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 deadly allergic reactions have happened with this drug. Be sure your child does not get this drug if your child has ever had an allergic reaction to this drug or to other drugs that have polysorbate 80 in them.
- The risk of death that may rarely happen with this drug is raised in people with liver problems and in people who get high doses of this drug. The risk is also raised in people with a certain type of lung cancer who have been treated with certain chemo drugs in the past. This drug must not be given to some people with high bilirubin levels, liver problems, or raised liver enzymes. If your child has any of these health problems or you have any questions, talk with the doctor.
- This drug may cause your child to swell or keep fluid in the body. Tell your child’s doctor if swelling, weight gain, or trouble breathing happens after this drug is given.
- This drug may lower the ability of the bone marrow to make blood cells that the body needs. This can lead to needing a blood transfusion and very bad and sometimes deadly bleeding problems or infections. Tell the doctor right away if your child has signs of infection like fever, chills, or sore throat; any bruising or bleeding; or if your child feels very tired or weak.
- Have your child’s blood work checked often. Talk with your child’s doctor.
- If your child has a low white blood cell count, talk with your child’s doctor. This drug must not be used in people with certain low white blood cell counts.
- It is used to treat cancer.
- 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 taking any of these drugs: Atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, or telithromycin.
- If your child is taking voriconazole.
If your child is breast-feeding a baby:
- Be sure your child does not breast-feed a baby while taking this drug and for 1 week after the last dose.
This is not a list of all drugs or health problems that interact with this drug.
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 your child avoid tasks or actions that call for alertness or clear eyesight until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or motorized vehicles.
- 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.
- 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.
- Rarely, other cancers have happened in people taking this drug with some other cancer treatments. This includes certain blood cancers and kidney cancer. This may happen months to years after treatment. If you have questions, talk with the doctor.
- Hair loss is common with this drug. Most of the time, normal hair growth has come back. Sometimes, hair growth has not gone back to normal. Talk with the doctor.
- Some people have felt very tired or weak with this drug. This may last a few days up to several weeks. Call the doctor if these signs are very bad, cause problems with daily living, or do not go away.
- This drug may affect being able to father a child. Talk with the doctor.
- If your child is of childbearing age, a pregnancy test will need to be done before starting this drug to make sure your child is not pregnant.
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.
- If your child’s partner may get pregnant, they must use birth control while taking this drug and for some time after the last dose. Ask the doctor how long they must use birth control. If your child’s partner gets pregnant, call the doctor right away.
Products that contain alcohol:
- This drug has alcohol in it. This may cause your child to feel drunk during and after treatment. Tell the doctor if your child has confusion, feels drunk, stumbles, or feels very sleepy during treatment or within 1 to 2 hours after treatment.
- Alcohol may interact with this drug. Be sure your child does not drink alcohol.
- Talk with your child’s doctor before your child uses marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your child’s actions.
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 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.
- 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 lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
- Signs of a very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.
- Dizziness or passing out.
- Fast or abnormal heartbeat.
- A burning, numbness, or tingling feeling that is not normal.
- Muscle weakness.
- Any skin reaction.
- This drug may cause tissue damage if the drug leaks from the vein. Tell your child’s nurse if your child has any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your child’s body.
- This drug may cause a certain eye problem called cystoid macular edema (CME). Your child may need to have eye exams while using this drug. Call your child’s doctor right away if your child has a change in eyesight like blurred eyesight or loss of eyesight.
- This drug can cause a severe bowel problem (neutropenic enterocolitis). This problem can be deadly, sometimes as early as the first day signs happen. Call your child’s doctor right away if your child has stomach pain with or without a fever, tender stomach, or diarrhea.
- Liver problems have rarely happened with this drug. Sometimes, this has been deadly. Call your child’s doctor right away if your child has signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
- Patients with cancer who take this drug may be at greater risk of getting a severe health problem called tumor lysis syndrome (TLS). This may lead to death. Call your child’s doctor right away if your child has a fast or abnormal heartbeat; any passing out; trouble passing urine; muscle weakness or cramps; upset stomach, throwing up, diarrhea, or not able to eat; or feels sluggish.
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:
- Mouth sores.
- Feeling tired or weak.
- Change in nails.
- Change in taste.
- Not hungry.
- Muscle or joint pain.
- Eye redness.
- More tears.
- Weight loss.
- Constipation, diarrhea, throwing up, and upset stomach are common with this drug. If these happen, talk with your child’s doctor about ways to lower these side effects. Call your child’s doctor right away if any of these effects bother your child, do not go away, or are severe.
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.
- A steroid drug like dexamethasone will be given before this drug to lower side effects. Talk with the doctor. Tell the doctor if the steroid drug is not used as your doctor has told you.
- You will need to be sure that your child is not dehydrated before getting this drug. Check with the doctor to see if you need to have your child drink extra fluids before getting this drug.
- 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 child’s 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. The use of this information is governed by the Lexicomp End User License Agreement, available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.
© 2021 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.