Photofrin

Generic Name: porfimer (Intravenous route)

POR-fi-mer

Commonly used brand name(s):

In the U.S.

• Photofrin

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antineoplastic Agent

Uses For Photofrin

Porfimer belongs to the group of medicines known as antineoplastics. It is used, together with a special laser light, to treat cancer of the esophagus (the part of the digestive tract that carries food to the stomach) and to treat a form of lung cancer. This medicine may also treat changes in the esophagus that might lead to cancer, such as a condition called Barrett's esophagus.

This medicine is available only with your doctor's prescription.

Before Using Photofrin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of porfimer in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of porfimer in the elderly.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Esophageal ulcers or
• Porphyria (a problem with enzymes in your body) or
• Tracheoesophageal or bronchoesophageal fistula (opening between the esophagus and breathing airways) or
• Tumors or lesions that obstruct blood vessels or breathing airways or
• Varices (swollen veins) in the esophagus or stomach—Should not be used in patients with these conditions.

• Kidney disease or
• Liver disease—Effects may be increased because of slower removal of this medicine from the body.

• Radiation therapy—You will need to wait 2 to 4 weeks between phototherapy and radiation therapy.

• Sensitivity of the skin or eyes to sunlight or bright lights—Use with caution. May make this condition worse.

Proper Use of Photofrin

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Treatment with porfimer and laser light occurs in three steps. First, the porfimer is injected into your body. Second, about 2 days later, a laser light is directed at the cancer. Then, about 2 or 3 days after the light is applied, your doctor will remove the cancer cells that have been destroyed.

Precautions While Using Photofrin

It is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by this medicine.

For at least 30 days after you receive an injection of porfimer, your eyes will be extra sensitive to light, including sunlight, bright indoor lights, and vehicle headlights. Certain types of sunglasses can help protect your eyes during this time. Check with your doctor about which sunglasses to use.

For at least 30 days after you receive an injection of porfimer, your skin will be extra sensitive to sunlight and to very bright indoor lights, such as lamps with unshaded light bulbs and lights in dental offices or operating rooms. Do not expose your skin to direct sunlight or to bright indoor lights during this time. Sunscreens will not protect your skin from a severe reaction to light (blistering, burning, and swelling of the skin). However, exposure to normal amounts of indoor light (e.g., daylight or light from lamps with shades) will help use up the porfimer remaining in your skin. Therefore, do not protect your skin from normal amounts of indoor light. If you have any questions about whether the light in your home is too bright, check with your doctor or nurse. Also, ask your doctor or nurse ahead of time about what you should do if a severe reaction to light occurs.

Thirty days after receiving an injection of porfimer, test a small portion of your skin by exposing it to sunlight for 10 minutes. (Do not test skin on your face.) If the exposed part of your skin does not become blistered, red, or swollen during the next 24 hours, you can slowly increase your exposure to sunlight and bright indoor lights. If a reaction does occur, wait another 2 weeks, then test your sensitivity to sunlight again.

Even after your skin and eyes are no longer sensitive to the lights in your home or the amount of sunlight in the area where you live, you may still be sensitive to brighter levels of light. If you travel to an area where the sunlight is stronger than at home, test yourself again before exposing your skin to the stronger light.

You might have pain around your chest after your treatment. If you have pain, talk with your doctor about the best way to treat it.

If you are using this medicine to treat Barrett's esophagus, your chance of having narrowing of the esophagus may be increased. Check with your doctor right away if you start to have trouble with swallowing after you have received this medicine.

Photofrin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Bladder pain
• bloody or cloudy urine
• blurred vision
• body aches or pain
• chest pain or discomfort
• confusion
• congestion
• cough
• coughing or spitting up blood
• difficult or troubled breathing
• difficult, burning, or painful urination
• difficulty in swallowing
• dilated neck veins
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• dryness or soreness of the throat
• extreme fatigue
• fast, pounding, or irregular heartbeat or pulse
• fever or chills
• frequent urge to urinate
• headache
• hoarseness
• increased sensitivity of skin to sunlight
• irregular, fast or slow, or shallow breathing
• itching
• lower back or side pain
• nervousness
• pale or blue lips, fingernails, or skin
• pale skin
• pounding in the ears
• redness or other discoloration of the skin
• runny nose
• severe pain in the chest
• severe sunburn
• shortness of breath
• skin rash
• slow or fast heartbeat
• sneezing
• sore throat
• sudden onset of severe breathing difficulty
• sweating
• swelling of the face, fingers, feet, or lower legs
• tender, swollen glands in the neck
• tightness in the chest
• unusual bleeding or bruising
• unusual tiredness or weakness
• voice changes
• vomiting of blood or material that looks like coffee grounds
• weight gain
• wheezing
• white patches in the mouth or throat or on the tongue
• white patches with diaper rash

• Bloody, black, or tarry stools
• decrease in the amount of urine
• decreased urination
• dry mouth
• fainting
• heartburn
• increase in heart rate
• noisy, rattling breathing
• pain or burning in the throat
• rapid breathing
• shortness of breath
• sores, ulcers, or white spots on the lips or tongue or inside the mouth
• sunken eyes
• thirst
• troubled breathing at rest
• vomiting
• wrinkled skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Acid or sour stomach
• back pain
• belching
• constipation
• diarrhea
• fear or nervousness
• indigestion
• lack or loss of strength
• loss of appetite
• nausea
• pain
• sleeplessness
• stomach discomfort, upset, or pain
• trouble sleeping
• unable to sleep
• weight loss

• Bloated, full feeling
• change in the color of treated skin
• excess air or gas in the stomach
• increased hair growth
• small lumps under the skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

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