve the symptoms of certain types of cancers or pre-cancerous conditions. 

Porfimer sodium belongs to a class of medications called photosensitizing agents. These help to increase the senstivity of tumors to certain types of light, leading to the death of cancer cells.  Porfimer sodium is used specifically in combination with laser light therapy in the treatment of certain types of cancer.

This medication comes in injectable form and is injected into a vein usually during a doctor's office visit by a healthcare professional. You will visit the doctor's office again typically 1-3 days after your injection to reveive light therapy. This gives time for the medication to be absorbed into the tumor cells.

Common side effects include photosensitivity and mild constipation.

Porfimer sodium is a prescription medication used to treat or relieve the symptoms of certain types of cancers or pre-cancerous conditions, including the following:

• Treats the symptoms of esophageal cancer (cancer of the esophagus) that is completely, or almost completely, blocking the esophagus
• Treats a certain type of lung cancer called non-small cell lung cancer when you and your doctor decide that radiation and surgery should not be used
• Relieves the symptoms of non-small cell lung cancer in patients whom the airways are blocked
• High-grade dysplasia in Barrett's Esophagus. This refers to a pre-cancerous condition of the esophagus.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Porfimer Sodium may be found in some form under the following brand names:

• Photofrin

Serious side effects have been reported with porfimer sodium. See the "Porfimer sodium Precautions" section.

The side effects you experience may differ depending on which section of your body the laser light is directed at.

Common side effects of porfimer sodium (used together with laser light therapy) include the following:

• photosensitivity. Photosensitivity means your skin may be more sensitive to sunlight or bright indoor lights. Photosensitivity will most likely start occuring when the skin is exposed to laser light treatment. It can continue for several weeks after your treatment session. You should limit your time outdoors for at least 30 days after light treatment. When you are outside, wear suncreen and protective clothing such as long sleeves and a wide-brimmed hat. Symptoms of photosensitivity may include:
  • redness
  • swelling
  • blistering
• anemia. Anemia is a condition in which your body does not make enough healthy red blood cells to carry oxygen throughout your body. Symptoms of anemia may include the following:
  • tiredness
  • lack of energy or feeling sluggish   
  • headaches
  • difficulty breathing 
• constipation
• nausea
• vomiting
• pleural effusion. Pleural effusion refers to a buildup of fluid within the lungs, making it difficult to breathe.
• difficulty breathing
• difficulty swallowing
• chest pain
• fever
• coughing up blood
• narrowing of the esophagus (may lead to difficulty swallowing)
• abdominal pain
• narrowing of the airways (may lead to difficulty breathing)

This is not a complete list of porfimer sodium side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

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

Tell your doctor about all the medicines you take, including presciption and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take medications that can increase your sensitivity to light, including certain antibiotics such as ciprofloxacin (Cipro).

This is not a complete list of porfimer sodium drug interactions. For more information, ask your doctor or pharmacist.

Serious side effects have been reported with porfimer sodium including the following:

• bronchoesophageal or tracheoesophageal fistula. A fistula is an opening that protrudes through two different tissues in the body that lie near each other. An opening can form between the esophagus (the swallowing tube) and trachea (windpipe) depending on where the tumor is located and where the light is applied. An opening can also form between the esophagus and the bronchi (airways).
• bleeding. Patients with esophageal varices (enlarged blood vessels around the esophagus that can rupture and bleed without treatment) may have an increased risk of bleeding. Rarely, this can lead to coughing up blood which can be fatal in some cases. For this reason, light should not be directly administered to an area known to have esophageal varices.
• gastrointestinal perforation. Gastrointestinal perforation can occur when the lining of the stomach or intestines become so irritated that a hole forms in the lining. This can lead to serious problems and be life-threatneing.
• airway obstruction. Inflammation of the tumor can happen after treatment, making it difficult to breathe. This can be especially serious for patients with lung cancer who already have difficulty breathing.
• ocular sensitivity. Your eyes may become more sensitive to light. You should wear dark sunglasses for 30 days when outside after treatment, or until the sensitivity resolves.
• liver or kidney impairment. You may at an increased risk of having side effects if you have liver or kidney disease.
• blood clots. A blood clot occurs when the blood thickens inside a blood vessel, usually in the legs. This can become a serious problems if the clot breaks off and travels to your lungs.

Do not use porfimer sodium if you:

• are allergic to porfimer sodium or any of its ingredients
• are allergic to porphyrins
• have porphyria. Porphyria is a rare disease in which the body does not produce enough enzymes to break down chemicals called porphyrins. When too many porphyrins build up, this can lead to nervous system disorders. Buildup of porphyrins may also lead to skin disorders including blisters, swelling, and itching when the skin is exposed to light. Tell your doctor if you have ever been told you have porpyhria.
• have an existing fistula between the esophagus and trachea
• have a tumor that is pressing on a major blood vessel
• have an esophageal or stomach varices >1 cm in diameter
• have an esophageal ulcer >1 cm in diameter

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of porfimer sodium, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking porfimer sodium, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to porfimer sodium, or any of its ingredients
• are allergic to porphyrins
• have porphyria
• have liver problems
• have kidney problems
• have esophageal or stomach varices
• have or have had esophageal ulcers
• are pregnant or breastfeeding
• have a fistula between your esophagus and other organs in the body
• know or have been told you have a tumor protruding into a major blood vessel
• know or have been told you have a tumor blocking your airways

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Porfimer sodium falls into category C.

In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if porfimer sodium crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using porfimer sodium.

Porfimer sodium comes in injectable form and is injected into a vein (IV) by a healthcare professional 1-3 days prior to laser light treatment.

You should avoid exposure to direct sunlight as much as possible for at least 30 days after treatment, as your skin will have an increased sensitivity to sunlight and bright indoor lights. When you are outside, wear suncreen and protective clothing such as long sleeves and a wide-brimmed hat.

You should wear dark sunglasses when outside for 30 days after treatment, as your eyes may be more sensitive to bright lights.

Increased light sensitivity of the skin and eyes may occur for up to 90 days after treatment in some patients, especially those with liver problems.

Use this medication exactly as prescribed by your doctor. It will be injected into a vein by a healthcare professional.

The dose your doctor recommends may be based on the following:

• the condition being treated
• your weight
• other medical conditions you may have
• how you respond to this medication

The recommended dose of porfimer sodium for the treatment of cancer is based on your weight. It is usually injected one time, 1-3 days before treatment with laser light therapy. You may receive additional doses of laser light for a certain amount of time after the initial injection of porfimer sodium.

If porfimer sodium is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention. Damage to normal tissue and worsening of symptoms of cancer have occurred when patients received laser light doses above the recommended range.