(ca baz i TAKS el)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Jevtana: 60 mg/1.5 mL (1.5 mL) [contains alcohol, usp, polysorbate 80]
Brand Names: U.S.
- Antineoplastic Agent, Antimicrotubular
- Antineoplastic Agent, Taxane Derivative
Cabazitaxel is a taxane derivative which is a microtubule inhibitor; it binds to tubulin promoting assembly into microtubules and inhibiting disassembly which stabilizes microtubules. This inhibits microtubule depolymerization and cell division, arresting the cell cycle and inhibiting tumor proliferation. Unlike other taxanes, cabazitaxel has a poor affinity for multidrug resistance (MDR) proteins, therefore conferring activity in resistant tumors.
Vdss: 4,864 L; has greater CNS penetration than other taxanes
Extensively hepatic; primarily via CYP3A4 and 3A5; also via CYP2C8 (minor)
Feces (76% as metabolites); Urine (~4%)
Terminal: 95 hours
89% to 92%; primarily to serum albumin and lipoproteins
Special Populations: Hepatic Function Impairment
Clearance was decreased 39% in patients with severe hepatic impairment (total bilirubin >3 times ULN) as compared to patients with mild impairment (total bilirubin >1 to ≤1.5 times ULN and AST >1.5 times ULN).
Use: Labeled Indications
Prostate cancer, metastatic: Treatment of hormone-refractory metastatic prostate cancer (in combination with prednisone) in patients previously treated with a docetaxel-containing regimen
Severe hypersensitivity to cabazitaxel or any component of the formulation, or to other medications formulated with polysorbate 80; neutrophil count ≤1,500/mm3; severe hepatic impairment (total bilirubin >3 times ULN)
Canadian labeling: Additional contraindications (not in the US labeling): Concomitant vaccination with yellow fever vaccine
Note: Premedicate at least 30 minutes prior to each dose of cabazitaxel with an antihistamine (eg, diphenhydramine IV 25 mg or equivalent), a corticosteroid (eg, dexamethasone 8 mg IV or equivalent), and an H2 antagonist (eg, ranitidine 50 mg IV or equivalent). Per the manufacturer, antiemetic prophylaxis (oral or IV) is also recommended.
Prostate cancer, metastatic: IV: 25 mg/m2 once every 3 weeks (in combination with prednisone) (de Bono 2010).
Off-label dosing: IV: A lower dose of 20 mg/m2 once every 3 weeks (in combination with prednisone) has been studied and was found to be non-inferior to the 25 mg/m2 dose. The lower dose also had a decreased incidence of grade 3 and 4 toxicities compared to the 25 mg/m2 dose (de Bono 2016).
Dosage adjustment for concomitant medications:
Strong CYP3A inhibitors: Concomitant use with strong CYP3A inhibitors (eg, ketoconazole, itraconazole, clarithromycin, protease inhibitors, nefazodone, telithromycin, voriconazole) may increase cabazitaxel plasma concentrations; avoid concurrent use. If concomitant use cannot be avoided, consider reducing cabazitaxel dose by 25%.
Dosing: Renal Impairment
Mild to moderate renal impairment (CrCl ≥30 mL/minute): No dosage adjustment necessary.
Severe renal impairment (CrCl <30 mL/minute) or end-stage renal disease: Use with caution; monitor closely.
Dosing: Hepatic Impairment
Mild impairment (total bilirubin >1 to ≤1.5 times ULN or AST ≥1.5 times ULN): Reduce dose to 20 mg/m2; use with caution and monitor closely.
Moderate impairment (total bilirubin >1.5 to ≤3 times ULN with any AST): Reduce dose to 15 mg/m2 (based on tolerability; efficacy of this dose is not known); use with caution and monitor closely.
Severe impairment (total bilirubin >3 times ULN): Use is contraindicated.
Dosing: Adjustment for Toxicity
Neutropenia ≥ grade 3 for >1 week despite WBC growth factors: Delay treatment until ANC >1,500/mm3 and then reduce dose to 20 mg/m2 with continued WBC growth factor secondary prophylaxis.
