Pentostatin Side Effects

Medically reviewed by Drugs.com. Last updated on Mar 27, 2025.

Applies to pentostatin: intravenous powder for solution.

Important warnings This medicine can cause some serious health issues

Intravenous route (powder for solution)

Pentostatin should be administered under the supervision of a physician qualified and experienced in the use of cancer chemotherapeutic agents.

The use of doses higher than those specified is not recommended.

Dose-limiting severe renal, liver, pulmonary, and CNS toxicities occurred in Phase 1 studies that used pentostatin at higher doses (20 to 50 mg/m(2) in divided doses over 5 days) than recommended.

In a clinical investigation in patients with refractory chronic lymphocytic leukemia using pentostatin at the recommended dose in combination with fludarabine phosphate, 4 of 6 patients entered in the study had severe or fatal pulmonary toxicity.

The use of pentostatin in combination with fludarabine phosphate is not recommended.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

You should not use this medicine if you are also taking fludarabine (Fludara®). Taking it together with this medicine may increase the chance of serious side effects.

While you are being treated with pentostatin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Pentostatin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Pentostatin can lower the number of white blood cells in your blood temporarily, increasing the chance of getting an infection (e.g., pneumonia). It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

If you develop a skin rash or any allergic reaction to this medicine, stop using the medicine and check with your doctor as soon as possible.

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.

Common side effects of pentostatin

Some side effects of pentostatin 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 side effects

• diarrhea
• headache
• loss of appetite
• muscle pain
• nausea and vomiting
• skin rash

Less common side effects

• back pain
• bloating or gas
• constipation
• dry skin
• general feeling of discomfort or illness
• itching
• joint pain
• weakness
• weight loss

Serious side effects of pentostatin

Along with its needed effects, pentostatin may cause some unwanted effects. Some side effects will have signs or symptoms that you can see or feel. Your doctor may watch for others by doing certain tests.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer. Discuss these possible effects with your doctor.

Check with your doctor immediately if any of the following side effects occur while taking pentostatin:

More common side effects

• cough or hoarseness
• fever or chills
• lower back or side pain
• pain
• painful or difficult urination
• skin rash or itching (sudden)
• unusual tiredness or weakness

Less common side effects

• anxiety or nervousness
• black, tarry stools
• blood in the urine or stools
• changes in vision
• chest pain
• confusion
• cramps in lower legs
• mental depression
• nosebleed
• numbness or tingling of the hands or feet
• pinpoint red spots on the skin
• shortness of breath
• sleepiness
• sore, red eyes
• sores in the mouth or on the lips
• stomach pain
• swelling of the feet or lower legs
• trouble with sleeping
• unusual bleeding or bruising

Serious side effects of pentostatin

Along with its needed effects, pentostatin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

For healthcare professionals

Applies to pentostatin: intravenous powder for injection.

Hematologic adverse events

• Very common (10% or more): Leukopenia (22%), thrombocytopenia, anemia, blood disorder, eosinophilia, hypochromic pancytopenia
• Common (1% to 10%): Agranulocytosis, acute leukemia, febrile neutropenia, ecchymosis, lymphadenopathy, splenomegaly, hemorrhage, agranulocytosis
• Uncommon (0.1% to 1%): Pure red cell aplasia, autoimmune hemolytic anemia, anemia-hemolytic, aplastic anemia hemolytic uremic syndrome, idiopathic thrombocytopenia purpura, thrombotic thrombocytopenia purpura
• Rare (less than 0.1%): Autoimmune thrombocytopenia^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea/vomiting (63%), diarrhea (17%), abdominal pain (16%), stomatitis (12%)
• Common (1% to 10%): Oral candidiasis, perianal abscess, dental abnormalities, dyspepsia, flatulence, gingivitis
• Uncommon (0.1% to 1%): Acute gastroenteritis
• Rare (less than 0.1%): Esophageal candidiasis
• Frequency not reported: Constipation, dysphagia, glossitis, ileus^[Ref]

