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.
- A very bad health problem called cytokine release syndrome (CRS) has happened with this drug. Sometimes, this has been life-threatening or deadly. This can happen while getting this drug or within 4 weeks after getting this drug. Get medical help right away if you have signs like chills; confusion; dizziness; fast heartbeat; feeling tired or weak; fever; headache; passing out; rash; swelling of the face; trouble breathing; very bad muscle or joint pain; very bad upset stomach, throwing up, or diarrhea; or wheezing.
- Do not take this drug if you have an infection or any inflammation.
- Nervous system problems have happened after treatment with this drug. Sometimes, these have been severe and can be life-threatening or deadly. Call your doctor right away if you feel agitated, confused, nervous, or restless. Call your doctor right away if you have anxiety, change in balance, change in eyesight, dizziness or passing out, hallucinations (seeing or hearing things that are not there), headaches, seizures, shakiness, trouble speaking, or new or worse behavior or mood changes.
- An immune system problem called hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS) has happened with this drug. Sometimes, this has been life-threatening and even deadly. Call your doctor right away if you feel confused or not alert or have fever, swollen gland, rash, seizures, change in balance, or trouble walking that is new or worse.
- Long-lasting low blood cell counts with bleeding and infection have happened with this drug. Sometimes, this has been deadly in people who got a bone marrow transplant to try to help with the blood cell counts.
- It is used to treat multiple myeloma.
- If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.
This drug may interact with other drugs or health problems.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- Have Patient Wallet Card with you at all times.
- Avoid driving and doing other tasks or actions that call for you to be alert for at least 8 weeks after getting this drug. If you have any questions, call your doctor or pharmacist.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
- You may have more of a chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu. Some infections have been very bad and even deadly.
- You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
- If you have had hepatitis B before or carry the virus, talk with your doctor. Drugs like this one can cause the virus to become active. This can lead to very bad and sometimes deadly liver problems.
- Hepatitis and HIV testing will be done before taking this drug.
- Talk with your doctor before getting any vaccines. Some types of vaccines must not be given for at least 6 weeks before starting this drug, during treatment, and for some time after your last dose.
- New types of cancer have happened in people taking this drug. If you have questions, talk with the doctor.
- Do not donate blood, organs, or tissues or cells. Talk with your doctor to see when you can do these things after getting this drug.
- This drug may cause harm to an unborn baby. A pregnancy test will be done before you start this drug to show that you are NOT pregnant.
- If you may become pregnant, you must use birth control while taking this drug and for some time after the last dose. Ask your doctor how long to use birth control. If you get pregnant, call your doctor right away.
- Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
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 doctor or get medical help right away if you have 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 kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
- 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 a common cold.
- Chest pain or pressure, a fast heartbeat, or an abnormal heartbeat.
- Shortness of breath.
- Feeling very sleepy.
- Not able to focus.
- Memory problems or loss.
- Hallucinations (seeing or hearing things that are not there).
- A burning, numbness, or tingling feeling that is not normal.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Constipation, diarrhea, upset stomach, throwing up, or feeling less hungry.
- Feeling dizzy, tired, or weak.
- Back, muscle, or joint pain.
- Muscle spasm.
- Muscle weakness.
- Weight loss.
- Trouble sleeping.
- Mouth pain.
- Dry mouth, eyes, skin, or lips.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
Use this drug as ordered by your 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.
- Other drugs may be given before this drug to help avoid side effects.
- Call your doctor to find out what to do.
- If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- 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.
- This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, 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.
© 2021 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.