Neutropenic fever or neutropenic infection: Delay treatment until improvement/resolution and ANC >1,500/mm3 and then reduce dose to 20 mg/m2 with continued WBC growth factor secondary prophylaxis.
Persistent hematologic toxicity (despite dosage reduction): Discontinue treatment.
Severe hypersensitivity: Discontinue immediately.
Diarrhea ≥ grade 3 or persistent despite appropriate medication, fluids, and electrolyte replacement: Delay treatment until improves or resolves and then reduce dose to 20 mg/m2.
Persistent diarrhea (despite dosage reduction): Discontinue treatment.
Peripheral neuropathy (grade 2): Delay treatment until improves or resolves and then reduce dose to 20 mg/m2
Persistent peripheral neuropathy (despite dosage reduction) or ≥ grade 3 peripheral neuropathy: Discontinue treatment
Pulmonary symptoms (new or worsening): Interrupt cabazitaxel treatment, monitor closely and promptly investigate and manage symptoms. May require discontinuation (carefully evaluate the potential benefits of treatment resumption).
ASCO Guidelines for appropriate chemotherapy dosing in obese adults with cancer: Utilize patient’s actual body weight (full weight) for calculation of body surface area- or weight-based dosing, particularly when the intent of therapy is curative; manage regimen-related toxicities in the same manner as for nonobese patients; if a dose reduction is utilized due to toxicity, consider resumption of full weight-based dosing with subsequent cycles, especially if cause of toxicity (eg, hepatic or renal impairment) is resolved (Griggs 2012).
Do not prepare or administer in PVC-containing infusion containers or polyurethane infusion sets. Cabazitaxel and diluent vials contain overfill. Preparation requires 2 steps. Slowly inject the entire contents of the provided diluent vial into the cabazitaxel 60 mg/1.5 mL vial, directing the diluent down the vial wall. Mix gently by inverting the vial for at least 45 seconds; do not shake. Allow vial to sit so that foam dissipates and solution appears homogeneous. This results in an intermediate reconstituted concentration of 10 mg/mL. Further dilute within 30 minutes into a 250 mL D5W or NS non-PVC infusion container to final concentration of 0.1 to 0.26 mg/mL (total doses >65 mg will require a larger infusion volume; final concentration should not exceed 0.26 mg/mL). Gently invert container to mix. Do not use infusion solutions if crystals or precipitate appear; discard if this occurs. Infusion should be completed within 8 hours if stored at room temperature. For infusion solutions stored under refrigeration, the infusion should be completed within 24 hours.
IV: Infuse over 1 hour using a 0.22-micron inline filter. Do not use polyurethane-containing infusion sets for administration. Allow to reach room temperature prior to infusion. Premedicate with an antihistamine, a corticosteroid, and an H2 antagonist at least 30 minutes prior to infusion. Observe closely during infusion (for hypersensitivity). Per the manufacturer, antiemetic prophylaxis (oral or IV) is also recommended.
Avoid grapefruit juice.
Store intact vials at 25°C (77°F); excursions permitted between 15°C and 30°C (59°F and 86°F). Do not refrigerate. Do not prepare or administer in PVC-containing infusion containers or polyurethane infusion sets. The initial reconstituted solution (at 10 mg/mL) is stable for 30 minutes in the vial and solutions for infusion are stable for up to 8 hours at room temperature (includes the 1 hour infusion) or 24 hours refrigerated (includes the 1 hour infusion).
