When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to teniposide or polyoxyl castor oil or if you are pregnant.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein. This medicine is given slowly, so your IV will remain in place for 30 to 60 minutes. You may also need to stay for observation for an additional hour or more.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• You may also receive other medicines to help prevent allergic reactions.
• Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

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

• Some foods and medicines can affect how teniposide works. Tell your doctor if you are using any of the following:
  
  • Sodium salicylate
  • Sulfamethizole
  • Tolbutamide
  • Vincristine
• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• This medicine may cause birth defects if either partner is using it during conception or pregnancy. Tell your doctor right away if you or your partner becomes pregnant.
• This medicine may reduce a man's ability to have children, or it may increase the risk of birth defects. Talk to your doctor if you would like information on how to store sperm for future use.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease, low blood pressure, or any type of infection.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine may damage tissue and cause scarring at the injection site if it leaks out of the vein into which it is injected.
• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

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

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Fast, pounding, or uneven heartbeat
• Fever, chills, cough, sore throat, and body aches
• Lightheadedness, dizziness, or fainting
• Painful mouth sores
• Pain, burning, redness, or swelling where the needle was placed
• Unusual bleeding or bruising
• Warmth or redness in your face, neck, arms, or upper chest

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

• Hair loss
• Mild nausea, vomiting, or diarrhea

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