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Defibrotide is a mixture of single-stranded oligodeoxyribonucleotides derived from the intestinal mucosa of pigs, with anti-thrombotic, thrombolytic, and fibrinolytic activities. Upon administration, and although the exact mechanism of action has yet to be fully elucidated, defibrotide induces the release of prostaglandin I2 (PGI2), E2 (PGE2), and prostacyclin and reduces the expression of adhesion molecules on endothelial cells. This relaxes the smooth muscle of blood vessels and prevents platelets from adhering to each other and to the endothelium. This protects the endothelium lining blood vessels. Defibrotide increases tissue plasminogen activator (tPA) and decreases plasminogen activator inhibitor-1 activity. This increases the activity of plasmin, prevents blood clot formation, and dissolves blood clots.
Defibrotide is a complex mixture of single-stranded polydeoxyribonucleotides derived from porcine intestinal mucosa that has antithrombotic and profibrinolytic activity and is used in the treatment of severe sinusoidal obstruction syndrome (SOS) after hematopoietic cell transplantation (HCT). Defibrotide is used in patients with severe liver injury and has not been associated with worsening of serum aminotransferase elevations during therapy and has not been linked to cases of clinically apparent, idiosyncratic liver injury.
Defibrotide Sodium is a polydeoxyribonucleotide with antithrombotic, thrombolytic, and fibrinolytic properties. Defibrotide induces the release of prostaglandin 12 and reduces the expression of adhesion molecules on endothelial cells, thereby interfering with platelet and infection. সহজ বাংলা: শ্বেত রক্তকণিকা।" data-rx-term="leukocyte" data-rx-definition="Leukocyte means white blood cell, which helps fight infection. সহজ বাংলা: শ্বেত রক্তকণিকা।">leukocyte adhesion to the endothelium. (NCI04) Defibrotide is the sodium salt of a mixture of single-stranded oligodeoxyribonucleotides derived from porcine mucosal DNA. It has been shown to have antithrombotic, pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।" data-rx-term="anti-inflammatory" data-rx-definition="Anti-inflammatory means reducing inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।">anti-inflammatory, and anti-ischemic properties (but without associated significant systemic anticoagulant effects). It is marketed under the brand names Dasovas (FM), Noravid, and Prociclide in a variety of countries. In the USA it was approved in March 2016 as Defitelio.
Mechanism of Action
The drug appears to prevent the formation of blood clots and to help dissolve blood clots by increasing levels of prostaglandin I2, E2, and prostacyclin, altering platelet activity, increasing tissue plasminogen activator function, and decreasing activity of tissue plasminogen activator inhibitor. Prostaglandin I2 relaxes the smooth muscle of blood vessels and prevents platelets from adhering to each other. Prostaglandin E2 at certain concentrations also inhibits platelet aggregation. Moreover, the drug provides additional beneficial infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।" data-rx-term="anti-inflammatory" data-rx-definition="Anti-inflammatory means reducing inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।">anti-inflammatory and antiischemic activities as recent studies have shown. It is yet unclear if the latter effects can be utilized clinically (e.g., treatment of ischemic stroke).
Defibrotide is a deoxyribonucleic acid derivative extracted from mammalian organs, which has been developed for the treatment of a number of vascular disorders. It appears to increase fibrinolysis and may possess antithrombotic, antiatherosclerotic, and anti-ischaemic actions, probably due to its ability to selectively increase prostaglandin I2 and E2 levels and to increase tissue plasminogen activator and decrease plasminogen activator inhibitor function. Defibrotide is available as an intravenous and intramuscular preparation, and also as an oral formulation for long-term use.
Indications
- Indicated for the treatment of severe hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), with renal or pulmonary dysfunction following hematopoietic stem-cell transplantation (HSCT).
- Defitelio is indicated for the treatment of severe hepatic veno-occlusive disease (VOD) also known as sinusoidal obstructive syndrome (SOS) in hematopoietic stem-cell transplantation (HSCT) therapy. It is indicated in adults and in adolescents, children, and infants over 1 month of age.
- Defibrotide is a complex mixture of single-stranded polydeoxyribonucleotides derived from porcine intestinal mucosa that has antithrombotic and profibrinolytic activity and is used in the treatment of severe sinusoidal obstruction syndrome (SOS) after hematopoietic cell transplantation (HCT). Defibrotide is used in patients with severe liver injury.
- Defibrotide injection is used to treat adults and children with hepatic veno-occlusive disease (VOD; blocked blood vessels inside the liver, also known as sinusoidal obstruction syndrome), who have kidney or lung problems after receiving a hematopoietic stem-cell transplant (HSCT; procedure in which certain blood cells are removed from the body and then returned to the bo
Use in Cancer
Defibrotide sodium is approved to treat:
- Hepatic veno-occlusive disease (also known as sinusoidal obstruction syndrome) in adults and children who also have kidney or lung problems after receiving a stem cell transplant.
Contraindications
- an increased risk of bleeding
- bleeding
- The use of defibrotide for people who are already taking anticoagulants is dangerous and the use of other drugs that affect platelet aggregation, like NSAIDs, should be done with care.
- Defibrotide should not be given to people who have a difficult time maintaining steady blood pressure.[rx]
Dosage
Strengths: 80 mg/mL
Hepatic Veno-Occlusive Disease
- 6.25 mg/kg IV every 6 hours given as a constant 2-hour infusion
- Duration of therapy: Minimum of 21 days; if signs and symptoms of hepatic venous-occlusive disease (VOD) remain after 21 days, continue this drug until resolution of VOD or up to a maximum of 60 days. Baseline body weight prior to the preparative regimen for hematopoietic stem-cell transplantation (HSCT) should be used to calculate the dose.
Pediatric Dose for Hepatic Veno-Occlusive Disease
1 Month or Older:
- 6.25 mg/kg IV every 6 hours given as a constant 2-hour infusion
- Duration of therapy: Minimum of 21 days; if signs and symptoms of hepatic venous-occlusive disease (VOD) remain after 21 days, continue this drug until resolution of VOD or up to a maximum of 60 days.
- Baseline body weight prior to the preparative regimen for hematopoietic stem-cell transplantation (HSCT) should be used to calculate the dose.
Dose Adjustments
TREATMENT MODIFICATIONS FOR TOXICITY OR INVASIVE PROCEDURES:
- Severe or Life-Threatening Hypersensitivity Reaction (Anaphylaxis): Discontinue this drug permanently; do not resume treatment.
- Persistent, Severe, or Potentially Life-Threatening Bleeding: Withhold this drug; treat the underlying cause and provide supportive care as indicated; consider resuming treatment at the same dose and infusion volume when bleeding stops and the patient is hemodynamically stable.
- Recurrent Significant Bleeding: Discontinue this drug permanently; do not resume treatment.
- Invasive Procedures: Discontinue this drug at least 2 hours prior to an invasive procedure; resume treatment after the procedure as soon as any procedure-related risk of bleeding is resolved.
Administration advice:
- Use an infusion set equipped with a 0.2-micron in-line filter.
- Flush the IV line (peripheral or central) with a 5% dextrose injection or 0.9% sodium chloride injection immediately before and after administration.