Antineoplastic Agents (Anthracycline, Systemic): Taxane Derivatives may enhance the adverse/toxic effect of Antineoplastic Agents (Anthracycline, Systemic). Taxane Derivatives may increase the serum concentration of Antineoplastic Agents (Anthracycline, Systemic). Taxane Derivatives may also increase the formation of toxic anthracycline metabolites in heart tissue. Consider therapy modification
Aprepitant: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy
BCG (Intravesical): Immunosuppressants may diminish the therapeutic effect of BCG (Intravesical). Avoid combination
BCG (Intravesical): Myelosuppressive Agents may diminish the therapeutic effect of BCG (Intravesical). Avoid combination
Bosentan: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy
CloZAPine: Myelosuppressive Agents may enhance the adverse/toxic effect of CloZAPine. Specifically, the risk for neutropenia may be increased. Monitor therapy
Coccidioides immitis Skin Test: Immunosuppressants may diminish the diagnostic effect of Coccidioides immitis Skin Test. Monitor therapy
Conivaptan: May increase the serum concentration of CYP3A4 Substrates. Avoid combination
CYP3A4 Inducers (Moderate): May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy
CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. Consider therapy modification
CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4 Substrates. Monitor therapy
CYP3A4 Inhibitors (Strong): May increase the serum concentration of Cabazitaxel. Management: Concurrent use of cabazitaxel with strong inhibitors of CYP3A4 should be avoided when possible. If such a combination must be used, consider a 25% reduction in the cabazitaxel dose. Consider therapy modification
Dabrafenib: May decrease the serum concentration of CYP3A4 Substrates. Management: Seek alternatives to the CYP3A4 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely (particularly therapeutic effects). Consider therapy modification
Dasatinib: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy
Deferasirox: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy
Deferiprone: Myelosuppressive Agents may enhance the neutropenic effect of Deferiprone. Avoid combination
Denosumab: May enhance the adverse/toxic effect of Immunosuppressants. Specifically, the risk for serious infections may be increased. Monitor therapy
Dipyrone: May enhance the adverse/toxic effect of Myelosuppressive Agents. Specifically, the risk for agranulocytosis and pancytopenia may be increased Avoid combination
DOXOrubicin (Conventional): Taxane Derivatives may decrease the metabolism of DOXOrubicin (Conventional). Management: Consider using docetaxel instead of paclitaxel as a way to avoid this potential interaction, and monitor closely for toxic effects of doxorubicin. Administer doxorubicin prior to paclitaxel when used concomitantly. Consider therapy modification
Echinacea: May diminish the therapeutic effect of Immunosuppressants. Consider therapy modification
Enzalutamide: May decrease the serum concentration of CYP3A4 Substrates. Management: Concurrent use of enzalutamide with CYP3A4 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP3A4 substrate should be performed with caution and close monitoring. Consider therapy modification
Fingolimod: Immunosuppressants may enhance the immunosuppressive effect of Fingolimod. Management: Avoid the concomitant use of fingolimod and other immunosuppressants when possible. If combined, monitor patients closely for additive immunosuppressant effects (eg, infections). Consider therapy modification
Fosaprepitant: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy
Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates. Avoid combination
Idelalisib: May increase the serum concentration of CYP3A4 Substrates. Avoid combination
Leflunomide: Immunosuppressants may enhance the adverse/toxic effect of Leflunomide. Specifically, the risk for hematologic toxicity such as pancytopenia, agranulocytosis, and/or thrombocytopenia may be increased. Management: Consider not using a leflunomide loading dose in patients receiving other immunosuppressants. Patients receiving both leflunomide and another immunosuppressant should be monitored for bone marrow suppression at least monthly. Consider therapy modification
