Defibrotide治疗期间要注意什么？

Defibrotide is indicated for adults and children with hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), and renal or pulmonary dysfunction after hematopoietic stem cell transplantation (HSCT). So, what should you pay attention to during defibrotide treatment?

1. Defibrotide must be diluted before infusion. Prior to administration of defibrotide, confirm that the patient is not experiencing clinically significant bleeding and is hemodynamically stable on no more than one vasopressor. 2. Do not co-administer Defibrotide with other intravenous drugs in the same intravenous line at the same time. 3. Bleeding: Defibrotide increases the activity of plasmin in vitro, and sputum may increase the risk of bleeding after hematopoietic stem cell transplantation (HSCT) in patients with VOD. Do not initiate defibrotide in patients with active bleeding. Monitor patients for signs of bleeding. If bleeding occurs in a patient taking DEFITELIO, discontinue defibrotide, treat the cause, and provide supportive care until bleeding has stopped. Concomitant use of defibrotide and a systemic anticoagulant or fibrinolytic therapy (excluding use for routine maintenance or central venous line reopening) may increase the risk of bleeding. Discontinue anticoagulants and fibrinolytics before defibrotide therapy, and consider delaying initiation of defibrotide administration until the effects of the anticoagulants have lessened. 4. Hypersensitivity reactions: Hypersensitivity reactions have occurred in less than 2% of patients treated with Defibrotide. These reactions include rash, urticaria, and angioedema. One case of allergic reaction was reported in a patient who had previously received defibrotide. Monitor patients for hypersensitivity reactions. Especially if there is a history of previous exposure. If a severe hypersensitivity reaction occurs, discontinue defibrotide, treat with standard medical care, and monitor until symptoms resolve. 5. Special populations: Clinical studies of defibrotide in the elderly did not include a sufficient number of subjects aged 65 and above to determine whether their responses were different from those of younger subjects. Other reported clinical experiences did not identify differences in responses between older and younger patients. 6. Overdose: There are no known cases of overdose with Defibrotide. There are no known antitoxicants for Defibrotide, and Defibrotide is not dialyzable. If overdose occurs, initiate general supportive measures.