Teniposide

Teniposide is a prescription medication used for the treatment of acute lymphoblastic leukemia.

• Teniposide is available under the following different brand names: vm 26, Vumon

Common side effects of Teniposide include:

• nausea,  
• vomiting,
• diarrhea,
• mouth sores,
• hair loss,
• infections, and
• low blood cell counts

Serious side effects of Teniposide include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• skin rash,
• warmth or tingling,
• fever,
• chills,
• lightheadedness,
• wheezing,
• chest tightness,
• fast or irregular heartbeats,
• dizziness,
• nausea,
• itching,
• anxiety,
• warmth in the face,
• diarrhea,
• severe ongoing vomiting,
• sores or white patches in or around the mouth,
• trouble swallowing or talking,
• dry mouth,
• bad breath,
• altered sense of taste,
• pain, burning, irritation, or skin changes where the injection was given,
• skin sores,
• easy bruising,
• unusual bleeding,
• pale skin,
• cold hands and feet,
• shortness of breath,
• tiredness,
• loss of appetite,
• trouble thinking,
• confusion,
• severe drowsiness,
• fast heartbeats,
• rapid breathing, and
• feeling very ill

Rare side effects of Teniposide include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out. 

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Injectable solution

• 10 mg/mL

Acute Lymphoblastic Leukemia

Adult dosage

• 165 mg/m²/dose IV on days 1, 4, 8, and 11

Pediatric dosage

• 165 mg/m² IV, in combo with cytarabine 300 mg/m² IV, twice/week for 8-9 doses, OR  
• 250 mg/m² IV, in combo with vincristine 1.5 mg/m² IV, once/week for 4-8 weeks
• Slow infusion (30-60 min)
• Down syndrome patients: Decrease dose by half
• Withhold treatment if platelets below 50 K/mm³ or ANC below 500/mm³

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Teniposide has severe interactions with no other drugs.
• Teniposide has serious interactions with at least 26 other drugs.
• Teniposide has serious interactions with at least 94 other drugs.
• Teniposide has serious interactions with the following drugs:
  • acetazolamide
  • anastrozole
  • aspirin
  • aspirin rectal
  • aspirin/citric acid/sodium bicarbonate
  • choline magnesium trisalicylate
  • cyclophosphamide
  • diflunisal
  • larotrectinib
  • ribociclib
  • ruxolitinib
  • ruxolitinib topical
  • salsalate
  • sulfasalazine
  • tolbutamide

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to teniposide or castor oil
• Platelets below 50,000/mm³ or ANC below 500/mm³

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Teniposide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Teniposide?”

Cautions

• Hypersensitivity reactions variably manifested by chills, fever, urticaria, tachycardia, bronchospasm, dyspnea, hypertension or hypotension, rash, and facial flushing may occur with any dose
• Acute CNS depression and metabolic acidosis were observed in patients receiving high-dose investigational infusions who were pretreated with antiemetic drugs; thought to be caused by the antiemetic depressant and the alcohol content of high-dose teniposide
• Extravasation may cause local tissue necrosis or thrombophlebitis

Pregnancy and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug is available; animal studies observed a decreased sperm count and genetic damage to sperm 
• Lactation
  • Not known if excreted in breast milk