Dermatologic

• Very common (10% or more): Rash (43%), pruritus (21%)
• Common (1% to 10%): Furunculosis, abscess skin, mycotic skin infection, sweating, skin disorder, face edema, dry skin urticaria^[Ref]

Hepatic

• Common (1% to 10%): Hepatic disorder, elevated liver function tests
• Frequency not reported: Kidney function abnormal, nephropathy^[Ref]

Genitourinary

• Common (1% to 10%): Urinary tract infection
• Uncommon (0.1% to 1%): Cystitis
• Frequency not reported: Amenorrhea, breast lump, impotence^[Ref]

Respiratory

• Very common (10% or more): Cough (20%), upper respiratory infection (13%), rhinitis (11%), dyspnea (11%), pharyngitis
• Common (1% to 10%): Sinusitis, pneumonia, bronchitis, E. coli pneumonia, fungal pneumonia, asthma
• Uncommon (0.1% to 1%): Pulmonary aspergillosis, pulmonary aspergillosis
• Frequency not reported: Bronchospasm, larynx edema^[Ref]

Nervous system

• Very common (10% or more): Headache (17%)
• Common (1% to 10%): Dizziness, paresthesia
• Frequency not reported: Amnesia, ataxia, convulsions, dysarthria, encephalitis, hyperkinesia, meningism, neuralgia, neuritis, neuropathy, paralysis, syncope, twitching, vertigo^[Ref]

Cardiovascular

• Common (1% to 10%): Chest pain, hypotension
• Frequency not reported: Angina pectoris, arrhythmia, A-V block, bradycardia, extrasystoles ventricular, heart arrest, heart failure, hypertension, pericardial effusion, phlebitis, pulmonary embolus, sinus arrest, tachycardia, thrombophlebitis deep, vasculitis^[Ref]

Hypersensitivity

• Common (1% to 10%): Allergic reaction
• Rare (0.01% to 0.1%): Anaphylaxis^[Ref]

Ocular

• Common (1% to 10%): Conjunctivitis
• Frequency not reported: Amblyopia, dry eyes, labyrinthitis, lacrimation disorder, nonreactive eye, photophobia, retinopathy, abnormal vision, watery eyes^[Ref]

Musculoskeletal

• Very common (10% or more): Myalgia (19%)
• Common (1% to 10%): Osteomyelitis, arthralgia
• Frequency not reported: Arthritis, gout^[Ref]

Metabolic

• Very common (10% or more): Anorexia (13%)
• Common (1% to 10%): Neurologic disorder, CNS/CNS toxicity
• Frequency not reported: Hypercalcemia, hyponatremia^[Ref]

Immunologic

• Very common (10% or more): Viral infection
• Common (1% to 10%): (Herpes zoster, infection unspecified), cellulitis, bacterial infection, herpes simplex, sepsis, septic shock, staphylococcal infection, Graft versus host disease
• Uncommon (0.1% to 1%): Clostridium difficile colitis, cytomegalovirus infection, graft failure
• Frequency not reported: Influenza-like symptoms^[Ref]

Psychiatric

• Common (1% to 10%): Confusion, insomnia, somnolence, anxiety, depression, nervousness
• Frequency not reported: decrease/loss libido, emotional lability, hallucination, hostility, neurosis, thinking abnormal, dreaming abnormal^[Ref]

Oncologic

• Common (1% to 10%): Neoplasms, skin carcinoma
• Uncommon (0.1% to 1%): Tumor lysis syndrome
• Frequency not reported: Acute leukemia, hemolytic anemia, aplastic anemia^[Ref]

Other

• Very common (10% or more): Fever (46%), fatigue (42%), chills (19%), asthenia (12%)
• Common (1% to 10%): Pain, peripheral edema
• Frequency not reported: Hangover effect, deafness, earache, tinnitus, unusual taste^[Ref]

Renal

• Common (1% to 10%): Urosepsis, elevated creatinine
• Frequency not reported: Renal failure, renal insufficiency, renal stone^[Ref]

See also:

Further information

Pentostatin side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer