Palifermin Side Effects
Commonly reported side effects of palifermin include pruritus, edema, arthralgia, paresthesia, skin rash, dysesthesia, increased serum amylase, tongue edema, hyperesthesia, hypoesthesia, mouth discoloration, dysgeusia, erythema, and tongue discoloration. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to palifermin: intravenous powder for solution
As well as its needed effects, palifermin may cause unwanted side effects that require medical attention.
If any of the following side effects occur while taking palifermin, check with your doctor or nurse immediately:More common
- Skin rash (severe)
Some palifermin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:More common
- Bad, unusual, or unpleasant (after) taste
- blurred vision
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- change in taste
- difficulty with moving
- discoloration of the tongue
- flushing or redness of the skin
- increased sensitivity to pain
- increased sensitivity to touch
- itching skin
- muscle pain or stiffness
- pain in the joints
- pounding in the ears
- rash (mild)
- slow or fast heartbeat
- thickening of the tongue
- tingling in the hands and feet
- unusually warm skin
- redness or swelling of the vagina
- redness, swelling, or pain of the skin
- scaling of the skin on the hands and feet
- ulceration of the skin
For Healthcare Professionals
Applies to palifermin: intravenous powder for injection
Dermatologic side effects for palifermin in relation to placebo therapy have included rash (62% vs. 50%), pruritus (35% vs. 24%), and erythema (32% vs. 22%).[Ref]
Skin rash was the most common serious side effect reported.
Clinical studies (n=409) reported the occurrence of grade 3 skin rash in 14 patients (9 palifermin, 5 placebo) resulting in the discontinuation of treatment in 7 patients (5 palifermin, 2 placebo).
Following the first 3 consecutive days of administration, the median time to cutaneous side effects is 6 days with a median duration of 5 days.[Ref]
Following the first 3 consecutive days of administration, the median time to cutaneous side effects, including edema, is 6 days with a median duration of 5 days.[Ref]
Other side effects for palifermin in relation to placebo therapy have included edema (28% vs. 21%), pain (16% vs. 11%), fever (39% vs. 34%) and perianal pain (12% vs. 5%). Other side effects of palifermin following a single 90 mcg/kg IV dose include fatigue (26%) and headache (23%).[Ref]
Gastrointestinal side effects for palifermin in relation to placebo therapy have included mouth/tongue thickness and/or discoloration (17% vs. 8%) and altered taste (16% vs. 8%). Oral/perioral dysesthesia and white film coating of the mouth or tongue has also been reported.[Ref]
Musculoskeletal side effects for palifermin in relation to placebo therapy have included arthralgia (10% vs 5%).[Ref]
Dysthesias in palifermin treated patients have generally been reported as localized to the perioral region. In contrast, patients receiving placebo have generally reported dysthesias in extremities.[Ref]
Nervous system side effects for palifermin in relation to placebo therapy have included dysthesias (12% vs. 7%). Types of dysthesias reported have included hyperesthesia, hypoesthesia, and paresthesia.[Ref]
There are no available data on the effects of palifermin on stimulation of KGF receptor- expressing, non- hematopoietic tumors in patients.
At concentrations greater than 15 times the average therapeutic human concentration palifermin has been reported to enhance the growth of human epithelial tumor cell lines in vitro.
In nude mouse xenograft models, doses 25 and 67 times higher than the recommended human dose administered daily for 3 consecutive weeks and repeated weekly for 4 to 6 weeks may have resulted in a dose-dependent increase in the growth rate of 1 of 7 KGF receptor- expressing human tumor cell lines.[Ref]
Oncologic side effects have included enhancement in the growth of human epithelial tumor cell lines in vitro and an increase in the rate of tumor cell line growth in a human carcinoma xenograft model.[Ref]
In clinical studies, the elevated serum lipase and amylase levels were reversible with peak increases recorded during the period of cytotoxic therapy. Levels returned to baseline by the day of PBPC infusion. There are no reports of required treatment intervention.
The increased amount of amylase is reported to be predominantly salivary in origin.[Ref]
Metabolic side effects for palifermin in relation to placebo therapy have included elevated serum lipase grade 3 (28% vs. 23%), elevated serum lipase grade 4 (11% vs. 5%), elevated serum amylase grade 3 (62% vs. 54%), and elevated serum amylase grade 4 (38% vs. 31%).[Ref]
Cardiovascular side effects have included hypertension.[Ref]
Hypertension was reported with doses of 60 mcg/kg and 80 mcg/kg in patients undergoing hematopoietic transplantation. This effect appeared to be transient. There are no reports of treatment discontinuation due to hypertension.[Ref]
There have been reports of 2+ or greater proteinuria in patients treated with palifermin; however, a causal relationship between palifermin and proteinuria has not been established.[Ref]
Genitourinary side effects have included proteinuria.[Ref]
In general, doses of 80 mcg/kg administered intravenously 3 doses prior to and 3 doses after myeloablative chemotherapy/TBI produced the same type of side effects seen with 60 mcg/kg doses; however, a higher level of severity was reported with the higher dose.[Ref]
Respiratory side effects for palifermin in relation to placebo therapy have included cough (34% vs. 28%) and rhinitis (17% vs. 9%).[Ref]
1. "Product Information. Kepivance (palifermin)." Shire US Inc, Florence, KY.
2. Spielberger R, Stiff P, Bensinger W, et al "Palifermin for oral mucositis after intensive therapy for hematologic cancers." N Engl J Med 351 (2004): 2590-8
3. Gillespie B, Zia-Amirhosseini P, Salfi M, et al. "Effect of renal function on the pharmacokinetics of palifermin." J Clin Pharmacol 46 (2006): 1460-8
It is possible that some side effects of palifermin may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.
More about palifermin
- Other brands: Kepivance
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