gemtuzumab (Intravenous route)
Hepatotoxicity, including severe or fatal hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), has been reported in association with the use of gemtuzumab ozogamicin as a single agent, and as part of a combination chemotherapy regimen. Monitor frequently for signs and symptoms of VOD after treatment with gemtuzumab ozogamicin
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
- Powder for Solution
Therapeutic Class: Antineoplastic Agent
Pharmacologic Class: Antibody Drug Conjugate
Uses For gemtuzumab
Gemtuzumab injection is used alone or together with other medicines (eg, cytarabine, daunorubicin) to treat newly-diagnosed CD33-positive acute myeloid leukemia (AML) in adults. It is also used to treat CD33-positive AML that has come back or after other medicines did not work well, in adults and children 2 years of age and older.
Gemtuzumab is an antineoplastic (cancer) medicine. It interferes with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal cells may also be affected by gemtuzumab, other side effects can occur. Before you begin treatment, talk to your doctor about the benefits of gemtuzumab as well as the possible risks of using it.
gemtuzumab is to be given only by or under the direct supervision of your doctor.
Before Using gemtuzumab
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 gemtuzumab, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to gemtuzumab 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.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of gemtuzumab injection in children 2 years of age and older. Safety and efficacy have been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of gemtuzumab injection in the elderly. However, elderly patients are more likely to have high fever or serious infections, which may require caution in patients receiving gemtuzumab.
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.
Interactions with Medicines
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 receiving gemtuzumab, 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 gemtuzumab 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
Using gemtuzumab 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
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Influenza Virus Vaccine, Live
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine
- Yellow Fever Vaccine
Interactions with Food/Tobacco/Alcohol
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 gemtuzumab. Make sure you tell your doctor if you have any other medical problems, especially:
- Electrolyte imbalance or
- Liver disease, moderate or severe or
- Patients who have had hematopoietic stem cell transplant (HSCT)—Use with caution. May cause side effects to become worse.
- Heart rhythm problems (including QT prolongation), history of—Use with caution. May make this condition worse.
- Hyperleukocytosis (blood problem)—Surgical removal of cancer cells is recommended before starting treatment with gemtuzumab.
Proper Use of gemtuzumab
A nurse or other trained health professional will give you gemtuzumab in a hospital or cancer treatment center. gemtuzumab is given through a needle placed into one of your veins.
You may receive other medicines (eg, allergy medicine, fever medicine, steroids) before starting treatment with gemtuzumab.
Precautions While Using gemtuzumab
It is very important that your doctor check your progress at regular visits to make sure gemtuzumab is working properly. Blood tests are needed to check for unwanted effects.
Using gemtuzumab while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Female patients should use effective birth control during treatment with gemtuzumab and for at least 6 months after the last dose. Male patients who have female partners should use effective birth control during treatment with gemtuzumab and for at least 3 months after the last dose. If you think you have become pregnant while receiving gemtuzumab, tell your doctor right away.
If you plan to have children, talk with your doctor before receiving gemtuzumab. Some men and women receiving gemtuzumab have become infertile (unable to have children).
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
gemtuzumab may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving gemtuzumab.
gemtuzumab will lower the number of some types of blood cells in your body. Because of this, you may bleed more easily, which can be life-threatening. Check with your doctor right away if you have any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, headache, dizziness, weakness, pain, swelling, or discomfort in a joint, pinpoint red spots on your skin, unusual nosebleeds, or unusual vaginal bleeding that is heavier than normal.
Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you had a heart rhythm problem, such as QT prolongation.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
gemtuzumab 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 or nurse immediately if any of the following side effects occur:More common
- Bleeding gums
- blood in the urine or stools
- bone pain
- chest pain
- coughing up blood
- decreased urine output
- difficulty in breathing or swallowing
- dizziness, lightheadedness, or fainting
- dry mouth
- fast or irregular heartbeat
- increased menstrual flow or vaginal bleeding
- increased thirst
- irregular heartbeat
- loss of appetite
- loss of consciousness
- lower back or side pain
- mood changes
- muscle pain or cramps
- numbness or tingling in the hands, feet, or lips
- painful or difficult urination
- pinpoint red spots on the skin
- prolonged bleeding from cuts
- rapid, shallow breathing
- red or black, tarry stools
- red or dark brown urine
- sore throat
- swelling of the face, ankles, or hands
- tightness in the chest
- unusual bleeding or bruising
- unusual tiredness or weakness
- Blue lips and fingernails
- coughing that sometimes produces a pink frothy sputum
- difficult, fast, noisy breathing
- fast, pounding, or irregular heartbeat or pulse
- increased sweating
- pale skin
- right upper abdominal pain and fullness
- stomach pain and bloating
- ulcers, sores, or white spots in the mouth
- Frequent urination
- lower abdominal cramping
- watery or bloody diarrhea
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
- Cracked lips
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.
See also: Side effects (in more detail)
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More about gemtuzumab
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
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- Drug class: CD33 monoclonal antibodies
Other brands: Mylotarg