Lenograstim: Antineoplastic Agents may diminish the therapeutic effect of Lenograstim. Consider therapy modification
MiFEPRIStone: May increase the serum concentration of CYP3A4 Substrates. Management: Minimize doses of CYP3A4 substrates, and monitor for increased concentrations/toxicity, during and 2 weeks following treatment with mifepristone. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Consider therapy modification
Mitotane: May decrease the serum concentration of CYP3A4 Substrates. Management: Doses of CYP3A4 substrates may need to be adjusted substantially when used in patients being treated with mitotane. Consider therapy modification
Natalizumab: Immunosuppressants may enhance the adverse/toxic effect of Natalizumab. Specifically, the risk of concurrent infection may be increased. Avoid combination
Netupitant: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy
Nivolumab: Immunosuppressants may diminish the therapeutic effect of Nivolumab. Consider therapy modification
Ocrelizumab: May enhance the immunosuppressive effect of Immunosuppressants. Monitor therapy
Palbociclib: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy
Palifermin: May enhance the adverse/toxic effect of Antineoplastic Agents. Specifically, the duration and severity of oral mucositis may be increased. Management: Do not administer palifermin within 24 hours before, during infusion of, or within 24 hours after administration of myelotoxic chemotherapy. Consider therapy modification
Pimecrolimus: May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination
Platinum Derivatives: May enhance the myelosuppressive effect of Taxane Derivatives. Administer Taxane derivative before Platinum derivative when given as sequential infusions to limit toxicity. Consider therapy modification
Promazine: May enhance the myelosuppressive effect of Myelosuppressive Agents. Monitor therapy
Roflumilast: May enhance the immunosuppressive effect of Immunosuppressants. Consider therapy modification
Sarilumab: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy
Siltuximab: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy
Simeprevir: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy
Sipuleucel-T: Immunosuppressants may diminish the therapeutic effect of Sipuleucel-T. Monitor therapy
St John's Wort: May decrease the serum concentration of CYP3A4 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. Consider therapy modification
Stiripentol: May increase the serum concentration of CYP3A4 Substrates. Management: Use of stiripentol with CYP3A4 substrates that are considered to have a narrow therapeutic index should be avoided due to the increased risk for adverse effects and toxicity. Any CYP3A4 substrate used with stiripentol requires closer monitoring. Consider therapy modification
Tacrolimus (Topical): May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination
Tertomotide: Immunosuppressants may diminish the therapeutic effect of Tertomotide. Monitor therapy
Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy
Tofacitinib: Immunosuppressants may enhance the immunosuppressive effect of Tofacitinib. Management: Concurrent use with antirheumatic doses of methotrexate or nonbiologic disease modifying antirheumatic drugs (DMARDs) is permitted, and this warning seems particularly focused on more potent immunosuppressants. Consider therapy modification
Trastuzumab: May enhance the neutropenic effect of Immunosuppressants. Monitor therapy
Vaccines (Inactivated): Immunosuppressants may diminish the therapeutic effect of Vaccines (Inactivated). Management: Vaccine efficacy may be reduced. Complete all age-appropriate vaccinations at least 2 weeks prior to starting an immunosuppressant. If vaccinated during immunosuppressant therapy, revaccinate at least 3 months after immunosuppressant discontinuation. Consider therapy modification
Vaccines (Live): Immunosuppressants may enhance the adverse/toxic effect of Vaccines (Live). Immunosuppressants may diminish the therapeutic effect of Vaccines (Live). Management: Avoid use of live organism vaccines with immunosuppressants; live-attenuated vaccines should not be given for at least 3 months after immunosuppressants. Avoid combination
Adverse reactions reported for combination therapy with prednisone.
Central nervous system: Fatigue (37%), peripheral neuropathy (13%; grades 3/4: <1%)
Gastrointestinal: Diarrhea (47%), nausea (34%), vomiting (22%), constipation (20%), abdominal pain (17%), anorexia (16%), dysgeusia (11%)
Genitourinary: Hematuria (17%)
Hematologic & oncologic: Anemia (98%; grades 3/4: 11%), leukopenia (96%; grades 3/4: 69%), neutropenia (94%; grades 3/4: 82%), thrombocytopenia (48%; grades 3/4: 4%)
Neuromuscular & skeletal: Weakness (20%), back pain (16%), arthralgia (11%)
Respiratory: Dyspnea (12%), cough (11%)
Miscellaneous: Fever (12%)
1% to 10%:
Cardiovascular: Peripheral edema (9%), cardiac arrhythmia (5%), hypotension (5%)
Central nervous system: Dizziness (8%), headache (8%), pain (5%)
Dermatologic: Alopecia (10%)
Endocrine & metabolic: Weight loss (9%), dehydration (5%)
Gastrointestinal: Dyspepsia (10%), mucosal inflammation (6%)
Genitourinary: Urinary tract infection (8%), dysuria (7%)
Hematologic & oncologic: Febrile neutropenia (7%; grades 3/4: 7%)
Hepatic: Increased serum ALT, increased serum AST, increased serum bilirubin
Neuromuscular & skeletal: Muscle spasm (7%)
Renal: Renal failure (4%)
Frequency not defined:
Endocrine & metabolic: Electrolyte disturbance
<1% (Limited to important or life-threatening): Adult respiratory distress syndrome, enterocolitis, gastritis, gastrointestinal hemorrhage, gastrointestinal perforation, hypersensitivity reaction (includes bronchospasm, erythema, hypotension, skin rash), interstitial pneumonitis, interstitial pulmonary disease, intestinal obstruction, neutropenic enterocolitis, sepsis, septic shock
Concerns related to adverse effects:
• Bone marrow suppression: [US Boxed Warning]: Deaths due to neutropenia have been reported. Cabazitaxel is contraindicated in patients with neutrophil count ≤1,500/mm3. Monitor blood counts frequently. Neutropenia, anemia, thrombocytopenia, and/or pancytopenia may occur with use; grade 3 and 4 neutropenia was observed in over 80% of patients treated with cabazitaxel in a clinical trial. Dose reductions are recommended following neutropenic fever or prolonged neutropenia. Administration of WBC growth factors may reduce the risk of complications due to neutropenia. Consider primary WBC growth factor prophylaxis in high-risk patients (eg, >65 years of age, poor performance status, history of neutropenic fever, extensive prior radiation, poor nutrition status, other serious comorbidities); secondary prophylaxis and therapeutic WBC growth factors should be considered in all patients with increased risk for neutropenic complications. Use cautiously in patients with hemoglobin <10 g/dL. Monitor complete blood counts weekly during cycle 1 and prior to subsequent treatment cycles, or as clinically indicated.
• Gastrointestinal toxicity: Nausea, vomiting and diarrhea may occur. Diarrhea may be severe and may result in dehydration and electrolyte imbalance; fatalities have been reported. Per the manufacturer, antiemetic prophylaxis is recommended. Antidiarrheal medication and fluid and electrolyte replacement may be necessary. Diarrhea ≥ grade 3 may require treatment delay and or dosage reduction. Gastrointestinal hemorrhage and perforation, enterocolitis, neutropenic enterocolitis, and ileus (some fatal) have also been observed. Use with caution in patients at risk of developing gastrointestinal complications (eg, elderly patients, those with neutropenia or a prior history of pelvic radiation, adhesions, GI ulceration or bleeding, concomitant use of steroids, NSAIDs, antiplatelet or anticoagulant medications). Evaluate promptly if symptoms such as abdominal pain and tenderness, fever, persistent constipation, and diarrhea (with or without neutropenia) occur. May require treatment interruption and/or therapy discontinuation.
• Hypersensitivity reactions: [US Boxed Warning]: Severe hypersensitivity reactions, including generalized rash, erythema, hypotension, and bronchospasm may occur. Immediate discontinuation is required if hypersensitivity is severe; administer appropriate supportive medications. Premedicate with an IV antihistamine, corticosteroid, and H2 antagonist prior to infusion. Use in patients with history of severe hypersensitivity to cabazitaxel or other medications formulated with polysorbate 80 is contraindicated. Observe closely during infusion, especially during the first and second infusions; reaction may occur within minutes. Do not rechallenge after severe hypersensitivity reactions.
• Pulmonary toxicity: Interstitial pneumonia/pneumonitis, interstitial lung disease, and acute respiratory distress syndrome have been observed; may be fatal. Patients with underlying pulmonary disease may be at higher risk for these events. Acute respiratory distress syndrome may occur in the setting of infection. If new or worsening pulmonary symptoms develop, interrupt cabazitaxel treatment, monitor closely and promptly investigate and manage symptoms. May require discontinuation (carefully evaluate the potential benefits of treatment resumption).
