Defibrotide

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What is Defibrotide?[edit | edit source]

What are the uses of this medicine?[edit | edit source]

How does this medicine work?[edit | edit source]

  • The mechanism of action of defibrotide sodium has not been fully elucidated.
  • In vitro, defibrotide sodium enhances the enzymatic activity of plasmin to hydrolyze fibrin clots.
  • In vitro, defibrotide sodium increased tissue plasminogen activator (t-PA) and thrombomodulin expression, and decreased von Willebrand factor (vWF) and plasminogen activator inhibitor‑1 (PAI-1) expression, thereby reducing EC activation and increasing EC‑mediated fibrinolysis.
  • Defibrotide sodium protected ECs from damage caused by chemotherapy, tumor necrosis factor-α (TNF-α), serum starvation, and perfusion.

Who Should Not Use this medicine ?[edit | edit source]

This medicine cannot be used in patients with:

What drug interactions can this medicine cause?[edit | edit source]

Is this medicine FDA approved?[edit | edit source]

  • It was approved for use in the United States in 2016.

How should this medicine be used?[edit | edit source]

Recommended Dosage:

  • The recommended dosage of Defitelio for adult and pediatric patients is 6.25 mg/kg every 6 hours given as a 2‑hour intravenous infusion.
  • Administer Defitelio for a minimum of 21 days.
  • If after 21 days signs and symptoms of hepatic VOD have not resolved, continue Defitelio until resolution of VOD or up to a maximum of 60 days.

Administration

  • Defitelio must be diluted prior to infusion.
  • Prior to administration of Defitelio, confirm that the patient is not experiencing clinically significant bleeding and is hemodynamically stable on no more than one vasopressor.
  • Administer Defitelio by constant intravenous infusion over a 2-hour period.
  • Administer the diluted Defitelio solution using an infusion set equipped with a 0.2 micron in-line filter.
  • Flush the intravenous administration line (peripheral or central) with 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP immediately before and after administration.
  • Do not co‑administer Defitelio and other intravenous drugs concurrently within the same intravenous line.

What are the dosage forms and brand names of this medicine?[edit | edit source]

This medicine is available in fallowing doasage form:

  • As Injection: 200 mg/2.5 mL (80 mg/mL) in a single-patient-use vial.

This medicine is available in fallowing brand namesː

  • Defitelio

What side effects can this medication cause?[edit | edit source]

The most common side effects of this medicine include:

What special precautions should I follow?[edit | edit source]

  • Defitelio may increase the risk of bleeding in patients with VOD after hematopoietic stem-cell transplantation (HSCT). Monitor patients for bleeding. Withhold or discontinue Defitelio if significant bleeding occurs.
  • Hypersensitivity reactions have occurred in less than 2% of patients treated with Defitelio. These reactions include rash, urticaria and angioedema.
  • If severe or life threatening allergic reaction occurs, discontinue Defitelio, treat according to standard of care, and monitor until signs and symptoms resolve.

What to do in case of emergency/overdose?[edit | edit source]

  • There are no known cases of overdose with Defitelio.

Management for overdosage:

  • There is no known antidote for Defitelio, and Defitelio is not dialyzable.
  • If an overdose occurs, institute general supportive measures.

Can this medicine be used in pregnancy?[edit | edit source]

  • There are no available data on Defitelio use in pregnant women.

Can this medicine be used in children?[edit | edit source]

  • The safety and effectiveness of Defitelio have been established in pediatric patients.

What are the active and inactive ingredients in this medicine?[edit | edit source]

Active ingredient:

  • defibrotide sodium

Inactive ingredients:

  • trisodium citrate dihydrate
  • water
  • hydrochloric acid
  • sodium hydroxide

Who manufactures and distributes this medicine?[edit | edit source]

Distributed by:

What should I know about storage and disposal of this medication?[edit | edit source]

  • Store Defitelio (defibrotide sodium) injection at 20°C-25°C (68°F-77°F); excursions permitted between 15°C to 30°C (59°F to 86°F)
Defibrotide Resources
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