Side Effects
The Most Common
- dizziness
- diarrhea
- vomiting
- nausea
- nose bleeding
- rash
- hives
- itching
- swelling of the face, lips, tongue or throat
- unusual bleeding or bruising
- blood in urine or stool
- pain in the head or upper neck. সহজ বাংলা: মাথাব্যথা।" data-rx-term="headache" data-rx-definition="Headache means pain in the head or upper neck. সহজ বাংলা: মাথাব্যথা।">headache
- confusion
- slurred speech
- vision changes
- fever, cough, or other signs of infection
More common
- Black, tarry stools
- bloody nose
- bloody stools
- blurred vision
- chills
- confusion
- dizziness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fainting
- fast heartbeat
- fever
- lightheadedness
- rapid, shallow breathing
- sweating
- unusual tiredness or weakness
- vomiting of blood or material that looks like coffee grounds
- Chest pain
- cough or hoarseness
- lower back or side pain
- painful or difficult urination
- sneezing
- sore throat
- tightness in the chest
- troubled breathing
Rare
- abdominal pain
- dizziness
- headache
- increased menstrual bleeding
- Difficulty with swallowing
- hives, itching, or skin rash
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- itchy skin
- rash
- stiff, sore, hot, or painful joints
- sudden pain or swelling in muscles
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- signs of bleeding in the stomach (e.g., bloody, black, or tarry stools; spitting up of blood; vomiting blood or material that looks like coffee grounds)
- signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of severe skin reactions (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
Drug Interaction
| Abciximab | The risk or severity of bleeding can be increased when Abciximab is combined with Defibrotide. |
| Abrocitinib | The risk or severity of bleeding and thrombocytopenia can be increased when Defibrotide is combined with Abrocitinib. |
| Aceclofenac | The risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Defibrotide. |
| Acemetacin | The risk or severity of bleeding and hemorrhage can be increased when Defibrotide is combined with Acemetacin. |
| Acenocoumarol | The risk or severity of bleeding can be increased when Defibrotide is combined with Acenocoumarol. |
| Acetylsalicylic acid | Acetylsalicylic acid may increase the antiplatelet activities of Defibrotide. |
| Albutrepenonacog alfa | The therapeutic efficacy of Albutrepenonacog alfa can be decreased when used in combination with Defibrotide. |
| Alclofenac | The risk or severity of bleeding and hemorrhage can be increased when Alclofenac is combined with Defibrotide. |
| Aldesleukin | The risk or severity of bleeding can be increased when Defibrotide is combined with Aldesleukin. |
| Alemtuzumab | The risk or severity of bleeding can be increased when Defibrotide is combined with Alemtuzumab. |
| Alteplase | The risk or severity of bleeding can be increased when Defibrotide is combined with Alteplase. |
| Altretamine | The risk or severity of bleeding can be increased when Defibrotide is combined with Altretamine. |
| Aminophenazone | The risk or severity of bleeding and hemorrhage can be increased when Aminophenazone is combined with Defibrotide. |
| Aminosalicylic acid | The risk or severity of bleeding can be increased when Aminosalicylic acid is combined with Defibrotide. |
| Amsacrine | The risk or severity of bleeding can be increased when Defibrotide is combined with Amsacrine. |
| Anagrelide | The risk or severity of bleeding can be increased when Anagrelide is combined with Defibrotide. |
| Ancrod | The risk or severity of bleeding can be increased when Defibrotide is combined with Ancrod. |
| Andexanet alfa | The therapeutic efficacy of Andexanet alfa can be decreased when used in combination with Defibrotide. |
| Anistreplase | The risk or severity of bleeding can be increased when Defibrotide is combined with Anistreplase. |
| Anti-inhibitor | The therapeutic efficacy of Anti-inhibitor coagulant complex can be decreased when used in combination with Defibrotide. |
| Antihemophilic | The therapeutic efficacy of Antihemophilic factor (recombinant), PEGylated can be decreased when used in combination with Defibrotide. |
| Antihemophilic factor | The therapeutic efficacy of Antihemophilic factor human can be decreased when used in combination with Defibrotide. |
| Antihemophilic | The therapeutic efficacy of Antihemophilic factor, human recombinant can be decreased when used in combination with Defibrotide. |
| Antipyrine | The risk or severity of bleeding and hemorrhage can be increased when Antipyrine is combined with Defibrotide. |
| Antithrombin Alfa | The risk or severity of bleeding can be increased when Defibrotide is combined with Antithrombin Alfa. |
| Antithrombin III | The risk or severity of bleeding can be increased when Defibrotide is combined with Antithrombin III human. |
| Antrafenine | The risk or severity of bleeding and hemorrhage can be increased when Antrafenine is combined with Defibrotide. |
| Apixaban | Apixaban may increase the anticoagulant activities of Defibrotide. |
| Aprotinin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Aprotinin. |
| Ardeparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Ardeparin. |
| Argatroban | The risk or severity of bleeding can be increased when Defibrotide is combined with Argatroban. |
| Arsenic trioxide | The risk or severity of bleeding can be increased when Defibrotide is combined with Arsenic trioxide. |
| Azacitidine | The risk or severity of bleeding can be increased when Defibrotide is combined with Azacitidine. |
| Azficel-T | The risk or severity of adverse effects can be increased when Defibrotide is combined with Azficel-T. |
| Azithromycin | The risk or severity of adverse effects can be increased when Azithromycin is combined with Defibrotide. |
| Balsalazide | The risk or severity of bleeding and hemorrhage can be increased when Balsalazide is combined with Defibrotide. |
| Belinostat | The risk or severity of bleeding can be increased when Defibrotide is combined with Belinostat. |
| Bemiparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Bemiparin. |
| Bendamustine | The risk or severity of bleeding can be increased when Defibrotide is combined with Bendamustine. |
| Bendroflumethiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Bendroflumethiazide. |
| Benorilate | The risk or severity of bleeding and hemorrhage can be increased when Benorilate is combined with Defibrotide. |
| Benoxaprofen | The risk or severity of bleeding and hemorrhage can be increased when Benoxaprofen is combined with Defibrotide. |
| Benzthiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Benzthiazide. |
| Benzydamine | The risk or severity of bleeding and hemorrhage can be increased when Benzydamine is combined with Defibrotide. |
| Beroctocog alfa | The therapeutic efficacy of Beroctocog alfa can be decreased when used in combination with Defibrotide. |
| Betrixaban | The risk or severity of bleeding can be increased when Defibrotide is combined with Betrixaban. |
| Bexarotene | The risk or severity of bleeding can be increased when Defibrotide is combined with Bexarotene. |
| Bismuth subsalicylate | The risk or severity of bleeding can be increased when Bismuth subsalicylate is combined with Defibrotide. |
| Bivalirudin | The risk or severity of bleeding can be increased when Defibrotide is combined with Bivalirudin. |
| Blinatumomab | The risk or severity of bleeding can be increased when Defibrotide is combined with Blinatumomab. |
| Bortezomib | The risk or severity of bleeding can be increased when Defibrotide is combined with Bortezomib. |
| Bosutinib | The risk or severity of bleeding can be increased when Defibrotide is combined with Bosutinib. |
| Bumadizone | The risk or severity of bleeding and hemorrhage can be increased when Bumadizone is combined with Defibrotide. |
