Methoxsalen (Extracorporeal-Systemic)
   
Methoxsalen (Extracorporeal-Systemic)
US Brand Names
• Uvadex
Description
Methoxsalen (meth-OX-a-len) belongs to the group of medicines called psoralens. It is used along with ultraviolet light (found in sunlight and some special lamps) to treat the white blood cells from your blood in a process called photopheresis. The treated white blood cells are returned to your body to control skin problems associated with cutaneous T-cell lymphoma, a cancer of the lymph system.
Methoxsalen is to be administered only by or under the supervision of your doctor or other health care professional. It is available in the following dosage form:
Special Considerations
Methoxsalen is a very strong medicine that increases the skin's sensitivity to sunlight. In addition to causing serious sunburns, if precautions are not properly taken, it has been reported to increase the chance of skin cancer and cataracts. Too much sunlight can also cause premature aging of the skin. 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 wil make. For methoxsalen, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to psoralens. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Diet
Eating certain foods while you are receiving methoxsalen treatment may increase your skin's sensitivity to sunlight. To help prevent this, avoid eating limes, figs, parsley, parsnips, mustard, carrots, and celery while you are being treated with this medicine.
Pregnancy
It is best to avoid pregnancy during treatment with this medicine. Studies in animals have found that methoxsalen causes birth defects and death of the fetus. Be sure you have discussed this with your doctor before starting treatments with this medicine. Also, tell your doctor right away if you think you have become pregnant while receiving this medicine.
Breast-feeding
It is not known whether methoxsalen passes into breast milk. Mothers who are receiving this medicine and who wish to breast-feed should discuss this with their doctor.
Children
Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of methoxsalen in children with use in other age groups.
Older adults
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of methoxsalen in the elderly with use in other age groups.
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 medical doctor may want to change the dose, or other precautions may be necessary. When you are receiving methoxsalen, it is especially important that your health care professional know if you are taking any of the following:
• Anthralin (e.g., Drithocreme) or
• Bacteriostatic soaps or
• Certain organic dyes (such as methylene blue, methyl orange, rose bengal, and toluidine blue) or
• Coal tar or medicine made from coal tar (e.g., Alphosyl) or
• Griseofulvin (e.g., Fulvicin-U/F) or
• Nalidixic acid (e.g., NegGram) or
• Phenothiazines (acetophenazine [e.g., Tindel], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], methotrimeprazine [e.g., Nozinan], pericyazine [e.g., Neuleptil], perphenazine [e.g., Trilafon], pipotiazine [e.g., Piportil L4], prochlorperazine [e.g., Compazine], promazine [e.g., Primazine], thiopropazate [e.g., Dartal], thioproperazine [e.g., Majeptil], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin]) or
• Sulfonamides (sulfa medicine) or
• Tetracyclines (medicine for infection) or
• Thiazide diuretics (water pills)-May increase sensitivity to light
Other medical problems
The presence of other medical problems may affect the use of methoxsalen. Make sure you tell your doctor if you have any other medical problems, especially:
• Albinism (pigment lacking in the skin, hair, and eyes, or eyes only) or
• Erythropoietic protoporphyria or
• Lupus erythematosus or
• Porphyria cutanea tarda or
• Skin cancer or
• Variegate porphyria or
• Xeroderma pigmentosum-Methoxsalen treatment may make condition worse
• Eye problems, such as cataracts or loss of the lens of the eye-Methoxsalen and light treatment may make these conditions worse or may cause damage to the eye
Precautions
Your doctor should check your progress at regular visits to make sure this treatment is working and that it does not cause unwanted effects. You also should have regular eye examinations.
This medicine increases the sensitivity of your skin to sunlight and also may cause premature aging of the skin. Therefore, exposure to the sun, even through window glass or on a cloudy day, could cause a serious burn . If you must go out during the daylight hours:
• After each treatment, cover your skin with protective clothing for at least 24 hours . In addition, use a sun block product that has a skin protection factor (SPF) of at least 15 on those areas of your body that cannot be covered. If you have any questions about this, check with your health care professional.
For 24 hours after your methoxsalen treatment, your eyes should be protected during daylight hours with special wraparound sunglasses that totally block or absorb ultraviolet light (ordinary sunglasses are not adequate). This is to prevent cataracts. Your doctor will tell you what kind of sunglasses to use. These glasses should be worn even in indirect light, such as light coming through a window, or on a cloudy day.
Side Effects
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.
Check with your doctor immediately if any of the following side effects occur:
Rare
Fever; irregular heartbeat; redness or pain at catheter site.
Symptoms of overdose
Blistering and peeling of skin; reddened, sore skin.
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 the following side effect continues or is bothersome:
Reddening of skin, slight.
Treatment with this medicine usually causes a slight reddening of your skin 24 to 48 hours after the treatment. This is an expected effect and is no cause for concern. However, check with your doctor right away if your skin becomes sore and red or blistered.
There is an increased risk of developing skin cancer after use of methoxsalen. You should check your body regularly and show your doctor any skin sores that do not heal, new skin growths, or skin growths that have changed in the way they look or feel.
Premature aging of the skin may occur as a result of prolonged methoxsalen therapy. This effect is permanent and is similar to what happens when a person sunbathes for long periods of time.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
September 17, 1999 
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