Teniposide Disease Interactions

Teniposide can induce severe myelosuppression at therapeutic doses. The use of teniposide may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with teniposide. Close clinical monitoring of hematopoietic function is recommended.

Teniposide induces severe myelosuppression at doses recommended to treat ALL. Leukopenia, primarily affecting neutrophils, thrombocytopenia, and anemia have been reported during teniposide therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Hemoglobin, white blood cell count and differential, and platelet count should be obtained before treatment initiation. Close clinical monitoring of hematopoietic function is recommended during treatment. If necessary, repeat bone marrow examination should be performed prior to the decision to continue therapy in the setting of severe myelosuppression. Patients with both Down syndrome and leukemia may be especially sensitive to myelosuppressive chemotherapy, therefore, initial dosing with teniposide should be reduced in these patients. It is suggested that the first course of teniposide should be given at half the usual dose.

The pharmacokinetic disposition of teniposide has not been fully assessed in patients with hepatic impairment. Patients with hepatic impairment may be at increased risk for teniposide toxicity. Therapy with teniposide should be administered cautiously and dosage modification considered in patients with compromised hepatic function.

Teniposide is primarily eliminated by the kidney. Approximately 44% of teniposide is excreted in the urine unchanged (10%) and as metabolites. The pharmacokinetic disposition of teniposide has not been fully assessed in patients with renal impairment. Therapy with teniposide should be administered cautiously and dosage modification considered in patients with compromised renal function. Clinical monitoring of renal function is recommended.