| Busulfan | The risk or severity of bleeding can be increased when Defibrotide is combined with Busulfan. |
| Cabazitaxel | The risk or severity of bleeding can be increased when Defibrotide is combined with Cabazitaxel. |
| Cangrelor | The risk or severity of bleeding can be increased when Defibrotide is combined with Cangrelor. |
| Capecitabine | The risk or severity of bleeding can be increased when Defibrotide is combined with Capecitabine. |
| Caplacizumab | The risk or severity of bleeding can be increased when Caplacizumab is combined with Defibrotide. |
| Carbamazepine | The risk or severity of bleeding can be increased when Defibrotide is combined with Carbamazepine. |
| Carbimazole | Carbimazole may increase the anticoagulant activities of Defibrotide. |
| Carboplatin | The risk or severity of bleeding can be increased when Defibrotide is combined with Carboplatin. |
| Carfilzomib | The risk or severity of bleeding can be increased when Defibrotide is combined with Carfilzomib. |
| Carmustine | The risk or severity of bleeding can be increased when Defibrotide is combined with Carmustine. |
| Carprofen | The risk or severity of bleeding and hemorrhage can be increased when Carprofen is combined with Defibrotide. |
| Catridecacog | The therapeutic efficacy of Catridecacog can be decreased when used in combination with Defibrotide. |
| Cefaclor | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefaclor. |
| Cefadroxil | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefadroxil. |
| Cefalotin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefalotin. |
| Cefamandole | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefamandole. |
| Cefamandole nafate | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefamandole nafate. |
| Cefapirin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefapirin. |
| Cefazolin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefazolin. |
| Cefdinir | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefdinir. |
| Cefditoren | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefditoren. |
| Cefepime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefepime. |
| Cefixime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefixime. |
| Cefmenoxime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefmenoxime. |
| Cefmetazole | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefmetazole. |
| Cefonicid | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefonicid. |
| Cefoperazone | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefoperazone. |
| Ceforanide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceforanide. |
| Cefotaxime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefotaxime. |
| Cefotetan | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefotetan. |
| Cefotiam | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefotiam. |
| Cefoxitin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefoxitin. |
| Cefpiramide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefpiramide. |
| Cefpirome | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefpirome. |
| Cefpodoxime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefpodoxime. |
| Cefprozil | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefprozil. |
| Cefradine | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefradine. |
| Ceftaroline fosamil | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftaroline fosamil. |
| Ceftazidime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftazidime. |
| Ceftibuten | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftibuten. |
| Ceftizoxime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftizoxime. |
| Ceftobiprole | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftobiprole. |
| Ceftobiprole medocaril | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftobiprole medocaril. |
| Ceftolozane | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftolozane. |
| Ceftriaxone | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ceftriaxone. |
| Cefuroxime | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cefuroxime. |
| Celecoxib | The risk or severity of bleeding and hemorrhage can be increased when Celecoxib is combined with Defibrotide. |
| Cephalexin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cephalexin. |
| Cephaloglycin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cephaloglycin. |
| Chenodeoxycholic acid | The risk or severity of adverse effects can be increased when Defibrotide is combined with Chenodeoxycholic acid. |
| Chlorambucil | The risk or severity of bleeding can be increased when Defibrotide is combined with Chlorambucil. |
| Chloramphenicol | The risk or severity of bleeding can be increased when Defibrotide is combined with Chloramphenicol. |
| Chlorothiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Chlorothiazide. |
| Cholic Acid | The risk or severity of adverse effects can be increased when Defibrotide is combined with Cholic Acid. |
| Choline magnesium | The risk or severity of bleeding and hemorrhage can be increased when Choline magnesium trisalicylate is combined with Defibrotide. |
| Choline salicylate | The risk or severity of bleeding can be increased when Choline salicylate is combined with Defibrotide. |
| Cilostazol | The risk or severity of bleeding can be increased when Cilostazol is combined with Defibrotide. |
| Cisplatin | The risk or severity of bleeding can be increased when Defibrotide is combined with Cisplatin. |
| Citalopram | The risk or severity of hemorrhage can be increased when Citalopram is combined with Defibrotide. |
| Cladribine | The risk or severity of bleeding can be increased when Defibrotide is combined with Cladribine. |
| Clofarabine | The risk or severity of bleeding can be increased when Defibrotide is combined with Clofarabine. |
| Clopidogrel | The risk or severity of bleeding can be increased when Clopidogrel is combined with Defibrotide. |
| Coagulation Factor IX | The therapeutic efficacy of Coagulation Factor IX (Recombinant) can be decreased when used in combination with Defibrotide. |
| Coagulation Factor IX | The therapeutic efficacy of Coagulation Factor IX Human can be decreased when used in combination with Defibrotide. |
| Coagulation factor VII | The therapeutic efficacy of Coagulation factor VII human can be decreased when used in combination with Defibrotide. |
| Coagulation | The therapeutic efficacy of Coagulation factor VIIa Recombinant Human can be decreased when used in combination with Defibrotide. |
| Coagulation factor X | The therapeutic efficacy of Coagulation factor X human can be decreased when used in combination with Defibrotide. |
| Collagenase | The risk or severity of adverse effects can be increased when Defibrotide is combined with Collagenase clostridium histolyticum. |
| Conjugated estrogens | Conjugated estrogens may decrease the anticoagulant activities of Defibrotide. |
| Cyclopenthiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cyclopenthiazide. |
| Cyclophosphamide | The risk or severity of bleeding can be increased when Defibrotide is combined with Cyclophosphamide. |
| Cyclothiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Cyclothiazide. |
| Cyproterone acetate | The risk or severity of adverse effects can be increased when Cyproterone acetate is combined with Defibrotide. |
| Cytarabine | The risk or severity of bleeding can be increased when Defibrotide is combined with Cytarabine. |
| Dabigatran | The risk or severity of bleeding can be increased when Defibrotide is combined with Dabigatran. |
| Dabigatran etexilate | Dabigatran etexilate may increase the anticoagulant activities of Defibrotide. |
| Dacarbazine | The risk or severity of bleeding can be increased when Defibrotide is combined with Dacarbazine. |
