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Indications and Dosage
Subcutaneous
Mobilisation of haematopoietic stem cells for autologous transplantation in patients with lymphoma or multiple myeloma Adult: In combination with granulocyte colony-stimulating factor (G-CSF): ≤83 kg: 20 mg fixed dose or 0.24 mg/kg once daily; >83 kg: 0.24 mg/kg once daily. Doses are usually given for 2-4 consecutive days (up to 7 days if required) and administered approx 6-11 hours prior to apheresis. Initiate treatment after 4 doses of G-CSF. Max: 40 mg daily.
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Renal Impairment
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Contraindications
Hypersensitivity.
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Special Precautions
Not intended for stem cell mobilisation and collection in patients with leukaemia. Renal impairment. Pregnancy and lactation.
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Adverse Reactions
Significant: Thrombocytopenia, leukocytosis, orthostatic hypotension, hypersensitivity reactions (e.g. urticaria, periorbital swelling, dyspnoea, hypoxia), splenomegaly or splenic rupture, syncope, inj site reactions.
Gastrointestinal disorders: Diarrhoea, nausea, vomiting, abdominal pain/discomfort, dyspepsia, constipation, flatulence, dry mouth. General disorders and administration site conditions: Fatigue, hyperhidrosis. Musculoskeletal and connective tissue disorders: Arthralgia. Nervous system disorders: Dizziness, headache. Psychiatric disorders: Insomnia. Skin and subcutaneous tissue disorders: Erythema. Potentially Fatal: Serious hypersensitivity reactions (e.g. anaphylactic shock). |
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Patient Counseling Information
This drug may cause dizziness, fatigue, or vasovagal reactions (e.g. orthostatic hypotension, syncope), if affected, do not drive or operate machinery.
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Monitoring Parameters
Obtain CBC with differential and platelet count prior to and during therapy. Monitor total WBC count, neutrophil, and platelet count regularly and during apheresis. Assess for signs and symptoms of splenic integrity (e.g. left upper abdominal pain and/or scapular or shoulder pain).
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Action
Description:
Mechanism of Action: Plerixafor, a CXCR4 chemokine-receptor antagonist, blocks the binding of the ligand, stromal cell-derived factor-1α (SDF-1α) to the CXC chemokine receptor 4 (CXCR4) on CD34+ cells, resulting in mobilisation of haematopoietic stem and progenitor cells into the blood. Pharmacokinetics: Absorption: Rapidly absorbed. Time to peak plasma concentration: Approx 30-60 minutes. Distribution: Primarily distributed to the extravascular fluid space. Volume of distribution: 0.3 L/kg. Plasma protein binding: Approx 58%. Excretion: Mainly via urine (approx 70%, as unchanged drug). Terminal elimination half-life: Approx 3-5 hours. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Plerixafor, CID=65015, https://pubchem.ncbi.nlm.nih.gov/compound/Plerixafor (accessed on Jan. 22, 2020) |
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Storage
Store at 25°C.
Any unused portions should be disposed of in accordance with local requirements. |
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MIMS Class
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ATC Classification
L03AX16 - plerixafor ; Belongs to the class of other immunostimulants.
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References
Anon. Plerixafor. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/03/2018. Buckingham R (ed). Plerixafor. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/03/2018. Joint Formulary Committee. Plerixafor. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/03/2018. McEvoy GK, Snow EK, Miller J et al (eds). Plerixafor. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 02/03/2018. Mozobil Solution (Sanofi-Aventis U.S. LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/03/2018.
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