Grafapex (treosulfan): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

7 mins read

Overview: Grafapex is used to help get your body ready for a stem cell transplant from a donor to treat certain types of blood cancer. Common side effects include muscle and bone pain, mouth sores, fever, nausea, and vomiting. Though less common, Grafapex can also cause skin problems. To reduce your risk of skin problems, wear loose fitting clothes and do not use creams or lotions on days that you get a dose. Tell your healthcare provider about any new or worsening rashes or skin irritation while you are using Grafapex.

Uses

What is Grafapex used for?

Grafapex (treosulfan) is commonly used to help get your body ready for a stem cell transplant from a donor in the treatment of the following types of blood cell cancer.

Grafapex may also be used for other conditions as determined by your healthcare provider.

How does Grafapex work (mechanism of action)?

A stem cell transplant is when stem cells (baby blood cells), usually collected from another person, are put in your body to give you healthy blood cells. Before you can get a stem cell transplant, you need to get rid of the cancer cells. Grafapex is a type of chemotherapy called an alkylating agent. It targets rapidly dividing cancer cells and attaches to the cell’s DNA to stop the cells from multiplying. This slows down cell growth and kills them.

How is Grafapex supplied (dosage forms)?

Brands and other names

Grafapex

Dosage forms and strengths

Grafapex is available in an injectable form that is given by a healthcare provider.

How should I store Grafapex?

Grafapex is usually given by a healthcare provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Grafapex?

The most common side effects of Grafapex are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

Muscle and bone pain
Mouth sores
Fever
Nausea or vomiting
Fluid retention (edema)
Infection

There may be other side effects of Grafapex that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Grafapex?

While less common, the most serious side effects of Grafapex are described below, along with what to do if they happen.

Severe Allergic Reactions. Grafapex may cause allergic reactions, which can be serious. Stop using Grafapex and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Blood Disorders. Grafapex is used to get rid of your blood cells, so you can get new healthy cells during your stem cell transplant. It lowers all three types of blood cells, causing low platelet levels (thrombocytopenia), low red blood cell levels (anemia), and low white blood cell levels (leukopenia). Tell your healthcare provider right away if you have any of the following symptoms of blood disorders.

Fever
Shortness of breath
Pale or yellowish skin
Easy bruising or bleeding
Frequent infection
Unusual weakness or tiredness
Dizziness, lightheadedness, or feeling like you are about to pass out
Headache
Fast or abnormal heartbeat

Infections. Grafapex can increase your risk of infections, including serious infections. Some of these infections may need to be treated in the hospital. Call your healthcare provider right away if you have an infection or any of the following symptoms.

Burning or stinging when you pee
Cough or coughing up blood
Headache
Fever, sweats, chills, or muscle aches
Shortness of breath
Diarrhea or stomach pain
Weight loss

Seizures. Some people who have used Grafapex have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Take any medicine you may be given to prevent seizures. Stop using Grafapex and tell your healthcare provider if you have any of the following signs that a seizure is happening or could happen.

Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
Stiffening of your arms and legs
Feeling anxious, nervous, confused, or a sense of dread
Feeling dizzy or lightheaded
Falling or losing consciousness

Skin Problems. Grafapex can cause a rash or other skin problems like dermatitis. Sometimes the skin problems can include redness and irritation near your genitals or in areas where you may have a bandage or diaper over irritated skin. Keep areas that usually get sweaty, such as armpits, genitals, and under your breasts, clean and dry. Grafapex in urine can irritate the skin. If you wear diapers, change them frequently during the first 12 hours after each dose. Also, change any occlusive dressing (bandage that protects a wound) you may be using after each dose. Wear loose fitting clothes. Do not use creams or lotions on days that you get a dose of Grafapex. Tell your healthcare provider about any new or worsening rashes or skin irritation.

Reactions at the Injection Site. Grafapex can cause redness, pain, or swelling where it is injected. This can sometimes be severe. Tell your healthcare provider about any problems you notice at or near where Grafapex is injected.

Cancer. Grafapex can cause a new cancer to develop. Your risk of cancer may be higher if you have a condition called Fanconi anemia or have a condition that causes your DNA to break. Tell your healthcare provider about any new symptoms that you may get.

Warnings & Precautions

Who should not use Grafapex?

Allergies to Ingredients. People who are allergic to any of the following should not use Grafapex.

Grafapex
Treosulfan
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Grafapex.

What should I know about Grafapex before using it?

Grafapex is usually given by a healthcare provider in a hospital or clinic.

Grafapex may make it difficult for you to get pregnant or get your partner pregnant. It is not known if these problems continue after you stop using Grafapex. Talk to your healthcare provider about any concerns.

If you are able to get your partner pregnant, you should use effective birth control while you are using Grafapex and for three months after your last dose. See the Pregnancy section for more details.

What should I tell my healthcare provider before using Grafapex?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Grafapex is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Skin problems
Seizures
Fanconia anemia, a type of anemia when you are not able to make healthy blood cells
DNA breakage disorders (inherited disorders involving problems with weak or broken DNA parts)

Other Medicines and Supplements. Grafapex may interact with other medicines and supplements. Before using Grafapex, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Grafapex may cause harm to an unborn baby. You may need a negative pregnancy test before you can start using Grafapex. You should use effective birth control while you are using Grafapex and for six months after your last dose. Tell your healthcare provider if you are, think you are, or plan to become pregnant.

Breastfeeding. Do not breastfeed while using Grafapex and for one week after your last dose. It is not known if Grafapex passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Grafapex?

For more information about Grafapex, you can visit the manufacturer’s website at www.grafapex.com or call them at 877-422-5242.

Interactions

Does Grafapex interact with foods or drinks?

There are no known interactions between Grafapex and foods or drinks.

It is unknown if drinking alcohol will affect Grafapex, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does Grafapex interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Grafapex.

Dronedarone (Multaq), which is a medicine used to help keep a normal heart rhythm in people who have had atrial fibrillation
Midazolam (Seizalam, Nayzilam), which is a medicine used for seizures
Triazolam (Halcion), which is a medicine used for trouble sleeping
Eletriptan (Relpax), which is a medicine commonly used to treat migraines

Grafapex may alter the blood levels of many other medicines. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Grafapex. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker