This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.
- Very bad and sometimes life-threatening infusion reactions have happened with this drug. Most of the reactions happened during or within 24 hours after the infusion. Other drugs will be given before the infusion to help with infusion side effects. Fluids will also need to be started before the infusion to avoid low blood pressure. Talk with the doctor.
- Your child will be watched closely while receiving this drug and for at least 4 hours after the dose. Tell the doctor right away if your child has any bad effects like chills, dizziness or passing out, fever, itching, swelling of the face or lips, or trouble breathing during or after the infusion.
- This drug may cause very bad nerve problems or pain like arm, leg, back, chest, joint, nerve, or stomach pain. An opioid like morphine or other pain drug will be given before, during, and for 2 hours after the infusion. Tell the doctor right away if your child has very bad pain or pain that gets worse. Tell the doctor right away if your child has signs of nerve problems like burning, numbness, tingling, weakness, trouble passing urine, or not able to control bladder or bowels.
- It is used to treat neuroblastoma, a cancer of the nervous system.
- It may be given to your child for other reasons. Talk with the doctor.
- If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
If your child is breast-feeding a baby:
- Be sure your child does not breast-feed a baby while taking this drug.
This drug may interact with other drugs or health problems.
Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.
- Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- High or low blood pressure may happen with this drug. Have your child’s blood pressure checked as you have been told by the doctor.
- If your child has an upset stomach or diarrhea, is throwing up, or is not hungry, talk with the doctor. There may be ways to lower these side effects.
- This drug may cause a severe and sometimes deadly problem called capillary leak syndrome (CLS). CLS may lead to low blood pressure, abnormal heartbeat, chest pain, or heart attack. It may also lead to lung or breathing problems, bleeding or lower blood flow in the stomach or bowel, kidney problems, swelling, or feeling confused. If you have questions, talk with the doctor.
- A very bad and sometimes deadly brain problem called posterior reversible encephalopathy syndrome (PRES) has happened with this drug. If you have questions, talk with the doctor.
- This drug may lower the ability of the bone marrow to make blood cells that the body needs. If blood cell counts get very low, this can lead to bleeding problems, infections, or anemia. If you have questions, talk with the doctor.
- Your child may have more chance of getting infections. Have your child wash hands often. Avoid crowds and people with infections, colds, or flu.
- Your child may bleed more easily. Make sure your child is careful and avoids injury. Be sure your child has a soft toothbrush.
- If your child has high blood sugar (diabetes), you will need to watch his/her blood sugar closely.
- Talk with the doctor before your child gets any vaccines. Use of some vaccines with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
- High triglyceride levels have happened with this drug. Tell your child’s doctor if your child has ever had high triglyceride levels.
If your child is or may be sexually active:
- This drug may cause harm to the unborn baby if your child takes it during pregnancy.
- Have your child use birth control while taking this drug and for some time after the last dose. Ask the doctor how long your child must use birth control. If your child becomes pregnant, call the doctor right away.
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
- Signs of electrolyte problems like mood changes, confusion, muscle pain or weakness, a heartbeat that does not feel normal, seizures, not hungry, or very bad upset stomach or throwing up.
- Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
- Signs of high blood sugar like confusion, feeling sleepy, more thirst, more hungry, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
- Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
- Blurred eyesight, change in pupil size, loss of eyesight, or other eye or eyesight changes.
- If bright lights bother your child’s eyes.
- A fast heartbeat.
- Feeling very tired or weak.
- Pale skin.
- Very bad headache.
- Feeling confused.
- Feeling less alert.
- This drug may cause a health problem called hemolytic-uremic syndrome. Very bad problems may happen in some patients who get this health problem. Call the doctor right away if your child is feeling very tired or weak or has any signs of bleeding or bruising, change in color of urine, change in how much urine is passed, a fever, or swelling of the face, hands, feet, or body.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:
- Diarrhea, upset stomach, or throwing up.
- Not hungry.
- Weight gain.
These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.
You may report side effects to your national health agency.
Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.
- It is given as an infusion into a vein over a period of time.
- Call your child’s doctor to find out what to do.
- If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.
- If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
- Do not share your child’s drug with others and do not give anyone else’s drug to your child.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.
© 2020 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.