| Dactinomycin | The risk or severity of bleeding can be increased when Defibrotide is combined with Dactinomycin. |
| Dalteparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Dalteparin. |
| Damoctocog alfa pegol | The therapeutic efficacy of Damoctocog alfa pegol can be decreased when used in combination with Defibrotide. |
| Danaparoid | The risk or severity of bleeding can be increased when Defibrotide is combined with Danaparoid. |
| Dasatinib | The risk or severity of bleeding and hemorrhage can be increased when Dasatinib is combined with Defibrotide. |
| Daunorubicin | The risk or severity of bleeding can be increased when Defibrotide is combined with Daunorubicin. |
| Decitabine | The risk or severity of bleeding can be increased when Defibrotide is combined with Decitabine. |
| Deferasirox | The risk or severity of gastrointestinal bleeding can be increased when Defibrotide is combined with Deferasirox. |
| Dehydrocholic acid | The risk or severity of adverse effects can be increased when Defibrotide is combined with Dehydrocholic acid. |
| Deoxycholic acid | The risk or severity of adverse effects can be increased when Defibrotide is combined with Deoxycholic acid. |
| Desirudin | The risk or severity of bleeding can be increased when Defibrotide is combined with Desirudin. |
| Desogestrel | The risk or severity of adverse effects can be increased when Desogestrel is combined with Defibrotide. |
| Desvenlafaxine | The risk or severity of hemorrhage can be increased when Desvenlafaxine is combined with Defibrotide. |
| Dexibuprofen | The risk or severity of bleeding can be increased when Dexibuprofen is combined with Defibrotide. |
| Dexketoprofen | The risk or severity of bleeding and hemorrhage can be increased when Dexketoprofen is combined with Defibrotide. |
| Dexrazoxane | The risk or severity of bleeding can be increased when Defibrotide is combined with Dexrazoxane. |
| Dextran | The risk or severity of bleeding can be increased when Defibrotide is combined with Dextran. |
| Diclofenac | The risk or severity of bleeding and hemorrhage can be increased when Diclofenac is combined with Defibrotide. |
| Dicoumarol | The risk or severity of bleeding can be increased when Defibrotide is combined with Dicoumarol. |
| Dienogest | The risk or severity of adverse effects can be increased when Dienogest is combined with Defibrotide. |
| Diethylstilbestrol | Diethylstilbestrol may decrease the anticoagulant activities of Defibrotide. |
| Diflunisal | The risk or severity of bleeding and hemorrhage can be increased when Diflunisal is combined with Defibrotide. |
| Dinutuximab | The risk or severity of bleeding can be increased when Defibrotide is combined with Dinutuximab. |
| Dipyridamole | The risk or severity of bleeding can be increased when Dipyridamole is combined with Defibrotide. |
| Docetaxel | The risk or severity of bleeding can be increased when Defibrotide is combined with Docetaxel. |
| Doxorubicin | The risk or severity of bleeding can be increased when Defibrotide is combined with Doxorubicin. |
| Doxycycline | The risk or severity of bleeding can be increased when Doxycycline is combined with Defibrotide. |
| Drospirenone | The risk or severity of adverse effects can be increased when Drospirenone is combined with Defibrotide. |
| Drostanolone | Drostanolone propionate may increase the anticoagulant activities of Defibrotide. |
| Drotrecogin alfa | The risk or severity of bleeding can be increased when Defibrotide is combined with Drotrecogin alfa. |
| Duloxetine | The risk or severity of hemorrhage can be increased when Duloxetine is combined with Defibrotide. |
| Dydrogesterone | Dydrogesterone may decrease the anticoagulant activities of Defibrotide. |
| Edetic acid | The risk or severity of bleeding can be increased when Defibrotide is combined with Edetic acid. |
| Edoxaban | The risk or severity of bleeding can be increased when Edoxaban is combined with Defibrotide. |
| Eftrenonacog alfa | The therapeutic efficacy of Eftrenonacog alfa can be decreased when used in combination with Defibrotide. |
| Emicizumab | The therapeutic efficacy of Emicizumab can be decreased when used in combination with Defibrotide. |
| Enoxaparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Enoxaparin. |
| Epirubicin | The risk or severity of bleeding can be increased when Defibrotide is combined with Epirubicin. |
| Epoprostenol | The risk or severity of bleeding can be increased when Epoprostenol is combined with Defibrotide. |
| Eptifibatide | The risk or severity of bleeding can be increased when Eptifibatide is combined with Defibrotide. |
| Eribulin | The risk or severity of bleeding can be increased when Defibrotide is combined with Eribulin. |
| Erythromycin | The risk or severity of bleeding can be increased when Erythromycin is combined with Defibrotide. |
| Escitalopram | The risk or severity of bleeding can be increased when Escitalopram is combined with Defibrotide. |
| Esterified estrogens | Esterified estrogens may decrease the anticoagulant activities of Defibrotide. |
| Estetrol | The risk or severity of adverse effects can be increased when Estetrol is combined with Defibrotide. |
| Estradiol | The risk or severity of adverse effects can be increased when Estradiol is combined with Defibrotide. |
| Estradiol acetate | Estradiol acetate may decrease the anticoagulant activities of Defibrotide. |
| Estradiol benzoate | Estradiol benzoate may decrease the anticoagulant activities of Defibrotide. |
| Estradiol cypionate | Estradiol cypionate may decrease the anticoagulant activities of Defibrotide. |
| Estradiol valerate | Estradiol valerate may decrease the anticoagulant activities of Defibrotide. |
| Estriol | Estriol may decrease the anticoagulant activities of Defibrotide. |
| Estrone sulfate | Estrone sulfate may decrease the anticoagulant activities of Defibrotide. |
| Ethinylestradiol | The risk or severity of adverse effects can be increased when Ethinylestradiol is combined with Defibrotide. |
| Ethynodiol diacetate | The risk or severity of adverse effects can be increased when Ethynodiol diacetate is combined with Defibrotide. |
| Etodolac | The risk or severity of bleeding and hemorrhage can be increased when Etodolac is combined with Defibrotide. |
| Etonogestrel | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Etonogestrel. |
| Etoposide | The risk or severity of bleeding can be increased when Defibrotide is combined with Etoposide. |
| Etoricoxib | The risk or severity of bleeding and hemorrhage can be increased when Etoricoxib is combined with Defibrotide. |
| Everolimus | The risk or severity of bleeding can be increased when Defibrotide is combined with Everolimus. |
| Factor IX Complex | The therapeutic efficacy of Factor IX Complex (Human) can be decreased when used in combination with Defibrotide. |
| Factor XIII (human) | The therapeutic efficacy of Factor XIII (human) can be decreased when used in combination with Defibrotide. |
| Fenbufen | The risk or severity of bleeding and hemorrhage can be increased when Fenbufen is combined with Defibrotide. |
| Fenoprofen | The risk or severity of bleeding and hemorrhage can be increased when Fenoprofen is combined with Defibrotide. |
| Fibrinogen human | The therapeutic efficacy of Fibrinogen human can be decreased when used in combination with Defibrotide. |
| Floctafenine | The risk or severity of bleeding and hemorrhage can be increased when Floctafenine is combined with Defibrotide. |
| Floxuridine | The risk or severity of bleeding can be increased when Defibrotide is combined with Floxuridine. |
| Flucytosine | The risk or severity of bleeding can be increased when Defibrotide is combined with Flucytosine. |
| Fludarabine | The risk or severity of bleeding can be increased when Defibrotide is combined with Fludarabine. |
| Fluindione | The risk or severity of bleeding can be increased when Defibrotide is combined with Fluindione. |
| Fluorouracil | The risk or severity of bleeding can be increased when Defibrotide is combined with Fluorouracil. |
| Fluoxetine | The risk or severity of hemorrhage can be increased when Fluoxetine is combined with Defibrotide. |
| Flurbiprofen | The risk or severity of bleeding and hemorrhage can be increased when Flurbiprofen is combined with Defibrotide. |
| Fluvoxamine | The risk or severity of hemorrhage can be increased when Fluvoxamine is combined with Defibrotide. |
| Fondaparinux | The risk or severity of bleeding can be increased when Defibrotide is combined with Fondaparinux. |
| Gemcitabine | The risk or severity of bleeding can be increased when Defibrotide is combined with Gemcitabine. |
| Gemtuzumab ozogamicin | The risk or severity of bleeding can be increased when Defibrotide is combined with Gemtuzumab ozogamicin. |
| Gestrinone | The risk or severity of adverse effects can be increased when Gestrinone is combined with Defibrotide. |
| Ginkgo biloba | Ginkgo biloba may increase the anticoagulant activities of Defibrotide. |
| Glucosamine | Glucosamine may increase the antiplatelet activities of Defibrotide. |
| Glycol salicylate | The risk or severity of bleeding and hemorrhage can be increased when Glycol salicylate is combined with Defibrotide. |
| Hemin | Hemin may increase the anticoagulant activities of Defibrotide. |
| Heparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Heparin. |
| Hydrochlorothiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Hydrochlorothiazide. |
| Hydroflumethiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Hydroflumethiazide. |
| Hydroxyprogesterone | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Hydroxyprogesterone caproate. |
| Hydroxyurea | The risk or severity of bleeding can be increased when Defibrotide is combined with Hydroxyurea. |
| Ibritumomab tiuxetan | The risk or severity of adverse effects can be increased when Defibrotide is combined with Ibritumomab tiuxetan. |
| Ibrutinib | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Defibrotide. |
| Ibuprofen | The risk or severity of bleeding can be increased when Ibuprofen is combined with Defibrotide. |
| Icosapent | The risk or severity of bleeding and hemorrhage can be increased when Icosapent is combined with Defibrotide. |
| Icosapent ethyl | The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Defibrotide. |
| Idarubicin | The risk or severity of bleeding can be increased when Defibrotide is combined with Idarubicin. |
| Ifosfamide | The risk or severity of bleeding can be increased when Ifosfamide is combined with Defibrotide. |
| Iloprost | The risk or severity of bleeding can be increased when Iloprost is combined with Defibrotide. |
| Imatinib | The risk or severity of bleeding can be increased when Defibrotide is combined with Imatinib. |
| Indomethacin | The risk or severity of bleeding and hemorrhage can be increased when Indomethacin is combined with Defibrotide. |
| Interferon alfa-2a | The risk or severity of bleeding can be increased when Defibrotide is combined with Interferon alfa-2a. |
| Interferon alfa-2b | The risk or severity of bleeding can be increased when Defibrotide is combined with Interferon alfa-2b. |
| Interferon alfa-n1 | The risk or severity of bleeding can be increased when Defibrotide is combined with Interferon alfa-n1. |
| Interferon alfa-n3 | The risk or severity of bleeding can be increased when Defibrotide is combined with Interferon alfa-n3. |
| Interferon alfacon-1 | The risk or severity of bleeding can be increased when Defibrotide is combined with Interferon alfacon-1. |
| Interferon beta-1b | The risk or severity of bleeding can be increased when Defibrotide is combined with Interferon beta-1b. |
| Interferon gamma-1b | The risk or severity of bleeding can be increased when Defibrotide is combined with Interferon gamma-1b. |
| Irinotecan | The risk or severity of bleeding can be increased when Defibrotide is combined with Irinotecan. |
| Isocarboxazid | The risk or severity of bleeding and hemorrhage can be increased when Isocarboxazid is combined with Defibrotide. |
| Isoxicam | The risk or severity of bleeding and hemorrhage can be increased when Isoxicam is combined with Defibrotide. |
| Ixabepilone | The risk or severity of bleeding can be increased when Defibrotide is combined with Ixabepilone. |
| Ketoprofen | The risk or severity of bleeding and hemorrhage can be increased when Ketoprofen is combined with Defibrotide. |
| Ketorolac | The risk or severity of bleeding and hemorrhage can be increased when Ketorolac is combined with Defibrotide. |
| Latamoxef | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Latamoxef. |
| Lenalidomide | The risk or severity of bleeding can be increased when Defibrotide is combined with Lenalidomide. |
| Lepirudin | The risk or severity of bleeding can be increased when Defibrotide is combined with Lepirudin. |
| Levocarnitine | The therapeutic efficacy of Defibrotide can be increased when used in combination with Levocarnitine. |
| Levomilnacipran | The risk or severity of hemorrhage can be increased when Levomilnacipran is combined with Defibrotide. |
| Levonorgestrel | The risk or severity of adverse effects can be increased when Levonorgestrel is combined with Defibrotide. |
| Linezolid | The risk or severity of bleeding and hemorrhage can be increased when Linezolid is combined with Defibrotide. |
| Lomustine | The risk or severity of bleeding can be increased when Defibrotide is combined with Lomustine. |
| Loracarbef | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Loracarbef. |
| Lornoxicam | The risk or severity of bleeding and hemorrhage can be increased when Lornoxicam is combined with Defibrotide. |
| Loxoprofen | The risk or severity of bleeding and hemorrhage can be increased when Loxoprofen is combined with Defibrotide. |
| Lumiracoxib | The risk or severity of bleeding and hemorrhage can be increased when Lumiracoxib is combined with Defibrotide. |
| Lynestrenol | The risk or severity of adverse effects can be increased when Lynestrenol is combined with Defibrotide. |
| Mechlorethamine | The risk or severity of bleeding can be increased when Defibrotide is combined with Mechlorethamine. |
| Meclofenamic acid | The risk or severity of bleeding and hemorrhage can be increased when Meclofenamic acid is combined with Defibrotide. |
| Medrogestone | Medrogestone may decrease the anticoagulant activities of Defibrotide. |
| Medroxyprogesterone | The risk or severity of adverse effects can be increased when Medroxyprogesterone acetate is combined with Defibrotide. |
| Mefenamic acid | The risk or severity of bleeding and hemorrhage can be increased when Mefenamic acid is combined with Defibrotide. |
| Megestrol acetate | The risk or severity of adverse effects can be increased when Megestrol acetate is combined with Defibrotide. |
| Meloxicam | The risk or severity of bleeding and hemorrhage can be increased when Meloxicam is combined with Defibrotide. |
| Melphalan | The risk or severity of bleeding can be increased when Defibrotide is combined with Melphalan. |
| Menthyl salicylate | The risk or severity of bleeding and hemorrhage can be increased when Menthyl salicylate is combined with Defibrotide. |
| Mercaptopurine | The risk or severity of bleeding can be increased when Defibrotide is combined with Mercaptopurine. |
| Mesalazine | The risk or severity of bleeding and hemorrhage can be increased when Mesalazine is combined with Defibrotide. |
| Mestranol | The risk or severity of adverse effects can be increased when Mestranol is combined with Defibrotide. |
| Methimazole | Methimazole may increase the anticoagulant activities of Defibrotide. |
| Methotrexate | The risk or severity of bleeding can be increased when Defibrotide is combined with Methotrexate. |
