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Teniposide Side Effects

In Summary

Commonly reported side effects of teniposide include: infection and bone marrow depression. Other side effects include: bronchospasm, hypersensitivity reaction, hypotension, hemorrhage, dyspnea, fever, hypertension, tachycardia, and chills. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to teniposide: intravenous solution

Along with its needed effects, teniposide 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 immediately if any of the following side effects occur while taking teniposide:

More common
  • Black, tarry stools
  • blood in urine or stools
  • chills
  • cough or hoarseness
  • fever
  • hives
  • lower back or side pain
  • painful or difficult urination
  • pinpoint red spots on skin
  • shortness of breath
  • tightness in chest or wheezing
  • troubled breathing
  • unusual bleeding or bruising

Check with your doctor as soon as possible if any of the following side effects occur while taking teniposide:

More common
  • Flushing of face
  • sores in mouth or on lips
  • unusually fast heartbeat
  • unusual tiredness
Less common Rare
  • Decreased urination
  • swelling of face, fingers, feet, or lower legs
  • yellow eyes or skin

Some side effects of teniposide 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

This medicine often causes a temporary loss of hair. After treatment with teniposide has ended, normal hair growth should return.

For Healthcare Professionals

Applies to teniposide: intravenous solution


Hematologic side effects have included bone marrow suppression which is the most significant toxicity associated with teniposide therapy. Hematologic effects including neutropenia (less than 2,000 ANC/mcL), leukopenia (less than 3,000 WBC/mcL), anemia (88%), thrombocytopenia (less than 100,000 platelets/mcL) (85%), myelosuppression (unspecified) (75%), and bleeding (5%) have been reported. Sepsis, sometimes fatal, may be a consequence of severe myelosuppression.[Ref]


Hypersensitivity side effects (5%) have been reported. These have included some potentially life threatening hypersensitivity reactions with anaphylaxis-like symptoms.[Ref]

The hypersensitivity reaction may include chills, fever, urticaria, tachycardia, bronchospasm, dyspnea, hypertension or hypotension, and facial flushing. Treatment for a severe hypersensitivity reaction include prompt use of antihistamines, corticosteroids, epinephrine, intravenous fluids, and other supportive measures.

One analysis of hypersensitivity reactions to teniposide concluded that the frequency of the reactions is substantially higher in patients with neuroblastoma and brain tumors.[Ref]


Cardiovascular side effects including hypotension/cardiovascular (2%) have been reported. One episode of sudden death attributable to probable arrhythmia and intractable hypotension has also been reported.[Ref]


Oncologic side effects include one report of a relative risk of developing secondary acute nonlymphocytic leukemia approximately twelve times that of patients treated with less intensive schedules.[Ref]

The patients in the report were children with acute lymphoblastic leukemia in remission who received teniposide plus other chemotherapeutic agents at weekly or twice weekly doses.

Compounds with similar mechanisms of action and mutagenicity profiles have been carcinogenic. Teniposide should be considered to be a potential carcinogen. Teniposide has been shown to be mutagenic in various bacterial and mammalian genetic toxicity tests.[Ref]


Gastrointestinal side effects including mucositis (76%), diarrhea (33%), and nausea/vomiting (29%) have been reported.[Ref]


Immunologic side effects including infection (12%) have been reported.[Ref]


Alopecia, which sometimes progressed to total baldness, was usually reversible.[Ref]

Dermatologic side effects including alopecia (9%) and rash (3%) have been reported.[Ref]


General side effects including fever and asthenia have been reported.[Ref]

Nervous system

Nervous system side effects have included headache, confusion, neurotoxicity and, at investigational high doses, acute CNS depression has been reported.[Ref]


Other side effects have included three case reports of somnolence, hypotension, and metabolic acidosis which have been reported with teniposide doses at three to five times the standard dose.[Ref]


1. "Product Information. Vumon (teniposide)." Bristol-Myers Squibb, Princeton, NJ.

2. Shimizu H, Frankel LS, Culbert SJ "Severe hypertensive reactions to teniposide (VM-26) in infants with congenital leukemia." Am J Pediatr Hematol Oncol 9 (1987): 239-41

3. O'Dwyer PJ, King SA, Fortner CL, Leyland-Jones B "Hypersensitivity reactions to teniposide (VM-26): an analysis." J Clin Oncol 4 (1986): 1262-9

4. McLeod HL, Baker DK Jr, Pui CH, Rodman JH "Somnolence, hypotension, and metabolic acidosis following high-dose teniposide treatment in children with leukemia." Cancer Chemother Pharmacol 29 (1991): 150-4

Some side effects of teniposide may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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