Must not be administered as IV push or bolus. Should be administered through a dedicated IV line & must not be mixed w/ other medicinal products. Risk of capillary leak syndrome (CLS); severe hypersensitivity reactions; thrombocytopenia & neutropenia; tumour lysis syndrome; elevations in liver enzymes. Monitor for signs & symptoms of hypersensitivity or CLS until at least 24 hr after the last infusion. Pre-medicate w/ H
1-histamine antagonist (eg, diphenhydramine HCl), H
2-histamine antagonist, corticosteroid (eg, 50 mg IV methylprednisolone or equiv) & paracetamol approx 60 min prior to start of infusion. Monitor vital signs prior to preparing each dose & frequently during dosing. Check albumin, transaminases, & creatinine prior to preparing each dose. Ensure adequate cardiac function & serum albumin ≥3.2 g/dL before initiating therapy. Temporarily w/hold treatment if transaminases rise to >5 times ULN & resume treatment when transaminase elevations are ≤2.5 times ULN. Full clinical & neuro-imaging exam, including fundoscopy & brain MRI, is recommended if clinical symptoms or signs suggestive of CNS damage occur. Consider other treatment alternatives if CNS disease is present. Must not be given to patients w/ hereditary fructose intolerance unless strictly necessary. Should not be used during pregnancy unless clinical condition of the woman requires treatment. Women of childbearing potential should obtain -ve pregnancy test w/in 7 days prior to initiation of therapy, & use effective contraception before the 1st dose & for at least 1 wk after the last dose. Breast-feeding should be discontinued during treatment & for at least 1 wk after the last dose. Safety & efficacy in childn & adolescents <18 yr have not been established.
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