Description
Teniposide injection is used in combination with other medicines to treat acute lymphoblastic leukemia (ALL).
Teniposide belongs to the group of medicines known as antineoplastic agents. It interferes with the growth of the cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by teniposide, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur until months or years after the medicine is used.
Before you begin treatment with teniposide, you and your doctor should talk about the benefits of this medicine as well as the risks of using it.
This medicine is to be administered only by or under the immediate supervision of your doctor.
This product is available in the following dosage forms:
- Solution
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of teniposide injection in children.
Geriatric
No information is available on the relationship of age to the effects of teniposide injection in geriatric patients. However, elderly patients are more likely to have unwanted side effects (e.g., hypotension or low blood pressure), which may require caution in patients receiving teniposide injection.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine, Live
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine Type 4, Live
- Adenovirus Vaccine Type 7, Live
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Dengue Tetravalent Vaccine, Live
- Ebola Zaire Vaccine, Live
- Glucosamine
- Influenza Virus Vaccine, Live
- Phenobarbital
- Poliovirus Vaccine, Live
- Smallpox Monkeypox Vaccine, Live Non-Replicating
- Smallpox Vaccine
- Typhoid Vaccine, Live
- Yellow Fever Vaccine
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Blood disorders due to bone marrow depression or
- Infection—There may be an increased risk of infections or worsening infections because of the body's reduced ability to fight them.
- Central nervous system (CNS) depression or
- Chickenpox (including recent exposure) or
- Herpes zoster (shingles) or
- Hypotension (low blood pressure) or
- Metabolic acidosis—Use with caution. May make these conditions worse.
- Down syndrome—Patients who have this condition may be more sensitive to this medicine. Dosage may be adjusted.
- Hypoalbuminemia (low albumin in the blood) or
- Kidney disease or
- Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Proper Use
A doctor or other trained health professional will give you this medicine in a hospital or cancer treatment center. This medicine is given through a needle placed in one of your veins. This medicine must be given slowly, so the IV tube must remain in place for at least 30 to 60 minutes.
Teniposide is sometimes given together with other medicines. If you are receiving a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by the mouth, ask your doctor to help you plan a way to take them at the right times.
Teniposide often causes nausea, vomiting, and loss of appetite, which may be severe. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your doctor for ways to lessen these effects.
You may also receive other medicines to help prevent nausea or vomiting and allergic reactions from teniposide.
Precautions
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.
This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you have chills; fever; lightheadedness, dizziness, or fainting; fast, pounding heartbeat; swelling of the face, tongue, and throat; or trouble with breathing after you receive the medicine.
If teniposide accidentally leaks out of the vein into which it is injected, it may damage some tissues and may cause scarring. Tell the doctor right away if you notice redness, pain, or swelling at the injection site.
While you are being treated with teniposide, and after you stop treatment, do not have any immunizations (vaccinations) without your doctor's approval. Teniposide may lower your body's resistance, and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine, since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
This medicine can cause birth defects if it is used by the mother while she is pregnant or by the father when his sexual partner becomes pregnant. Use an effective form of birth control to keep from getting pregnant. If a pregnancy occurs while you are using this medicine, tell your doctor right away.
This medicine may cause a decrease in the amount of sperm you ejaculate during sex. This may affect your ability to have children. Ask your doctor on whether you can store sperm for future artificial use.
Hypotension (low blood pressure) may occur with this medicine. Your doctor will measure your blood pressure and keep it from going too low while you are receiving this medicine.
Teniposide can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
- Check with your doctor immediately if you see any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick. Your doctor may show you other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
- Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injury could occur.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
- Black, tarry stools
- blood in urine or stools
- chills
- cough or hoarseness
- fever
- hives
- lower back or side pain
- painful or difficult urination
- pinpoint red spots on skin
- shortness of breath
- tightness in chest or wheezing
- troubled breathing
- unusual bleeding or bruising
Check with your doctor as soon as possible if any of the following side effects occur:
More common
- Flushing of face
- sores in mouth or on lips
- unusually fast heartbeat
- unusual tiredness
Less common
- Skin rash
Rare
- Decreased urination
- swelling of face, fingers, feet, or lower legs
- yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Diarrhea
- nausea and vomiting
This medicine often causes a temporary loss of hair. After treatment with teniposide has ended, normal hair growth should return.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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