When This Medicine Should Not Be Used:
In some cases, this medicine should not be used if you have severe bone marrow or blood disorders

How to Use This Medicine:
Injectable

• This medicine is very strong. Make sure you understand why you are getting it and what the risks and benefits of treatment are. It is important for you to work closely with your doctor.
• Your doctor will decide how much medicine you should have and when it will be given.
• Your medicine will be given through a tube put in one of your veins, usually in your arm, wrist, or hand and sometimes in the chest. This is called intravenous (in-tra-VEEN-us), or IV.
• A nurse or other caregiver trained to give cancer drugs will give your treatment.
• Do not get the medicine on your skin. If it does, wash the area well with soap and water, and tell your caregiver.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Talk to your doctor before getting any vaccines (such as flu shots).

Warnings While Using This Medicine:

• Do not breastfeed while you are being given this medicine.
• It may take a week or more before the medicine starts to help. You may have more pain 2 to 3 days after your treatment. Your doctor may give you extra medicine for pain during this time.
• The radiation in this medicine stays in your bones, but does not affect other people around you. For about one week after your treatment, the medicine will be in your blood, urine, and bowel movements.
• During the week after your treatment, flush the toilet twice after you go to the bathroom. Use a tissue to wipe up blood or urine spills, then flush the tissue down the toilet. Wash your hands with soap and water after you use the toilet or clean up urine and blood spills.
• Make sure your doctor knows if you have trouble controlling your bladder.
• If your urine, bowel movements, or blood gets on bed sheets or clothes, wash them right away separately from your other laundry.
• You may get infections more easily while getting this medicine. Stay away from crowds or people with colds, flu, or other infections.
• Do not get pregnant while you or your sexual partner are receiving this medicine. Use an effective form of birth control while you are being treated with this medicine.
• If you are pregnant, talk to your doctor before you start your treatments.
• Some cancer drugs may make you sterile (unable to have children), whether you are a man or woman. If you plan to have children someday, talk with your doctor before you start your treatments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Fever, chills, or sore throat
• Unusual bleeding or bruising
• Blood in urine or stools

If you notice these less serious side effects, talk with your doctor:

• Loss of appetite
• Hair loss

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088