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.
Brand Names: US
Brand Names: Canada
What is this drug used for?
- It is used to treat cancer.
- This drug may be used with another drug called ipilimumab. Some side effects that can happen may happen more often if this drug is used with ipilimumab. If you are also using ipilimumab, talk with your doctor about the risks and side effects that may happen.
What do I need to tell my doctor BEFORE I take this drug?
- 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 taking any of these drugs: Lenalidomide, pomalidomide, or thalidomide.
- If you are pregnant or may be pregnant. 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.
- If you are breast-feeding. Do not breast-feed while you take this drug and for 5 months after you stop taking it.
This is not a list of all drugs or health problems that interact with this drug.
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.
What are some things I need to know or do while I take this drug?
- High blood sugar has happened with this drug. This includes diabetes that is new or worse.
- Tell your doctor if you have signs of high or low blood sugar like breath that smells like fruit, dizziness, fast breathing, fast heartbeat, feeling confused, feeling sleepy, feeling weak, flushing, headache, unusual thirst or hunger, passing urine more often, shaking, or sweating.
- Severe health problems in some organs can happen with this drug. These may happen in the bowels, lungs, liver, thyroid, pituitary, adrenal, pancreas, kidneys, or other parts of the body. Nerve problems, muscle problems, or severe skin reactions may also happen. Sometimes, these problems have been deadly. These problems may happen anytime during or after treatment with this drug. If you have questions, talk with the doctor.
- Call your doctor right away if you have 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.
- A certain brain problem has happened with this drug. Rarely, this has been deadly. Call your doctor right away if you are confused, sleepy, very tired or weak, or have a fever, hallucinations, memory problems, seizures, stiff neck, or very bad headache.
- Some people have had side effects during the infusion. Sometimes, these could be severe or life-threatening. Tell your doctor if you have back or neck pain, chills, shaking, dizziness, passing out, fever, flushing, itching, rash, shortness of breath, swelling of the face, or wheezing.
- It is common to have diarrhea with this drug. However, a 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 doctor right away if you have 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 you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your 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 doctor right away if you have any changes in eyesight, eye pain, or very bad eye irritation.
- If you are having a stem cell transplant, talk with your doctor. Some problems with stem cell transplants using stem cells from someone else (allogeneic) have happened after treatment with this drug. These problems can be very bad and can lead to death.
What are some side effects that I need to call my doctor about 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 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:
For all uses of this drug:
- 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 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 a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
- 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 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.
- Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
- Any unexplained bruising or bleeding.
- Muscle pain or weakness.
- Chest pain.
- A heartbeat that does not feel normal.
- A burning, numbness, or tingling feeling that is not normal.
- Loss of skin color in blotches.
Bladder cancer treatment:
- Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
What are some other side effects of this drug?
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:
- Bone or joint pain.
- Stomach pain or heartburn.
- Feeling tired or weak.
- Signs of a common cold.
- Trouble sleeping.
- Weight loss.
- Dry mouth.
- Mouth irritation or mouth sores.
- Flu-like signs.
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.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
How is this drug best taken?
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.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- Check your blood sugar as you have been told by your doctor.
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- 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.
What do I do if I miss a dose?
- Call your doctor to find out what to do.
How do I store and/or throw out this drug?
- If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.
General drug facts
- 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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