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.
- It is used to treat cancer.
- This drug may be used with another drug called nivolumab. Some side effects may happen more often when this drug is used with nivolumab. Some side effects can be deadly. If your child is also using nivolumab, talk with your child’s doctor about the risks and side effects that may happen.
- 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 or for 3 months after the last dose.
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.
- This drug may cause very bad and sometimes deadly side effects. These side effects may happen anywhere in the body. Most of the time, they happen in the bowels, liver, skin, and nerves. They may also affect organs that change hormone levels in the body. Side effects that happen in the nerves can lead to not being able to move a part of the body (paralysis). Most of the time, these side effects have happened during the use of this drug but sometimes have happened weeks to months after this drug was stopped. If you have questions, talk with the doctor.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- High blood sugar has happened with this drug. This includes diabetes that is new or worse.
- Check your child’s blood sugar as you have been told by the doctor.
- Some people have had side effects during the infusion. Sometimes, these could be severe or life-threatening. Tell the doctor if your child has back or neck pain, chills or shaking, dizziness, passing out, fever, flushing, itching, rash, shortness of breath, swelling of the face, or wheezing.
- If your child is having or has had a stem cell transplant with stem cells from someone else (allogeneic), talk with your child’s doctor. Some problems with these types of stem cell transplants have happened in people who have had this drug. These problems can be very bad and can lead to death.
- If your child has had an organ transplant, talk with your child’s doctor. This drug may raise the chance of organ transplant rejection.
- 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.
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 liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
- 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 thyroid, pituitary, or adrenal gland problems like change in mood or behavior, change in weight or taste, constipation, deeper voice, dizziness, fainting, feeling cold, feeling very tired, hair loss, severe or long-lasting headache, change in sex interest, eye problems, fast heartbeat, more sweating, fast or deep breathing, sweet smelling breath, change in smell of urine or sweat, or passing urine more often.
- Signs of nerve problems like a burning, numbness, or tingling feeling that is not normal; weakness; or not being able to move a part of the body (paralysis).
- Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
- Signs of a brain problem like change in balance, feeling confused, fever, memory problems, muscle weakness, seizures, stiff neck, or very upset stomach or throwing up.
- Signs of heart problems like chest pain; fast, slow, or abnormal heartbeat; or shortness of breath.
- Signs of high blood sugar like confusion, feeling sleepy, unusual thirst or hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
- Signs of electrolyte problems like mood changes; confusion; muscle pain, cramps, or spasms; weakness; shakiness; change in balance; an abnormal heartbeat; seizures; loss of appetite; or severe upset stomach or throwing up.
- Any unexplained bruising or bleeding.
- Feeling very tired or weak.
- Change in bowel habits.
- It is common to have diarrhea with this drug. However, a severe bowel problem (colitis) with diarrhea has happened with this drug. This may lead to tears or holes in the bowels and may be life-threatening. Call your child’s doctor right away if your child has bloody stools; dark, tarry, or sticky stools; diarrhea; or severe stomach pain.
- A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if your child has signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.
- Eye problems have happened with this drug. Some types of eye problems may need to be treated right away to lower the chance of long-lasting eyesight loss. Call your child’s doctor right away if your child has any changes in eyesight, eye pain, or very bad eye irritation.
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:
- Feeling dizzy, tired, or weak.
- Trouble sleeping.
- Weight loss.
- Back, bone, joint, or muscle pain.
- Stomach pain.
- Diarrhea, throwing up, upset stomach, and decreased appetite 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 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 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.
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