In the U.S.—

• Antineoplastic

Porfimer (POR-fi-mer) belongs to the group of medicines known as antineoplastics. It is used, together with a special laser light, to treat cancer of the esophagus (the part of the digestive tract that carries food to the stomach) and to treat a form of lung cancer.

This medicine is available only with your doctor's prescription, in the following dosage form:

Parenteral
• Injection (U.S.)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For porfimer, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to porfimer. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Porfimer has not been studied in humans. However, it has caused harm to the fetus in animals. It is best to use some kind of birth control while you are receiving porfimer. Tell your doctor right away if you think you have become pregnant while receiving this medicine.

Breast-feeding—It is not known whether porfimer passes into breast milk. However, because this medicine may cause serious side effects, breast-feeding is generally not recommended while you are receiving it.

Children—There is no specific information comparing use of porfimer in children with use in other age groups.

Older adults—Porfimer has been studied in elderly patients. It has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are being treated with porfimer, it is important that your health care professional know if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Porphyria

Treatment with porfimer and laser light occurs in three steps. First, the porfimer is injected into your body. Second, about 2 days later, a laser light is directed at the cancer. Then, about 2 or 3 days after the light is applied, your doctor will remove the cancer cells that have been destroyed.

Dosing—

The dose of porfimer will be different for different patients. The dose that is used may depend on a number of things, including the patient's weight. If you have any questions about the proper dose of porfimer, ask your doctor.

• For injection dosage form:
  • For treating cancer of the esophagus or lung cancer:
    • Adults—2 milligrams (mg) per kilogram (about 0.8 mg per pound) of body weight, injected into a vein.
    • Children—Use and dose must be determined by your doctor.

For at least 30 days after you receive an injection of porfimer, your eyes will be extra sensitive to light, including sunlight, bright indoor lights, and vehicle headlights. Certain types of sunglasses can help protect your eyes during this time. Check with your doctor about which sunglasses to use.

For at least 30 days after you receive an injection of porfimer, your skin will be extra sensitive to sunlight and to very bright indoor lights, such as lamps with unshaded light bulbs and lights in dental offices or operating rooms. Do not expose your skin to direct sunlight or to bright indoor lights during this time. Sunscreens will not protect your skin from a severe reaction to light (blistering, burning, and swelling of the skin). However, exposure to normal amounts of indoor light (for example, daylight or light from lamps with shades) will help use up the porfimer remaining in your skin. Therefore, do not protect your skin from normal amounts of indoor light. If you have any questions about whether the light in your home is too bright, check with your doctor or nurse. Also, ask your doctor or nurse ahead of time about what you should do if a severe reaction to light occurs .

Thirty days after receiving an injection of porfimer, test a small portion of your skin by exposing it to sunlight for 10 minutes . (Do not test skin on your face.) If the exposed part of your skin does not become blistered, red, or swollen during the next 24 hours, you can slowly increase your exposure to sunlight and bright indoor lights. If a reaction does occur, wait another 2 weeks, then test your sensitivity to sunlight again.

Even after your skin and eyes are no longer sensitive to the lights in your home or the amount of sunlight in the area where you live, you may still be sensitive to brighter levels of light. If you travel to an area where the sunlight is stronger than at home, test yourself again before exposing your skin to the stronger light.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Coughing, difficulty in swallowing, breathing problems, and problems caused by sensitivity to light have occurred in patients being treated for lung cancer as well as in patients being treated for cancer of the esophagus. Spitting blood has been reported only in patients being treated for lung cancer. The other side effects listed below have occurred only in patients being treated for cancer of the esophagus. The number and kinds of side effects that might occur depend on where in the esophagus the tumor is located and on the size of the tumor.

Check with your doctor immediately if any of the following side effects occur:

• More common
  • Fast or irregular heartbeat;  shortness of breath or troubled breathing;  spitting blood 
  
  

• Less common
  • Abdominal or stomach pain (severe);  chest pain;  painful and/or difficult breathing 
  
  

Also, check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Abdominal or stomach pain (mild or moderate);  bloody or cloudy urine;  coughing;  difficult, burning, or painful urination;  difficulty in swallowing;  dizziness (severe) or fainting;  fever;  frequent urge to urinate;  swelling of face, feet, or lower legs;  tightness in chest or wheezing;  unusual tiredness or weakness;  unusual weight gain;  white patches inside the mouth 
  
  

• Less common
  • Chills;  constipation (severe);  nausea and vomiting (severe);  swelling of the neck;  yellow eyes or skin 
  
  

This medicine may also cause the following side effects that your doctor will watch for:

• More common
  • High blood pressure;  low blood pressure  
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Blistering, redness, or swelling of skin;  constipation (mild);  diarrhea;  nausea and vomiting (mild or moderate);  trouble in sleeping;  weakness 
  
  

• Less common
  • Double vision or other changes in vision;  eye pain when looking into bright light, including vehicle headlights 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.