• Renal failure: Renal failure (including rare fatalities) has been reported from clinical trials; generally associated with dehydration, sepsis, or obstructive uropathy. Use with caution in patients with severe renal impairment (CrCl <30 mL/minute) and end-stage renal disease.
• Hepatic impairment: Use is contraindicated in patients with severe hepatic impairment (total bilirubin >3 times ULN). Dose reduction is necessary in patients with mild impairment (total bilirubin >1 to ≤1.5 times ULN or AST >1.5 times ULN) and moderate impairment (total bilirubin >1.5 to ≤3 times ULN); use with caution and monitor closely. Due to extensive hepatic metabolism, cabazitaxel exposure is increased in patients with hepatic impairment.
Concurrent drug therapy issues:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
Dosage form specific issues:
• Polysorbate 80: Some dosage forms may contain polysorbate 80 (also known as Tweens). Hypersensitivity reactions, usually a delayed reaction, have been reported following exposure to pharmaceutical products containing polysorbate 80 in certain individuals (Isaksson 2002; Lucente 2000; Shelley 1995). Thrombocytopenia, ascites, pulmonary deterioration, and renal and hepatic failure have been reported in premature neonates after receiving parenteral products containing polysorbate 80 (Alade 1986; CDC 1984). See manufacturer’s labeling.
• Elderly: Patients ≥65 years of age are more likely to experience certain adverse reactions, including grade 3 and 4 neutropenia and neutropenic fever. Fatigue, asthenia, pyrexia, dizziness, urinary tract infection, and dehydration also occurred more frequently in elderly patients compared to younger patients. Death due to causes other than disease progression (within 30 days of the last cabazitaxel dose) was higher in elderly patients versus younger patients.
• Preparation for administration: Failure to properly reconstitute the concentrated vial of cabazitaxel with the correct amount of diluent may lead to higher dosage being administered and increased risk of toxicity. Follow manufacturer instructions carefully.
CBC with differential and platelets (weekly during first cycle, then prior to each treatment cycle and as clinically indicated); hepatic/renal function. Monitor for hypersensitivity reactions (especially during the first and second infusions). Monitor for signs/symptoms of gastrointestinal disorders (eg, nausea, vomiting, diarrhea, gastrointestinal hemorrhage and perforation, ileus, colitis, abdominal pain/tenderness). Monitor for new or worsening pulmonary symptoms.
Pregnancy Risk Factor
Adverse events have been observed in animal reproduction studies. Cabazitaxel is not indicated for use in women. May cause fetal harm if administered during pregnancy. Pregnant women should avoid exposure to cabazitaxel.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience headache, nausea, abdominal pain, lack of appetite, back pain, joint pain, burning or numbness feeling, hair loss, or change in taste. Have patient report immediately to prescriber signs of infection, signs of bowel problems (black, tarry, or bloody stools; fever; mucus in stools; vomiting; vomiting blood; severe abdominal pain; constipation; or diarrhea), signs of a severe pulmonary disorder (lung or breathing problems like difficulty breathing, shortness of breath, or a cough that is new or worse), signs of fluid and electrolyte problems (mood changes, confusion, muscle pain or weakness, abnormal heartbeat, severe dizziness, passing out, tachycardia, increased thirst, seizures, loss of strength and energy, lack of appetite, urinary retention or change in the amount of urine passed, dry mouth, dry eyes, or nausea or vomiting), signs of bleeding (vomiting blood or vomit that looks like coffee grounds; coughing up blood; hematuria; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a reason or that get bigger; or any severe or persistent bleeding), signs of severe cerebrovascular disease (change in strength on one side is greater than the other, difficulty speaking or thinking, change in balance, or vision changes), signs of kidney problems (urinary retention, hematuria, change in amount of urine passed, or weight gain), fecal discoloration, dizziness, passing out, abnormal heartbeat, shortness of breath, excessive weight gain, swelling of arms or legs, or severe loss of strength and energy (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
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- Drug class: mitotic inhibitors
Other brands: Jevtana