- This drug may cause very bad heart problems like heart failure. This can happen during care or months to years after your child gets this drug. Sometimes, these heart problems will not go away or may be deadly. The chance of heart problems may be raised if your child is using other drugs that may cause heart problems. The chance of heart problems may also be raised if your child has ever had heart problems or radiation to the chest area. The chance of heart problems may also be raised if your child has ever had this drug or other drugs like this one. Ask your child’s doctor if you are not sure if any drugs your child takes may cause heart problems. Your child’s chance of heart problems depends on the dose of this drug and your child’s health problem. Heart problems may happen even if your child does not have any risk factors. The chance of heart problems later in life is also raised. Call your child’s doctor right away if your child has cough, fast or slow heartbeat, a heartbeat that does not feel normal, swelling in the arms or legs, shortness of breath, sudden weight gain, or feeling very tired or weak.
- 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.
- Your child will be closely watched by the doctor.
- Children with kidney or liver disease may need a lower dose. Talk with your child’s doctor.
- 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.
- It is used to treat a type of leukemia.
- If your child has an allergy to this drug or any part of this drug.
- If your child is allergic to any drugs like this one or any other drugs, foods, or other substances. Tell the doctor about the allergy and what signs your child had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
- If your child has any of these health problems: Low blood cell count or poor bone marrow function.
- If your child has a high bilirubin level.
If your child is breast-feeding a baby:
- Be sure your child does not breast-feed a baby while taking this drug.
- 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.
- 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 an upset stomach or loose stools (diarrhea), is throwing up, or is not hungry, talk with the doctor. There may be ways to lower these side effects.
- If your child has had daunorubicin, doxorubicin, epirubicin, idarubicin, or mitoxantrone before, talk with your child’s doctor.
- Your child will need to get heart function tests while taking this drug. Talk with the doctor.
- Have your child’s blood work checked often. Talk with your child’s doctor.
- Talk with the doctor before your child gets any vaccines. Use with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
If your child is or may be sexually active:
- Have your child use birth control to prevent pregnancy while taking this drug.
If your child is pregnant:
- This drug may cause harm to the unborn baby if your child takes it during pregnancy. If your child is pregnant or gets pregnant while taking this drug, call the doctor right away.
- 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 blood or throw up that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; vaginal bleeding that is not normal; bruises without a reason or that get bigger; or any bleeding that is very bad or that you cannot stop.
- Feeling very tired or weak.
- Redness or irritation of the palms of hands or soles of feet.
- Mood changes.
- Mouth irritation or mouth sores.
- A burning, numbness, or tingling feeling that is not normal.
- Upset stomach or throwing up.
- Belly pain or loose stools (diarrhea).
- Stomach cramps.
- Hair loss.
- 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 a list of all your child’s drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child’s doctor.
- Talk with your child’s doctor before giving your child any new drug, including prescription or OTC, natural products, or vitamins.
- 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.