Thiotepa

Thiotepa is a prescription medication used to treat certain types of ovarian, breast, and bladder cancers. It is also used to treat malignant effusions (a condition when fluid collects in the lungs or around the heart) that are caused by cancerous tumors. Thiotepa belongs to a group of drugs called alkylating agents. These work by slowing or stopping the growth of cancer cells in your body.

This medication is available in an injectable form to be given directly into a vein (IV), into a body cavity, or into the urinary bladder by a healthcare professional.

Common side effects of thiotepa include dizziness, headache, blurred vision. Do not drive or operate heavy machinery until you know how this medication affects you.

Thiotepa is a prescription medication used to treat certain types of ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed). It may also be used to treat breast and bladder cancer. It is also used to treat malignant effusions (a condition when fluid collects in the lungs or around the heart) that are caused by cancerous tumors.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Thiotepa may be found in some form under the following brand names:

• Tepadina

• Thioplex

Common side effects of thiotepa include:

• increased risk of infection
• whole-body inflammation sepsis)
• decreased counts of white blood cells, platelets and red blood cells (anemia)
• the transplanted cells attack your body (graft versus host disease)
• dizziness, headache, blurred vision
• uncontrolled shaking of the body (convulsion)
• sensation of tingling, pricking or numbness
• partial loss of movement
• cardiac arrest
• nausea, vomiting, diarrhea
• inflammation of the mucosa of the mouth (mucositis)
• irritated stomach, gullet, intestine
• inflammation of the colon
• anorexia, decreased appetite
• high blood sugar
• skin rash, itching, shedding
• skin color disorder
• redness of the skin
• hair loss
• back and abdominal pain
• muscle and joint pain
• inflammation of lung tissue
• enlarged liver
• altered organ function
• blocking of a liver vein (VOD)
• yellowing of the skin and eyes (jaundice)
• hearing impairment
• high blood pressure
• increased liver, renal and digestive enzymes
• abnormal blood electrolytes
• weight gain
• fever, general weakness, chills
• bleeding
• nasal bleeding
• general swelling due to fluid retention (edema)
• pain or inflammation at the injection site
• eye infection (conjunctivitis)
• decreased sperm cell count
• vaginal bleeding
• absence of menstrual periods (amenorrhea)
• memory loss
• delayed weight and height increase
• bladder dysfunction
• underproduction of testosterone
• insufficient production of thyroid hormone
• deficient activity of the pituitary gland
• anxiety, confusion
• abnormal bulging outward of one of the arteries in the brain (intracranial aneurysm)
• allergic reactions
• blockage of a blood vessel (embolism)
• heart problems
• oxygen deficiency
• fluid accumulation in the lungs (pulmonary edema)
• pulmonary bleeding
• respiratory arrest
• blood in the urine (hematuria) and moderate renal insufficiency
• inflammation of the urinary bladder
• discomfort in urination and decrease in urine output (dysuria and oliguria)
• increase in the amount of nitrogen components in the bloodstream (BUN increase)
• cataract
• cerebral hemorrhage
• cough
• constipation and upset stomach
• obstruction of the bowel
• perforation of stomach
• changes in muscle tone
• gross lack of coordination of muscle movements
• bruises due to a low platelet count
• menopausal symptoms
• cancer (second primary malignancies)
• abnormal brain function

This is not a complete list of thiotepa side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take other chemotherapeutic medications.

This is not a complete list of thiotepa drug interactions. Ask your doctor or pharmacist for more information.

The most serious side effects of thiotepa therapy may include:

• a decrease in circulating blood cell counts (intended effect of the medicine to prepare you for your transplant infusion)
• infection
• liver disorders including blocking of a liver vein
• the graft attacks your body (graft versus host disease)
• respiratory complications

Your doctor will monitor your blood counts and liver enzymes regularly to detect and manage these events.

Thiotepa may interfere with the normal menstrual cycle (period) in women, may stop sperm production in men, and may cause infertility (difficulty becoming pregnant).

Before taking thiotepa, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to thiotepa or to any of its ingredients
• liver, kidney, or bone-marrow damage. However, if the need outweighs the risks, thiotepa may be used in low dosage, and accompanied by monitoring tests.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of thiotepa, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking thiotepa, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to thiotepa, any other medications, or any of the ingredients in thiotepa injection
• are taking other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products
• have or have ever had kidney or liver disease. Your doctor may not want you not to receive thiotepa.
• have previously received or will be receiving radiation (x-ray) therapy or other chemotherapy and if you have or have ever had any medical conditions
• If you are pregnant or planning to become pregnant.
• are breastfeeding. You should not breastfeed while you are receiving thiotepa.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if thiotepa crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using thiotepa.

Take thiotepa exactly as prescribed.

This medication is available in an injectable form to be given directly into a vein (IV), into a body cavity, or into the urinary bladder by a healthcare professional.

• Into the vein (IV) dosing: Thiotepa may be given by rapid intravenous administration in doses of 0.3 to 0.4 mg/kg. Doses should be given at 1 to 4 week intervals.
• Intracavitary (within a body cavity) dosing: The dosage recommended is 0.6 to 0.8 mg/kg.
• Intravesical (into the urinary bladder) dosing: 60 mg of thiotepa injected into the bladder. The usual course of treatment is once a week for 4 weeks. The course may be repeated if necessary, but second and third courses must be given with caution due to serious side effects.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.