Palifermin and Heparin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Palifermin
Heparin
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased palifermin plasma concentration
Interaction Deep Dive
Concurrent use of palifermin and heparin increases palifermin plasma concentration. In 2 drug interaction studies of healthy subjects, coadministration of palifermin and unfractionated heparin led to a 4- to 5-fold increase in palifermin AUC but did not cause changes in the pharmacodynamic effects of palifermin, anticoagulant activity of heparin, or safety findings1. If of heparin is required to maintain an IV line, flush the line with saline before and after palifermin administration 2.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) Concurrent administration of palifermin and a continuous IV infusion of unfractionated heparin led to a 4- to 5-fold increase in AUC of palifermin and a 40% to 50% decrease in palifermin t(1/2); however, pharmacodynamic effects of palifermin, anticoagulant activity of heparin, and safety findings were not affected. Pharmacokinetic and pharmacodynamic parameters were evaluated in 2 studies of healthy subjects: 1 study of a single IV bolus dose of palifermin 60 mcg/kg with or without concurrent heparin, and 1 study of daily IV doses of palifermin 40 mcg/kg/day for 3 consecutive days with or without concurrent heparin 1.
Common questions
Can I take Palifermin and Heparin together?
Increased palifermin plasma concentration Always confirm with your pharmacist or prescriber before making any change.
How serious is the Palifermin and Heparin interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Palifermin or Heparin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
- Yang BB, Gillespie B, Smith B, et al: Pharmacokinetic and pharmacodynamic interactions between palifermin and heparin. J Clin Pharmacol 2015; 55(10):1109-1118. PubMed
- Product Information: Kepivance(R) intravenous injection, palifermin intravenous injection. Swedish Orphan Biovitrum AB (per Manufacturer), Waltham, MA, 2015. DailyMed
Keep reading about Palifermin
Keep reading about Heparin
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