palifermin + heparin

**Palifermin + heparin** is a combination of two pharmaceuticals: palifermin, a recombinant human keratinocyte growth factor (KGF, also known as fibroblast growth factor 7 or FGF-7), and heparin, an anticoagulant polysaccharide. Palifermin acts as an epithelial cell mitogen targeting the KGF receptor (FGFR2b), stimulating epithelial cell proliferation, differentiation, and cytoprotection, primarily used to reduce the incidence and duration of severe oral mucositis in patients undergoing intensive chemotherapy and radiotherapy for hematologic malignancies. Heparin acts as an indirect anticoagulant by potentiating the activity of antithrombin III, thereby inhibiting thrombin and factor Xa. When administered together, pronounced pharmacokinetic interaction occurs: coadministration increases systemic exposure of palifermin 4- to 5-fold and decreases its clearance and half-life. However, pharmacodynamic effects of both drugs are largely unaffected, and dose adjustment is generally not required. Nevertheless, package labeling for palifermin warns to avoid deliberate co-administration with heparin unless necessary, and to flush intravenous lines with saline between administrations to avoid interaction effects[1][2][3][4][5][6][7].