Teniposide (Intravenous)

Teniposide injection is used with other medicines to treat acute lymphoblastic leukemia (ALL).

Teniposide is part of a group of medicines called antineoplastic agents. It works by interfering with the growth of cancer cells, which are eventually killed. Since normal body cells can also be affected by teniposide, there may be other effects as well. Some of these effects can be serious and should be reported to your doctor. Other effects, like hair loss, may not be serious but can still be concerning. Some effects might not appear until months or years after using the medicine.

Before starting treatment with teniposide, you and your doctor should discuss the benefits and risks of this medicine.

This medicine should only be given by or under the immediate supervision of your doctor.

It is very important for your doctor to check your progress at regular visits to ensure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine may cause a serious allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you experience chills, fever, lightheadedness, dizziness, or fainting, a fast or pounding heartbeat, swelling of the face, tongue, or throat, or trouble breathing after receiving the medicine.

If teniposide accidentally leaks out of the vein where it is injected, it may damage some tissues and 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 get any immunizations (vaccinations) without your doctor's approval. Teniposide may lower your body's resistance, and you might get the infection the immunization is meant to prevent. Additionally, other people living in your household should not take the oral polio vaccine, as they might pass the polio virus to you. Also, avoid close contact with anyone who has taken the oral polio vaccine in the last several months. Do not stay in the same room with them for very long. If you cannot take these precautions, consider wearing a protective face mask that covers your nose and mouth.

This medicine can cause birth defects if 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 prevent pregnancy. If you become pregnant while using this medicine, tell your doctor right away.

This medicine may decrease the amount of sperm you ejaculate during sex. This may affect your ability to have children. Ask your doctor if you can store sperm for future 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, which increases 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 precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If possible, avoid people with infections. Check with your doctor right away if you think you are getting an infection or if you have a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor right away if you notice any unusual bleeding or bruising, black or tarry stools, blood in your 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 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 using sharp objects like safety razors or fingernail or toenail clippers.
• Avoid contact sports or other situations where bruising or injury could happen.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine against its benefits. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Current studies have not shown any specific problems in children that would limit the use of teniposide injection.

Geriatric

There is no information on how age affects the use of teniposide injection in older patients. However, elderly patients are more likely to experience unwanted side effects (e.g., hypotension or low blood pressure), which may require caution when receiving teniposide injection.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while others may be used together, but your doctor may need to adjust the dose or take other precautions. When taking this medicine, it is very important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions are significant and may not be all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide to not 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 necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Adenovirus Vaccine
• Bacillus of Calmette and Guerin Vaccine, Live
• Cholera Vaccine, Live
• Dengue Tetravalent Vaccine, Live
• Glucosamine
• Influenza Virus Vaccine, Live
• Phenobarbital
• Poliovirus Vaccine, Live
• Smallpox Vaccine
• Typhoid Vaccine, Live
• Yellow Fever Vaccine

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around meal times or with certain foods due to potential interactions. Combining alcohol or tobacco with certain medicines may also result in interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect the use of this medicine. Be sure to tell your doctor if you have any other medical issues, especially:

• Blood disorders due to bone marrow depression or
• Infection—There may be an increased risk of infections or worsening infections due to 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. This may worsen these conditions.

• Down syndrome—Patients with this condition may be more sensitive to this medicine. Dosage may need to be adjusted.

• Hypoalbuminemia (low albumin in the blood) or
• Kidney disease or
• Liver disease—Use with caution. The effects may be stronger because the medicine may be removed from the body more slowly.

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.

In the U.S.

• Vumon

Available Dosage Forms:

• Solution

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Mitotic Inhibitor

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.