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.
- The chance of blood clots in your child’s veins or lungs may be raised with this drug. Tell your child’s doctor right away if your child has any chest pain or pressure; coughing up blood; shortness of breath; or pain, warmth, or swelling of the legs or arms.
If your child is pregnant:
- Do not give this drug to your child if she is pregnant. Use during pregnancy may cause birth defects or loss of the unborn baby. If your child gets pregnant while taking this drug or within 4 weeks after the last dose, call the doctor right away.
If your child is able to get pregnant:
- Your child must have 2 pregnancy tests that show she is NOT pregnant before starting this drug. Your child must have pregnancy tests done while taking this drug. Talk with the doctor.
- Your child must use 2 kinds of birth control to prevent pregnancy for at least 4 weeks before starting this drug, during treatment, and for at least 4 weeks after the last dose.
If your child is or may be sexually active:
- If your child has sex without using 2 kinds of birth control, if you think your child may be pregnant, or if your child misses her period, call the doctor right away.
- If your child is a male and has sex with a pregnant female or a female who can get pregnant, be sure he always uses a latex or synthetic condom during sex. Do this even if your child has had a vasectomy. Be sure he uses a latex or synthetic condom during treatment, during any treatment breaks, and for at least 4 weeks after his last dose.
- If your child is a male and has unprotected sex with a female who is or could get pregnant, or if his female partner gets pregnant, call the doctor right away.
- It is used to treat skin signs of leprosy.
- It is used to treat multiple myeloma.
- It may be given to your child for other reasons. Talk with the doctor.
- 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 taking pembrolizumab or nivolumab.
If your child is breast-feeding a baby:
- Be sure your child does not breast-feed a baby while taking this drug.
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.
- Have your child avoid tasks or actions that call for alertness until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or motorized vehicles.
- To lower the chance of feeling dizzy or passing out, have your child rise slowly if your child has been sitting or lying down. Have your child be careful going up and down stairs.
- Have your child’s blood work checked often. Talk with your child’s doctor.
- Be sure your child does not donate blood while using this drug and for 1 month after stopping.
- If you touch a broken capsule, or the drug inside the capsule, wash the area with soap and water.
- 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.
- Alcohol may interact with this drug. Be sure your child does not drink alcohol.
- Avoid giving your child marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your child’s actions.
- This drug may cause nerve problems. Most of the time, nerve problems have happened after long-term use over a few months. Nerve problems have also happened after short-term use. Signs of nerve problems may happen some time after the last dose of this drug. The signs may go away slowly or may not go away at all.
- A severe and sometimes deadly reaction has happened. Most of the time, this reaction has signs like fever, rash, or swollen glands with problems in body organs like the liver, kidney, blood, heart, muscles and joints, or lungs. If you have questions, talk with the doctor.
- Pregnant women or females of childbearing age must not touch the capsules. Talk with the doctor.
- If your child is male, be sure he does not donate sperm while using this drug and for 1 month after stopping.
- This drug may affect being able to father a child. Talk with the doctor.
If your child is or may be sexually active:
- Certain drugs may cause birth control pills and other hormone-based birth control not to work. Be sure to tell the doctor or pharmacist about all drugs your child takes. You will need to see if your child needs to use other forms of birth control while taking this drug.
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 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 low calcium levels like muscle cramps or spasms, numbness and tingling, or seizures.
- A burning, numbness, or tingling feeling that is not normal.
- Very bad dizziness or passing out.
- Fast or slow heartbeat.
- Feeling very tired or weak.
- Swollen gland.
- 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 very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad 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.
- The chance of heart attack or stroke due to blood clots may be raised. Call the doctor right away if your child has signs of heart attack like chest pain that may spread to the arms, neck, jaw, back, or stomach; abnormal sweating; or feeling sick or throwing up. Call the doctor right away if your child has signs of stroke like weakness on 1 side of the body; eyesight, speech, or balance problems; drooping on 1 side of the face; feeling confused; or severe headache.
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, sleepy, tired, or weak.
- Upset stomach.
- Not hungry.
- Dry skin.
- Dry mouth.
- Weight gain or 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.
- If giving once daily, give this drug with water at bedtime at least 1 hour after the evening meal.
- Have your child swallow whole. Do not let your child chew, break, or crush.
- Do not open the capsules.
- Wear gloves when touching this drug.
- Give a missed dose as soon as you think about it and go back to your child’s normal time.
- If it has been 12 hours or more since the missed 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.
- Store in the original container at room temperature.
- Protect from light.
- Store in a dry place. Do not store in a bathroom.
- 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.
This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.
© 2020 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.