Eflornithine: Price, Dosage & Where to Buy

Eflornithine is an ornithine decarboxylase inhibitor used to reduce the risk of relapse in high-risk neuroblastoma. Its labelled use is for adults and children who have shown at least a partial response to previous treatment involving several medicines and treatment approaches, including anti-GD2 immunotherapy. It is a medicine that requires a prescription in the United Kingdom.

The oral eflornithine product IWILFIN is indicated to reduce the risk of high-risk neuroblastoma returning after previous treatment. This indication covers adults and children whose disease has shown at least a partial response to treatment involving several medicines and different treatment approaches, including anti-GD2 immunotherapy.

The purpose of treatment is relapse risk reduction following that response. The label does not establish its safety and effectiveness in children for other indications.

Eflornithine inhibits an enzyme called ornithine decarboxylase. Enzymes are proteins that help chemical reactions occur within cells. Ornithine decarboxylase helps cells produce polyamines, substances involved in cell growth and multiplication.

Blocking this enzyme reduces polyamine production and can limit processes that support cell growth. This explains the general pharmacological action of an ornithine decarboxylase inhibitor; it does not mean that every patient will have the same response to treatment.

The label lists 250 mg oral tablets in the product listing and 192 mg tablets in the IWILFIN product description; these are distinct strength descriptions and should not be treated as interchangeable. The label lists body-surface-area-based IWILFIN doses of 192 mg, 384 mg, 576 mg or 768 mg orally twice daily, with or without food. The label lists treatment for up to two years, or until disease recurrence or unacceptable toxicity.

The label lists a 50% reduction of the recommended dose for severe renal impairment with eGFR <30 mL/min. The label lists further dose reductions or treatment interruption for adverse reactions, with permanent discontinuation if 192 mg once daily cannot be tolerated. Before treatment, the label specifies a complete blood count, liver function tests and a baseline hearing assessment.

The tablets are described as suitable for chewing or crushing and mixing with soft food or liquid, as well as administration whole. Product-specific prescribing details require confirmation because the strength descriptions differ.

The label states that a missed dose should be administered as soon as possible. If the next scheduled dose is approaching, a pharmacist or the treating team can clarify how to resume the prescribed schedule. A missed dose should not be compensated for by doubling a later dose.

Eflornithine can cause fetal harm based on animal studies and its mechanism of action. There are no available data on its use in pregnant women. The label advises effective contraception during treatment and for 1 week after the last dose for females of reproductive potential and males with female partners of reproductive potential.

There are no data on eflornithine in human milk, effects on breastfed children or milk production. Breastfeeding is not advised during treatment or for 1 week after the last dose because of the potential for serious adverse reactions in breastfed children.

Store at room temperature, 20°C to 25°C, with excursions permitted between 15°C to 30°C. Keep the tablets in their original container and out of the sight and reach of children.