| Methyl salicylate | The risk or severity of bleeding can be increased when Methyl salicylate is combined with Defibrotide. |
| Methylene blue | The risk or severity of bleeding and hemorrhage can be increased when Methylene blue is combined with Defibrotide. |
| Mifepristone | The risk or severity of adverse effects can be increased when Mifepristone is combined with Defibrotide. |
| Milnacipran | The risk or severity of hemorrhage can be increased when Milnacipran is combined with Defibrotide. |
| Minaprine | The risk or severity of bleeding and hemorrhage can be increased when Minaprine is combined with Defibrotide. |
| Mitomycin | The risk or severity of bleeding can be increased when Defibrotide is combined with Mitomycin. |
| Mitoxantrone | The risk or severity of bleeding can be increased when Defibrotide is combined with Mitoxantrone. |
| Moclobemide | The risk or severity of bleeding and hemorrhage can be increased when Moclobemide is combined with Defibrotide. |
| Moroctocog alfa | The therapeutic efficacy of Moroctocog alfa can be decreased when used in combination with Defibrotide. |
| Mosunetuzumab | The risk or severity of bleeding can be increased when Defibrotide is combined with Mosunetuzumab. |
| Nabumetone | The risk or severity of bleeding and hemorrhage can be increased when Nabumetone is combined with Defibrotide. |
| Nadroparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Nadroparin. |
| Naproxen | The risk or severity of bleeding and hemorrhage can be increased when Naproxen is combined with Defibrotide. |
| Nefazodone | The risk or severity of hemorrhage can be increased when Nefazodone is combined with Defibrotide. |
| Nelarabine | The risk or severity of bleeding can be increased when Defibrotide is combined with Nelarabine. |
| Nialamide | The risk or severity of bleeding and hemorrhage can be increased when Nialamide is combined with Defibrotide. |
| Nilotinib | The risk or severity of bleeding can be increased when Defibrotide is combined with Nilotinib. |
| Nimesulide | The risk or severity of bleeding and hemorrhage can be increased when Nimesulide is combined with Defibrotide. |
| Nintedanib | The risk or severity of bleeding can be increased when Nintedanib is combined with Defibrotide. |
| Nomegestrol | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Nomegestrol. |
| Nomegestrol acetate | The risk or severity of adverse effects can be increased when Nomegestrol acetate is combined with Defibrotide. |
| Nonacog beta pegol | The therapeutic efficacy of Nonacog beta pegol can be decreased when used in combination with Defibrotide. |
| Norelgestromin | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Norelgestromin. |
| Norethisterone | The risk or severity of adverse effects can be increased when Norethisterone is combined with Defibrotide. |
| Norethynodrel | The risk or severity of adverse effects can be increased when Norethynodrel is combined with Defibrotide. |
| Norgestimate | The risk or severity of adverse effects can be increased when Norgestimate is combined with Defibrotide. |
| Norgestrel | The risk or severity of adverse effects can be increased when Norgestrel is combined with Defibrotide. |
| Obeticholic acid | The risk or severity of adverse effects can be increased when Defibrotide is combined with Obeticholic acid. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Defibrotide is combined with Obinutuzumab. |
| Olaparib | The risk or severity of bleeding can be increased when Defibrotide is combined with Olaparib. |
| Olive oil | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Olive oil. |
| Olsalazine | The risk or severity of bleeding and hemorrhage can be increased when Olsalazine is combined with Defibrotide. |
| Omacetaxine | The risk or severity of bleeding can be increased when Defibrotide is combined with Omacetaxine mepesuccinate. |
| Omega-3 fatty acids | Omega-3 fatty acids may increase the antiplatelet activities of Defibrotide. |
| Omega-3-acid ethyl | The risk or severity of bleeding can be increased when Omega-3-acid ethyl esters is combined with Defibrotide. |
| Omega-3-carboxylic | The therapeutic efficacy of Defibrotide can be increased when used in combination with Omega-3-carboxylic acids. |
| Oxaliplatin | The risk or severity of bleeding can be increased when Defibrotide is combined with Oxaliplatin. |
| Oxaprozin | The risk or severity of bleeding and hemorrhage can be increased when Oxaprozin is combined with Defibrotide. |
| Oxyphenbutazone | The risk or severity of bleeding and hemorrhage can be increased when Oxyphenbutazone is combined with Defibrotide. |
| Paclitaxel | The risk or severity of bleeding can be increased when Defibrotide is combined with Paclitaxel. |
| Padeliporfin | The risk or severity of bleeding can be increased when Defibrotide is combined with Padeliporfin. |
| Palbociclib | The risk or severity of bleeding can be increased when Defibrotide is combined with Palbociclib. |
| Pantothenic acid | The therapeutic efficacy of Pantothenic acid can be decreased when used in combination with Defibrotide. |
| Parecoxib | The risk or severity of bleeding and hemorrhage can be increased when Parecoxib is combined with Defibrotide. |
| Pargyline | The risk or severity of bleeding and hemorrhage can be increased when Pargyline is combined with Defibrotide. |
| Parnaparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Parnaparin. |
| Paroxetine | The risk or severity of hemorrhage can be increased when Paroxetine is combined with Defibrotide. |
| Peginterferon alfa-2a | The risk or severity of bleeding can be increased when Defibrotide is combined with Peginterferon alfa-2a. |
| Peginterferon alfa-2b | The risk or severity of bleeding can be increased when Defibrotide is combined with Peginterferon alfa-2b. |
| Peginterferon beta-1a | The risk or severity of bleeding can be increased when Defibrotide is combined with Peginterferon beta-1a. |
| Pemetrexed | The risk or severity of bleeding can be increased when Defibrotide is combined with Pemetrexed. |
| Penicillamine | The risk or severity of bleeding can be increased when Defibrotide is combined with Penicillamine. |
| Pentosan polysulfate | The risk or severity of adverse effects can be increased when Pentosan polysulfate is combined with Defibrotide. |
| Pentostatin | The risk or severity of bleeding can be increased when Defibrotide is combined with Pentostatin. |
| Pentoxifylline | The therapeutic efficacy of Defibrotide can be increased when used in combination with Pentoxifylline. |
| Phenelzine | The risk or severity of bleeding and hemorrhage can be increased when Phenelzine is combined with Defibrotide. |
| Phenindione | The risk or severity of bleeding can be increased when Defibrotide is combined with Phenindione. |
| Phenprocoumon | The risk or severity of bleeding can be increased when Defibrotide is combined with Phenprocoumon. |
| Phenyl aminosalicylate | The risk or severity of bleeding can be increased when Phenyl aminosalicylate is combined with Defibrotide. |
| Phenylalanine | The risk or severity of bleeding can be increased when Defibrotide is combined with Phenylalanine. |
| Phenylbutazone | The risk or severity of bleeding and hemorrhage can be increased when Phenylbutazone is combined with Defibrotide. |
| Piroxicam | The risk or severity of bleeding and hemorrhage can be increased when Piroxicam is combined with Defibrotide. |
| Polyestradiol | Polyestradiol phosphate may decrease the anticoagulant activities of Defibrotide. |
| Polythiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Polythiazide. |
| Pomalidomide | The risk or severity of bleeding can be increased when Defibrotide is combined with Pomalidomide. |
| Ponatinib | The risk or severity of bleeding can be increased when Defibrotide is combined with Ponatinib. |
