Plerixafor

Plerixafor is a prescription medication indicated in combination with filgrastim to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with multiple myeloma and non-Hodgkin lymphoma.

• Plerixafor is available under the following different brand names: Mozobil.

Common side effects of Plerixafor include:

• nausea
• vomiting
• diarrhea
• constipation
• dry mouth
• numbness in or around the mouth
• upset stomach
• bloating
• gas
• tired feeling
• trouble sleeping
• headache
• dizziness
• joint or muscle pain
• increased sweating
• itching
• rash, or other irritation where the medication was injected

Serious side effects of Plerixafor include:

• hives
• difficulty breathing
• swelling of the face, lips, tongue, or throat
• easy bruising
• unusual bleeding
• unusual weakness
• lightheadedness
• severe pain in the left upper stomach, spreading to the shoulder blade

Rare side effects of Plerixafor include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors.
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Single use injection

• 20 mg/mL (24mg vial)

Stem cell transplantation

Adult dosage

• Initiate treatment after a patient has received granulocyte-colony stimulating factor (G-CSF) once a day for 4 days
• Recommended dose: 0.24 mg/kg SC once a day; repeat up to 4 consecutive days; not to exceed 40 mg/day  
• Start treatment approximately 11 hours before apheresis initiation

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Plerixafor has no noted severe interactions with any other drugs
• Plerixafor has no noted serious interactions with any other drugs
• Plerixafor has no noted moderate interactions with any other drugs
• Plerixafor has no noted minor interactions with any other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• None listed in the manufacturer's labeling
• History of hypersensitivity; anaphylaxis reported

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Plerixafor?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Plerixafor?”

Cautions

• Not intended for HSC mobilization and harvest in patients with leukemia
• Combined with filgrastim tumor cells may be released from the bone marrow and collected in the leukapheresis product. Effects of potential reinfusion of tumor cells not studied
• Dose reduction is recommended in patients with moderate-severe renal impairment
• Leukocytosis; use in conjunction with G-CSF increases circulating leukocytes as well as HSC populations
• Risk of thrombocytopenia; monitor platelet counts in all patients receiving treatment and then undergo apheresis
• Risk of splenic enlargement and rupture
• The optimal effective dose in patients weighing more than 175% of the ideal body weight not studied
• Cases of splenic enlargement and rupture were reported following administration in conjunction with growth factor G-CSF
• Medications that reduce renal function or compete for active tubular secretion may increase serum concentrations of Plerixafor

Pregnancy and Lactation

• Limited available data on pregnant women are insufficient to inform a drug-associated risk of adverse developmental outcomes
• Advise pregnant women of potential risk to the fetus
• Advise women of reproductive potential to avoid becoming pregnant while receiving treatment
• Verify pregnancy status in women of reproductive potential before initiating therapy
• Contraception
  • Therapy can cause embryo-fetal harm when administered to pregnant women; advise women of reproductive potential to use effective contraception during treatment and for one week after the final dose
  • Males treated with this medication should use effective contraception during treatment and for one week after cessation of treatment
• Lactation
  • There are no data on the presence of Plerixafor in human milk, its effect on the breastfed child, or the effect on milk production; because of potentially serious adverse reactions in breastfed children, advise women that breastfeeding is not recommended during treatment and for one week after the final dose