How does this medication work? What will it do for me?

Plerixafor belongs to the class of medications called hematopoietic agents. It is used in adults to help collect stem cells for transplantation to treat non-Hodgkin's lymphoma and multiple myeloma, which are specific cancers affecting blood cells.

It may also be used to help collect stem cells in children 1 to 18 years of age with lymphoma or solid cancerous tumours, who have too low a number of stem cells in the blood to successfully collect enough for stem cell transplant.

When used along with another medication called granulocyte-colony stimulating factor (G-CSF), plerixafor works by increasing the number of blood stem cells in the blood stream so they can be collected and used in stem cell transplant.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each 1 mL of sterile, clear, colourless solution, contains 20 mg of plerixafor. Nonmedicinal ingredients: sodium chloride in sterile water for injection, adjusted to a pH of 6 to 7.3 with hydrochloric acid and with sodium hydroxide, if required.

How should I use this medication?

Plerixafor is given by subcutaneous (under the skin) injection, usually in the abdominal area.

The recommended dose of plerixafor for adults and children is based on body weight, calculated as 0.24 mg per kilogram of body weight, to a maximum of 40 mg daily. For adults, it is usually given as a single dose approximately 10 to 11 hours before the procedure to gather stem cells from the blood. For children, it is usually given as a single dose 8 to 12 hours before the procedure to gather stem cells from the blood.

This medication is generally given under the supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive plerixafor, contact your doctor as soon as possible to reschedule your appointment.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you are allergic to plerixafor or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abnormal dreams or nightmares
  • anxiety
  • bruising, swelling or pain at the injection site
  • constipation
  • diarrhea
  • dizziness
  • excessive sweating
  • feeling tired
  • feeling unwell
  • gas
  • headache
  • heartburn
  • joint pain
  • muscle and bone pain
  • nausea
  • skin redness
  • stuffy or runny nose
  • sweating
  • trouble falling asleep
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • feeling faint
  • feeling of pins and needles and numbness
  • fever with low levels of white blood cells
  • low blood pressure
  • numbness around the mouth
  • pain in the upper left abdomen or tip of the shoulder
  • severe diarrhea
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
  • signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • stomach pain, swelling, or discomfort
  • symptoms of low level of protein in the blood (e.g., weakness, swelling in the feet, ankles, hands, legs and/or face)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, rash or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood counts: This medication can increase the number of white blood cells and decrease the number of platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Blood pressure: This medication may cause low blood pressure or dizziness and lightheadedness when rising from a lying or sitting position. People taking medications that can cause dizziness should rise slowly from sitting or lying down to reduce the possibility of severe dizziness or fainting.

Drowsiness/reduced alertness: Plerixafor may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how this medication affects you.

Electrolyte balance: Plerixafor may cause the levels of electrolytes such as potassium, sodium, magnesium, chloride, and calcium in the blood to change while taking this medication. If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible. Your doctor will do blood tests regularly to monitor the levels of these electrolytes in your blood while you are taking this medication.

Heart attack: Although rare, this medication has been associated with heart attack. If you experience signs of a heart attack such as chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating, let your doctor know immediately.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication may cause harm to the developing baby if it is used during pregnancy. Plerixafor should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. People who may become pregnant or people whose partners could become pregnant should use effective birth control while being treated with plerixafor and for at least 1 week after the last dose of this medication.

Breast-feeding: It is not known if plerixafor passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children younger than 1 year old.

What other drugs could interact with this medication?

For a full list of interactions, use the Drug Interaction Checker available on the website.

If you are taking other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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