| Potassium Iodide | Potassium Iodide may increase the anticoagulant activities of Defibrotide. |
| Potassium perchlorate | Potassium perchlorate may increase the anticoagulant activities of Defibrotide. |
| Prasugrel | The risk or severity of bleeding can be increased when Defibrotide is combined with Prasugrel. |
| Procaine | The risk or severity of bleeding and hemorrhage can be increased when Procaine is combined with Defibrotide. |
| Procarbazine | The risk or severity of bleeding and hemorrhage can be increased when Procarbazine is combined with Defibrotide. |
| Progesterone | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Progesterone. |
| Propylthiouracil | Propylthiouracil may increase the anticoagulant activities of Defibrotide. |
| Protein C | The risk or severity of bleeding can be increased when Defibrotide is combined with Protein C. |
| Protein S human | The risk or severity of bleeding can be increased when Defibrotide is combined with Protein S human. |
| Prothrombin | The therapeutic efficacy of Prothrombin can be decreased when used in combination with Defibrotide. |
| Quinestrol | Quinestrol may decrease the anticoagulant activities of Defibrotide. |
| Quinidine | The therapeutic efficacy of Defibrotide can be increased when used in combination with Quinidine. |
| Quinine | The therapeutic efficacy of Defibrotide can be increased when used in combination with Quinine. |
| Raltitrexed | The risk or severity of bleeding can be increased when Defibrotide is combined with Raltitrexed. |
| Rasagiline | The risk or severity of bleeding and hemorrhage can be increased when Rasagiline is combined with Defibrotide. |
| Reteplase | The risk or severity of bleeding can be increased when Defibrotide is combined with Reteplase. |
| Reviparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Reviparin. |
| Rituximab | The risk or severity of bleeding can be increased when Defibrotide is combined with Rituximab. |
| Rivaroxaban | Defibrotide may increase the anticoagulant activities of Rivaroxaban. |
| Rofecoxib | The risk or severity of bleeding and hemorrhage can be increased when Rofecoxib is combined with Defibrotide. |
| Ropeginterferon alfa | The risk or severity of bleeding can be increased when Defibrotide is combined with Ropeginterferon alfa-2b. |
| Rurioctocog alfa | The therapeutic efficacy of Rurioctocog alfa pegol can be decreased when used in combination with Defibrotide. |
| Ruxolitinib | The risk or severity of bleeding can be increased when Defibrotide is combined with Ruxolitinib. |
| Safinamide | The risk or severity of bleeding and hemorrhage can be increased when Safinamide is combined with Defibrotide. |
| Salicylamide | The risk or severity of bleeding and hemorrhage can be increased when Salicylamide is combined with Defibrotide. |
| Salicylic acid | The risk or severity of bleeding and hemorrhage can be increased when Salicylic acid is combined with Defibrotide. |
| Salsalate | The risk or severity of bleeding and hemorrhage can be increased when Salsalate is combined with Defibrotide. |
| Selegiline | The risk or severity of bleeding and hemorrhage can be increased when Selegiline is combined with Defibrotide. |
| Sertraline | The risk or severity of bleeding can be increased when Sertraline is combined with Defibrotide. |
| Sibutramine | The risk or severity of hemorrhage can be increased when Sibutramine is combined with Defibrotide. |
| Sildenafil | The risk or severity of hemorrhage can be increased when Defibrotide is combined with Sildenafil. |
| Sirolimus | The risk or severity of bleeding can be increased when Defibrotide is combined with Sirolimus. |
| Sodium citrate | The risk or severity of bleeding can be increased when Defibrotide is combined with Sodium citrate. |
| Sorafenib | The risk or severity of bleeding can be increased when Defibrotide is combined with Sorafenib. |
| Soybean oil | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Soybean oil. |
| Streptokinase | The risk or severity of bleeding can be increased when Defibrotide is combined with Streptokinase. |
| Streptozocin | The risk or severity of bleeding can be increased when Defibrotide is combined with Streptozocin. |
| Sugammadex | The risk or severity of bleeding and hemorrhage can be increased when Defibrotide is combined with Sugammadex. |
| Sulfasalazine | The risk or severity of bleeding and hemorrhage can be increased when Sulfasalazine is combined with Defibrotide. |
| Sulfinpyrazone | The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Defibrotide. |
| Sulindac | The risk or severity of bleeding and hemorrhage can be increased when Sulindac is combined with Defibrotide. |
| Sulodexide | The risk or severity of bleeding can be increased when Defibrotide is combined with Sulodexide. |
| Susoctocog alfa | The therapeutic efficacy of Susoctocog alfa can be decreased when used in combination with Defibrotide. |
| Sy Estrogens, A | Synthetic Conjugated Estrogens, A may decrease the anticoagulant activities of Defibrotide. |
| S Estrogens, B | Synthetic Conjugated Estrogens, B may decrease the anticoagulant activities of Defibrotide. |
| Tacrolimus | The risk or severity of bleeding can be increased when Defibrotide is combined with Tacrolimus. |
| Tamoxifen | The risk or severity of bleeding can be increased when Tamoxifen is combined with Defibrotide. |
| Taurocholic acid | The risk or severity of adverse effects can be increased when Defibrotide is combined with Taurocholic acid. |
| Tauroursodeoxycholic | The risk or severity of adverse effects can be increased when Defibrotide is combined with Tauroursodeoxycholic acid. |
| Tazobactam | The risk or severity of bleeding can be increased when Tazobactam is combined with Defibrotide. |
| Tedizolid phosphate | The risk or severity of bleeding can be increased when Defibrotide is combined with Tedizolid phosphate. |
| Temozolomide | The risk or severity of bleeding can be increased when Defibrotide is combined with Temozolomide. |
| Temsirolimus | The risk or severity of bleeding can be increased when Defibrotide is combined with Temsirolimus. |
| Tenecteplase | The risk or severity of bleeding can be increased when Defibrotide is combined with Tenecteplase. |
| Teniposide | The risk or severity of bleeding can be increased when Defibrotide is combined with Teniposide. |
| Tenoxicam | The risk or severity of bleeding and hemorrhage can be increased when Tenoxicam is combined with Defibrotide. |
| Testosterone | Testosterone may increase the anticoagulant activities of Defibrotide. |
| Testosterone cypionate | Testosterone cypionate may increase the anticoagulant activities of Defibrotide. |
| Testosterone | Testosterone enantate benzilic acid hydrazone may increase the anticoagulant activities of Defibrotide. |
| Testosterone enanthate | Testosterone enanthate may increase the anticoagulant activities of Defibrotide. |
| Testosterone propiona | Testosterone propionate may increase the anticoagulant activities of Defibrotide. |
| Testosterone undecanoate | Testosterone undecanoate may increase the anticoagulant activities of Defibrotide. |
| Thalidomide | The risk or severity of bleeding can be increased when Defibrotide is combined with Thalidomide. |
| Thiotepa | The risk or severity of bleeding can be increased when Defibrotide is combined with Thiotepa. |
| Tiaprofenic acid | The risk or severity of bleeding and hemorrhage can be increased when Tiaprofenic acid is combined with Defibrotide. |
| Tibolone | Tibolone may increase the anticoagulant activities of Defibrotide. |
| Ticagrelor | The risk or severity of bleeding can be increased when Defibrotide is combined with Ticagrelor. |
| Ticlopidine | The risk or severity of bleeding can be increased when Ticlopidine is combined with Defibrotide. |
| Tinzaparin | The risk or severity of bleeding can be increased when Defibrotide is combined with Tinzaparin. |
