Defitelio is a key drug used to treat hepatic veno-occlusive disease (VOD) after hematopoietic stem cell transplantation. Its mechanism of action involves endothelial cell protection and coagulation function regulation. This article will systematically introduce the core information of the drug from three aspects: medication guidelines, storage methods, and patient preparation before medication, to provide a scientific basis for clinical use.
Defitelio Medication Guide
Defitelio has shown obvious clinical value in specific patient groups, but its application must strictly follow a standardized medication regimen. The following is an explanation from two dimensions: indications and dosage management, adverse reactions and contraindications.
Indications and Dosage Management
Defitelio is mainly used to treat hepatic veno-occlusive disease (VOD) with renal or pulmonary dysfunction after hematopoietic stem cell transplantation. The recommended dose for adults and children is 6.25 mg/kg intravenously every 6 hours for at least 21 days. If symptoms are not relieved, it can be extended to up to 60 days. It needs to be diluted to a concentration of 4-20 mg/mL before infusion and administered through a 0.2μm filter to avoid mixing with other intravenous drugs.
Adverse reactions and contraindications
Common adverse reactions include hypotension, diarrhea and epistaxis, with an incidence rate of more than 10%. Patients with active bleeding are prohibited from using this drug, and should be alert to interactions with anticoagulants. Bleeding signs should be closely monitored during treatment. If severe allergic reactions (such as angioedema) occur, the drug should be discontinued immediately and emergency measures should be initiated.
Reasonable dose adjustment and risk monitoring are the key to ensuring the effectiveness of treatment. Medical staff need to dynamically evaluate the medication regimen based on individual differences of patients to maximize the balance between efficacy and safety.
Storage of Defibrotide
Correct storage conditions directly affect drug stability and clinical efficacy. This section explains the storage points from the two aspects of environmental requirements and post-preparation management.
Ambient temperature and expiration date
Unopened Defibrotide should be stored at 20°C-25°C, and the temperature fluctuation range allowed during transportation is 15°C-30°C. The drug is valid for up to 40 months, but it is necessary to avoid light or extreme temperatures that damage the ingredients.
Storage and use restrictions after preparation
The diluted solution must be used within 4 hours at room temperature and can be extended to 24 hours under refrigeration. A maximum of four doses can be prepared at a time, and the remaining liquid should be discarded. Glass vials are for single-person single use only to avoid the risk of cross-contamination.
Standardized storage procedures not only prolong the activity of the drug, but also reduce the risk of treatment failure due to improper storage. Medical institutions need to establish standardized operating procedures to ensure that the drug is under control throughout the entire process.
Preparation before medication for patients with Defibrotide
Sufficient pre-medication evaluation is a prerequisite for ensuring the safety of treatment. This section focuses on basic examinations and precautions for special populations.
Basic examinations and contraindication screening
Before medication, it is necessary to confirm that the patient's hemodynamics is stable and there are no severe bleeding symptoms. Anticoagulants or fibrinolytic drugs need to be suspended, and liver and kidney function needs to be evaluated. The baseline weight is based on the data before transplant preparation to avoid dosage deviation.
Principles of medication for special populations
Pregnant women need to weigh the risk to the fetus, and breastfeeding women are advised to suspend breastfeeding. Elderly patients lack clear data support and need to adjust the dosage carefully; pediatric patients have been proven to be safe, but still need to be monitored more closely.
Individualized assessment and multidisciplinary collaboration can significantly improve medication safety. The clinical team needs to combine the patient's medical history and laboratory indicators to develop a precise medication plan to provide comprehensive support for complex cases.
