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 graft versus host effects after a bone marrow transplant.
- This drug may be used for other reasons. If your child has been given this drug for some other reason, talk with the doctor about the benefits and risks. Talk with the doctor if you have questions or concerns about giving this drug to your child.
- 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 has liver disease.
- If your child takes any drugs (prescription or OTC, natural products, vitamins) that must not be taken with this drug, like certain drugs that are used for HIV, infections, or seizures. There are many drugs that must not be taken with this drug.
If your child is breast-feeding a baby:
- Be sure your child does not breast-feed a baby while taking this drug and for 1 week after the last dose.
This is not a list of all drugs or health problems that interact with this drug.
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 need to be stopped before certain types of surgery as the doctor has told you. If this drug is stopped, the doctor will tell you when to start giving this drug again after your child’s surgery or procedure.
- Have your child’s blood work and heart function checked as you have been told by the doctor.
- High blood pressure has happened with this drug. Have your child’s blood pressure checked as you have been told by the doctor.
- 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. If you have questions, talk with the doctor.
- Your child may have more chance of getting an infection. Some infections have been deadly. Have your child wash hands often. Have your child stay away from 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. Rarely, some bleeding problems have been deadly.
- This drug may add to the chance of getting some types of cancer. Talk with the doctor.
- Patients with cancer who take this drug may be at greater risk of getting a severe health problem called tumor lysis syndrome (TLS). This may lead to death. Call your child’s doctor right away if your child has a fast or abnormal heartbeat; any passing out; trouble passing urine; muscle weakness or cramps; upset stomach, throwing up, diarrhea, or not able to eat; or feels sluggish.
- A severe brain problem called progressive multifocal leukoencephalopathy (PML) may happen with this drug. It may cause disability or death. Tell the doctor right away if your child has signs like confusion, memory problems, depression, change in the way your child acts, change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or change in eyesight.
If your child is pregnant or may be pregnant:
- 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 or your child’s partner may become pregnant, birth control must be used while taking this drug and for some time after the last dose. Ask the doctor how long birth control must be used. If your child or your child’s partner gets 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 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 skin infection like oozing, heat, swelling, redness, or pain.
- 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 fluid and electrolyte problems like mood changes, confusion, muscle pain or weakness, fast or abnormal heartbeat, severe dizziness or passing out, increased thirst, seizures, feeling very tired or weak, decreased appetite, unable to pass urine or change in the amount of urine produced, dry mouth, dry eyes, or severe upset stomach or throwing up.
- Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
- Change in eyesight.
- Change in color or size of a mole.
- A skin lump or growth.
- A burning, numbness, or tingling feeling that is not normal.
- Very bad and sometimes deadly kidney problems have happened with this drug. Call the doctor right away if your child is unable to pass urine, has blood in the urine, or has a change in the amount of urine passed.
- Liver problems have rarely happened with this drug. Sometimes, this has been deadly. Call your child’s doctor right away if your child has 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.
- Heart problems like heart failure and abnormal heartbeats have happened with this drug. Sometimes, these heart problems have been deadly. Sudden deaths have also happened. These effects have happened in people with and without high blood pressure or heart problems. Call your child’s doctor right away if your child has a fast, slow, or abnormal heartbeat; severe dizziness or passing out; shortness of breath; a big weight gain; or swelling in the arms or legs.
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:
- Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
- Mouth irritation or mouth sores.
- Feeling dizzy, tired, or weak.
- Bone, joint, or muscle pain.
- Muscle spasm.
- Signs of a common cold.
- Dry eyes.
- More tears.
- Trouble sleeping.
- Weight loss.
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.
- Give this drug at the same time of day.
- Give this drug with a full glass of water.
- Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.
- Avoid grapefruit and grapefruit juice.
- Avoid Seville oranges and Seville orange juice.
- If your child has heartburn, upset stomach, diarrhea, throwing up, or decreased appetite, talk with the doctor. There may be ways to lower these side effects.
- Have your child drink lots of noncaffeine liquids unless told to drink less liquid by your child’s doctor.
- If diarrhea or throwing up happens, talk with the doctor. You will need to make sure to avoid dehydration and electrolyte problems.
Tablets and capsules:
- Swallow whole. Do not chew, break, or crush.
- Do not open the capsules.
- Shake well before use.
- Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.
- Give a missed dose as soon as you think about it on the same day your child missed the dose.
- If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
- Do not give 2 doses at the same time or extra doses.
Tablets and capsules:
- Store in the original container at room temperature.
- Store in a dry place. Do not store in a bathroom.
- Store liquid (suspension) in a refrigerator or at room temperature. Throw away any unused portion after 60 days.
- Do not freeze.
- Keep lid tightly closed.
- 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.
- 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.
- 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.
© 2023 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.