Teniposide, Injection

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KEY POINTS

• This medicine is given by IV to treat childhood acute lymphocytic leukemia and other kinds of cancer.
• This medicine may cause birth defects. Males and females should use an effective form of birth control while receiving this medicine.
• You may get infections more easily when you are taking this medicine.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: teniposide, injection

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein) to treat childhood acute lymphocytic leukemia (ALL) and other kinds of cancer.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine or to castor oil
• Bleeding problems or blood disorders
• Down syndrome
• Kidney disease
• Liver disease

Also tell your provider if you have recently had any kind of infection or if you are taking radiation therapy or chemotherapy.

Males: Use effective birth control. This medicine may affect sperm and your ability to father children. It may also lead to birth defects.

Females of childbearing age: This medicine is not usually given during pregnancy because it can harm the baby. Tell your healthcare provider if you are pregnant. Do not become pregnant during this treatment. Contact your healthcare provider right away if you become pregnant. Do not breast-feed during this treatment.

How do I use it?

This is a very strong medicine. Only healthcare providers experienced with this drug should prescribe it. The infusions are given by your healthcare provider once or twice a week along with other medicines. You will be monitored closely while you are receiving this medicine and for a certain period of time after you receive this medicine. The length of treatment varies with your response and the combination of drugs used. Keep all your appointments for the infusions. If you need to take any medicines by mouth while you are having the infusions, take them exactly as prescribed.

What should I watch out for?

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may cause birth defects. Males and females should use an effective form of birth control while receiving this medicine. Talk with your healthcare provider about effective forms of birth control.

This medicine may increase your risk for other types of cancer. Talk with your healthcare provider about this.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine may cause nausea, vomiting, diarrhea, or sores in your mouth. Use a soft bristle brush or mouth swab to brush your teeth. Contact your healthcare provider if these continue or get worse.

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Fever, chills, fast or irregular heartbeat, facial flushing, decreased urination, trouble breathing, severe dizziness or fainting, mouth sores, unusual bruising or bleeding, unexplained sore throat, black or tarry bowel movements, blood in the urine, severe headache, unusual tiredness or weakness, severe drowsiness or confusion, numbness or tingling in hands or feet; severe nausea or vomiting; severe redness, swelling, pain, or irritation at the infusion site.

Other: Hair loss, nausea, vomiting, diarrhea, drowsiness, dizziness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), metronidazole, rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Antifungal medicines such as itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), fosphenytoin (Cerebyx), phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Aspirin and other salicylates
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Cimetidine (Tagamet)
• Clozapine (Clozaril, FazaClo)
• Conivaptan (Vaprisol)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Diabetes medicines such as chlorpropamide, glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), repaglinide (Prandin), tolazamide, and tolbutamide
• Disulfiram (Antabuse)
• Heart medicines such as amiodarone (Cordarone, Pacerone), dronedarone (Multaq), nicardipine (Cardene), quinidine, and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), cobicistat (Tybost), darunavir (Prezista), delavirdine (Rescriptor), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase), and tipranavir (Aptivus)
• Methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall)
• Natural remedies such as echinacea, glucosamine, and St. John’s wort
• Nefazodone
• Other cancer medicines such as enzalutamide (Xtandi), idelalisib (Zydelig), and mitotane (Lysodren)
• Sodium oxybate (Xyrem)
• Vaccines

Do not drink alcohol while you are receiving this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.