| Tioguanine | The risk or severity of bleeding can be increased when Defibrotide is combined with Tioguanine. |
| Tipranavir | Tipranavir may increase the antiplatelet activities of Defibrotide. |
| Tirofiban | The risk or severity of bleeding can be increased when Tirofiban is combined with Defibrotide. |
| Tofacitinib | The risk or severity of bleeding can be increased when Defibrotide is combined with Tofacitinib. |
| Tolfenamic acid | The risk or severity of bleeding and hemorrhage can be increased when Tolfenamic acid is combined with Defibrotide. |
| Tolmetin | The risk or severity of bleeding and hemorrhage can be increased when Tolmetin is combined with Defibrotide. |
| Topotecan | The risk or severity of bleeding can be increased when Defibrotide is combined with Topotecan. |
| Toremifene | The risk or severity of bleeding can be increased when Toremifene is combined with Defibrotide. |
| Tositumomab | The risk or severity of adverse effects can be increased when Defibrotide is combined with Tositumomab. |
| Trabectedin | The risk or severity of bleeding can be increased when Defibrotide is combined with Trabectedin. |
| Tranylcypromine | The risk or severity of bleeding and hemorrhage can be increased when Tranylcypromine is combined with Defibrotide. |
| Trastuzumab emtansine | The risk or severity of bleeding can be increased when Defibrotide is combined with Trastuzumab emtansine. |
| Trazodone | The risk or severity of bleeding can be increased when Trazodone is combined with Defibrotide. |
| Treprostinil | The risk or severity of adverse effects can be increased when Defibrotide is combined with Treprostinil. |
| Triamcinolone | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Triamcinolone. |
| Trichlormethiazide | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Trichlormethiazide. |
| Triflusal | The risk or severity of bleeding can be increased when Defibrotide is combined with Triflusal. |
| Trolamine salicylate | The risk or severity of bleeding can be increased when Trolamine salicylate is combined with Defibrotide. |
| Turoctocog alfa | The therapeutic efficacy of Turoctocog alfa can be decreased when used in combination with Defibrotide. |
| Turoctocog alfa pegol | The therapeutic efficacy of Turoctocog alfa pegol can be decreased when used in combination with Defibrotide. |
| Ulipristal | The therapeutic efficacy of Defibrotide can be decreased when used in combination with Ulipristal. |
| Urokinase | Urokinase may increase the anticoagulant activities of Defibrotide. |
| Ursodeoxycholic | The risk or severity of adverse effects can be increased when Defibrotide is combined with Ursodeoxycholic acid. |
| Valdecoxib | The risk or severity of bleeding and hemorrhage can be increased when Valdecoxib is combined with Defibrotide. |
| Venlafaxine | The risk or severity of bleeding can be increased when Defibrotide is combined with Venlafaxine. |
| Vinblastine | The risk or severity of bleeding can be increased when Defibrotide is combined with Vinblastine. |
| Vindesine | The risk or severity of bleeding can be increased when Defibrotide is combined with Vindesine. |
| Vinorelbine | The risk or severity of bleeding can be increased when Defibrotide is combined with Vinorelbine. |
| Vitamin E | Vitamin E may increase the antiplatelet activities of Defibrotide. |
| Von Willebrand | The therapeutic efficacy of Von Willebrand factor human can be decreased when used in combination with Defibrotide. |
| Vorapaxar | The risk or severity of bleeding and hemorrhage can be increased when Vorapaxar is combined with Defibrotide. |
| Vorinostat | The risk or severity of bleeding can be increased when Defibrotide is combined with Vorinostat. |
| Vortioxetine | The risk or severity of bleeding can be increased when Vortioxetine is combined with Defibrotide. |
| Warfarin | The risk or severity of bleeding can be increased when Defibrotide is combined with Warfarin. |
| Ximelagatran | The risk or severity of bleeding can be increased when Defibrotide is combined with Ximelagatran. |
| Zidovudine | The risk or severity of bleeding can be increased when Defibrotide is combined with Zidovudine. |
| Zimelidine | The risk or severity of hemorrhage can be increased when Zimelidine is combined with Defibrotide. |
Pregnancy and Lactation
US FDA pregnancy category: Not assigned
Pregnancy
There are no controlled data on human pregnancy. Use is not recommended unless clearly needed. The manufacturer makes no recommendation regarding use during pregnancy. No data exist regarding the use of this drug in pregnant women. Advise pregnant women of the potential risk of miscarriage.
Lactation
There are no adequate studies on women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
How should this medicine be used?
Defibrotide injection comes as a solution (liquid) to be injected intravenously (into a vein) over 2 hours by a doctor or nurse in a medical facility. It is usually injected once every 6 hours for 21 days but may be given for up to 60 days. The length of treatment depends on how well your body responds to the medication and the side effects that you may experience.
Your doctor may need to delay or stop your treatment if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with defibrotide.
What special precautions should I follow?
Before receiving defibrotide injection,
- tell your doctor and pharmacist if you are allergic to defibrotide, any other medications, or any of the ingredients in defibrotide injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor if you are taking or have received anticoagulants (‘blood thinners) such as apixaban (Eliquis), dabigatran (Pradaxa), dalteparin (Fragmin), edoxaban (Savaysa), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, rivaroxaban (Xarelto), and warfarin (Coumadin, Jantoven) or if you will be receiving medications thrombolytic medications tissue plasminogen activators such as alteplase (Activase), reteplase (Retavase), or tenecteplase (TNKase). Your doctor will probably tell you not to use defibrotide injections if you are taking or using one or more of these medications.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you are bleeding anywhere on your body or if you have bleeding problems.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving, call your doctor. Do not breastfeed while receiving defibrotide injection.
References
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208114lbl.pdf
- https://www.fda.gov/drugs/resources-information-approved-drugs/defitelio-defibrotide-sodium
- https://pubchem.ncbi.nlm.nih.gov/compound/Defibrotide
- https://medlineplus.gov/druginfo/meds/a616024.htm
- https://www.drugs.com/mtm/defibrotide.html
- https://www.mayoclinic.org/drugs-supplements/defibrotide-intravenous-route/side-effects/drg-20236361
- https://go.drugbank.com/drugs/DB04932
- https://en.wikipedia.org/wiki/Defibrotide
- https://www.webmd.com/drugs/2/drug-168292/defibrotide-intravenous/details/list-contraindications
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Defibrotide sodium [USAN]ChemIDplus Chemical Information Classification
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Defibrotide
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Defibrotide sodium
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Defitelio (EMEA/H/C/002393)
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ATC Code
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Defibrotide
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Defibrotide Sodium
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defibrotidedefibrotide sodium
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PubChem
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ChEMBL Protein Target Tree
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SID 392647841
