Patient leaflet - Plerixafor 20 mg/ml solution for injection
1. What Plerixafor 20 mg/ml solution for injection is and what it is used for
This medicine contains the active substance plerixafor, which blocks a protein on the surface of blood stem cells. This protein “ties” blood stem cells to the bone marrow. Plerixafor improves the release of stem cells into the blood stream (mobilisation). The stem cells can then be collected by a machine that separates blood constituents (apheresis machine), and subsequently frozen and stored until your transplant.
If mobilisation is poor, plerixafor is used to help collect blood stem cells from the patient, for collection, storage and reintroduction (transplantation),
- in adults who have lymphoma (a cancer of the white blood cells) or multiple myeloma (a cancer that affects plasma cells in the bone marrow)
in children age 1 to less than 18 years of age with lymphoma or solid tumours.
2. What you need to know before you use Plerixafor 20 mg/ml solution for injection
DO NOT use Plerixafor 20 mg/ml solution for injection
- if you are allergic to plerixafor or any of the other ingredients of this medicine (listed in section 6).
Warnings and precautions
Talk to your doctor before using this medicine.
Tell your doctor:
- if you have or have had any heart problems
- if you have kidney problems. Your doctor may adjust the dose
- if you have high white blood cell counts
- if you have low platelet counts
- if you have a history of feeling faint or lightheaded on standing or sitting or have fainted before when having injections
Your doctor may perform regular blood tests to monitor your blood cell count. It is not recommended to use plerixafor for stem cell mobilisation if you have leukaemia (a cancer of the blood or bone marrow).
Other medicines and Plerixafor 20 mg/ml solution for injection
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Pregnancy and breast-feeding
You should not use plerixafor if you are pregnant, since there is no experience with plerixafor in pregnant women. It is important to tell your doctor if you are, think you may be or are planning to become pregnant. It is recommended to use contraception if you are of child-bearing age.
You should not breast-feed if you are using this medicine, since it is not known if plerixafor is excreted in human milk.
Driving and using machines
This medicine may cause dizziness and fatigue. Therefore, you should avoid driving if you feel dizzy, tired or unwell.
Plerixafor contains sodium
This medicine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially ‘sodium-free’.
3. How to use Plerixafor 20 mg/ml solution for injection
Your medicine will be injected by a doctor or a nurse.
You will first receive G-CSF, then you will be given Plerixafor 20 mg/ml solution for injection
Mobilisation will be started by first giving you another medicine called G-CSF (granulocyte-colony stimulating factor). G-CSF will help Plerixafor to work properly in your body. If you want to know more about G-CSF ask your doctor and read the corresponding package leaflet.
How much Plerixafor 20 mg/ml solution for injection is given?
The recommended adult dose is either 20 mg (fixed dose) or 0.24 mg/kg body weight/day. The recommended dose for children, 1 to less than 18 years of age is 0.24 mg/kg of body weight/day.
Your dose will depend on your body weight, which should be measured the week before you receive your first dose. If you have moderate or severe kidney problems, your doctor will reduce the dose.
How is Plerixafor 20 mg/ml solution for injection given?
Plerixafor is given by subcutaneous injection (under your skin).
When is Plerixafor 20 mg/ml solution for injection given for the first time?
You will receive your first dose 6 to 11 hours before apheresis (collection of your blood stem cells).
How long will Plerixafor 20 mg/ml solution for injection be given?
Treatment lasts 2 to 4 consecutive days (in some cases up to 7 days), until enough stem cells have been collected for your transplant. In a few cases, enough stem cells may not be collected, and the collection attempt will be stopped.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Please tell your doctor immediately if
- shortly after receiving this medicine, you experience rash, swelling around the eyes, shortness of breath or lack of oxygen, feeling lightheaded on standing or sitting, feeling faint or fainting
- you have pain in the upper left abdomen (belly) or your left shoulder
Very common side effects (may affect more than 1 in 10 people)
- diarrhoea, nausea (feeling sick), injection site redness or irritation
- low red blood cell count by laboratory test (anaemia in children)
Common side effects (may affect up to 1 in 10 people)
- headache
- dizziness, feeling tired or unwell
- difficulty sleeping
- flatulence, constipation, indigestion, vomiting
- stomach symptoms such as pain, swelling or discomfort
- dry mouth, numbness around the mouth
- sweating, generalised redness of the skin, joint pain, muscle and bone pain
Uncommon side effects (may affect up to 1 in 100 people)
- allergic reactions such as skin rash, swelling around the eyes, shortness of breath • anaphylactic reactions, including anaphylactic shock
- abnormal dreams, nightmares
Rarely, gastrointestinal side effects may be severe (diarrhoea, vomiting, stomach pain and nausea).
Heart attacks
In clinical trials, patients with risk factors for a heart attack uncommonly suffered heart attacks after being given plerixafor and G-CSF. Please inform your doctor immediately if you experience chest discomfort.
Pins and needles and numbness
Pins and needles and numbness are common in patients being treated for cancers. About one in five patients suffered from these feelings. However, these effects do not seem to occur more frequently when you use plerixafor.
You may also have an increase in white blood cells count (leucocytosis), in your blood tests.
Reporting of side effects
If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
5. How to store Plerixafor 20 mg/ml solution for injection
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and vial. Does not require any special storage conditions.
After opening the vial, this medicine should be used immediately.
Do not throw away any medicines via wastewater or household waste. The pharmacist will throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Plerixafor 20 mg/ml solution for injection contains
The active substance is plerixafor. Each ml solution for injection contains 20 mg plerixafor.
Each vial contains 24 mg plerixafor in 1.2 ml solution.
- The other ingredients are sodium chloride, hydrochloric acid (concentrated) and sodium hydroxide for pH adjustment and water for injections.
What Plerixafor 20 mg/ml solution for injection looks like and contents of the pack
This medicine is supplied as a clear colourless or pale yellow solution for injection in a clear type 1 Fiolax vial with a chlorobutyl/butyl flurotec stopper, sealed with an aluminum/polypropylene flip off cap. Each vial contains 1.2 ml solution.
Each pack contains 1 vial.
Marketing Authorisation Holder
STADA, Linthwaite, Huddersfield, HD7 5QH, United Kingdom
Manufacturer
Pharmadox Healthcare Limited, Kw20a, Kordin, Industrial Park, 3000 Paola, Malta