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 cancer.
- This drug may be used with another drug called nivolumab. Some side effects may happen more often when this drug is used with nivolumab. Some side effects can be deadly. If you are also using nivolumab, talk with your doctor about the risks and side effects that may happen.
- If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you are pregnant or may be pregnant. This drug may cause harm to an unborn baby. A pregnancy test will be done before you start this drug to show that you are NOT pregnant. If you may become pregnant, you must use birth control while taking this drug and for some time after the last dose. Ask your doctor how long to use birth control. If you get pregnant, call your doctor right away.
- If you are breast-feeding. Do not breast-feed while you take this drug or for 3 months after your last dose.
This drug may interact with other drugs or health problems.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- If you have upset stomach, throwing up, diarrhea, or are not hungry, talk with your doctor. There may be ways to lower these side effects.
- This drug may cause very bad and sometimes deadly side effects. These side effects may happen anywhere in the body. Most of the time, they happen in the bowels, liver, skin, and nerves. They may also affect organs that change hormone levels in the body. Side effects that happen in the nerves can lead to not being able to move a part of the body (paralysis). Most of the time, these side effects have happened during the use of this drug but sometimes have happened weeks to months after this drug was stopped. If you have questions, talk with the doctor.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- High blood sugar has happened with this drug. This includes diabetes that is new or worse.
- Check your blood sugar as you have been told by your doctor.
- Tell your doctor if you have signs of high blood sugar like confusion, feeling sleepy, more thirst, more hungry, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
- It is common to have diarrhea with this drug. However, a bowel problem (colitis) with diarrhea has happened with this drug. This may lead to tears or holes in the bowels and may be life-threatening. Call your doctor right away if you have bloody stools; dark, tarry, or sticky stools; diarrhea; or severe stomach pain.
- Some people have had side effects during the infusion. Sometimes, these could be severe or life-threatening. Tell your doctor if you have back or neck pain, chills, shaking, dizziness, passing out, fever, flushing, itching, rash, shortness of breath, swelling of the face, or wheezing.
- If you are having or have had a stem cell transplant with stem cells from someone else (allogeneic), talk with your doctor. Some problems with these types of stem cell transplants have happened in people who have had this drug. These problems can be very bad and can lead to death.
- If you have had an organ transplant, talk with your doctor. This drug may raise the chance of organ transplant rejection.
- A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
- Eye problems have happened with this drug. Some types of eye problems may need to be treated right away to lower the chance of long-lasting eyesight loss. Call your doctor right away if you have any changes in eyesight, eye pain, or very bad eye irritation.
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 doctor or get medical help right away if you have 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 liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
- Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- Signs of thyroid, pituitary, or adrenal gland problems. Some signs may be change in mood or the way you act, change in weight, constipation, deeper voice, dizziness, fainting, feeling cold, feeling very tired, hair loss, headache that lasts or is very bad, or lowered interest in sex.
- Signs of nerve problems like a burning, numbness, or tingling feeling that is not normal; weakness; or not being able to move a part of the body (paralysis).
- Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
- Signs of a brain problem like change in balance, feeling confused, fever, memory problems, muscle weakness, seizures, stiff neck, or very upset stomach or throwing up.
- Signs of heart problems like chest pain, fast heartbeat, a heartbeat that does not feel normal, or shortness of breath.
- Signs of electrolyte problems like mood changes, confusion, muscle pain or weakness, a heartbeat that does not feel normal, seizures, not hungry, or very bad upset stomach or throwing up.
- Any unexplained bruising or bleeding.
- Change in bowel habits.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Constipation, diarrhea, stomach pain, upset stomach, throwing up, or feeling less hungry.
- Feeling dizzy, tired, or weak.
- Trouble sleeping.
- Weight loss.
- Back, bone, joint, or muscle pain.
- Signs of a common cold.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- It is given as an infusion into a vein over a period of time.
- Call your doctor to find out what to do.
- If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- 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.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, 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.
© 2021 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.