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 severe health problem called cytokine release syndrome (CRS) has happened with this drug. Sometimes, this has been life-threatening or deadly. Get medical help right away if you have signs like chills; confusion; dizziness; fast or abnormal heartbeat; chest pain; change in how much urine is passed; feeling tired or weak; fever; headache; passing out; rash; swelling; trouble breathing; severe muscle or joint pain; severe 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 with this drug. Sometimes, these have been severe and can be life-threatening or deadly. These nervous system problems have happened within days, weeks, or months after treatment with this drug. Call your doctor right away if you feel confused, less alert, tired, or sleepy. Call your doctor right away if you have a burning, numbness, or tingling feeling that is not normal; change in balance or trouble moving around; not able to move muscles in the face; numbness of the face; seizures; shakiness; trouble controlling body movements; trouble speaking, writing, or thinking; trouble with words; not able to focus; memory problems; weakness; or new or worse behavior or mood changes.
- You will be watched for signs of CRS and nervous system problems for at least 4 weeks after getting this drug.
- 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.
- 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. Rarely, a stem cell transplant was needed due to low blood cell counts. If you have questions, talk with the doctor.
- New types of cancer, like myelodysplastic syndrome and leukemia, have happened in people taking this drug. If you have questions, talk with the doctor.
- It is used to treat multiple myeloma.
- This drug may be used with other drugs to treat your health condition. If you are also taking other drugs, talk with your doctor about the risks and side effects that may happen.
- 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.
- If you are able to get pregnant and are not using birth control.
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.
- 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 your blood work and other lab tests checked as you have been told by your doctor.
- You may have more of a chance of getting an infection. Some infections have been severe or deadly. Wash hands often. Stay away from people with infections, colds, or flu.
- You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor. Rarely, some bleeding problems have been deadly.
- 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.
- This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take 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.
- Do not donate blood, organs, tissues, or cells. Talk with your doctor to see when you can do these things after getting this drug.
- If you are 65 or older, use this drug with care. You could have more side effects.
- 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 or your sex partner 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 or your sex partner gets 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 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 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 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.
- Chest pain or pressure, a fast heartbeat, or an abnormal heartbeat.
- Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
- Shortness of breath.
- Not able to control stools or urine.
- Call your doctor right away if you have signs of a blood clot like chest pain or pressure; coughing up blood; shortness of breath; swelling, warmth, numbness, change of color, or pain in a leg or arm; or trouble speaking or swallowing.
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:
- Feeling dizzy, tired, or weak.
- Back, bone, joint, muscle, or neck pain.
- Muscle spasm.
- Muscle weakness.
- Signs of a common cold.
- Stuffy nose.
- Trouble sleeping.
- Diarrhea, throwing up, upset stomach, and decreased appetite are common with this drug. If these happen, talk with your doctor about ways to lower these side effects. Call your doctor right away if any of these effects bother you, do not get better, or are severe.
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.
- This drug will be given in a health care setting.
- This drug will be given in a hospital or doctor’s office. You will not store it at home.
- 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.
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