Fludalym Special Precautions

If the patient is not feeling very well, the doctor may decide not to give this medicine, or may give this medicine with caution. This is very important if the bone marrow is not working properly or if the patient is susceptible to infections.
If there is any unusual bruising, excessive bleeding after injury or if the patient seems to be catching a lot of infections, tell the doctor. The number of normal blood cells may be reduced, the patient must have a regular blood tests during treatment.
The disease itself and the therapy may cause a reduction of the number of blood cells and the immune system may attack different parts of the patient's body (autoimmune disorder). It may also be directed against the red blood cells (called 'autoimmune haemolysis'). This condition can be life threatening. If this condition occurs, the patient may receive further medication such as transfusion of blood (irradiated, see as follows) and corticosteroides.
If in need of blood transfusion and being (or have been) treated with this medicine, mention this to the doctor. The doctor will ensure that the only blood the patient will receive has gone through a special treatment (irradiation). There have been severe complications and even death reported when non-irradiated blood has been given.
If the patient needs to have stem cells collected and being (or have been) treated with this medicine, mention this to the doctor.
If the liver does not work properly, the doctor may give this medicine with caution.
If the patient has any form of kidney disease, the kidney function should be checked regularly. If it is found that the kidneys do not work properly, the patient may be given this medicine at a reduced dose. If the kidneys work at only a very low level, do not give this medicine at all. Patients aged 65 years or older should have their kidney function checked before start of treatment.
There is little information on the effects of Fludalym in patients aged 75 years and older. The doctor will use it with caution in this age group.
If the patient has very severe chronic lymphocytic leukaemia, the body may not be able to get rid of all the waste products from the cells destroyed by Fludalym. This is called tumour lysis syndrome and may cause dehydration, kidney failure and heart problems. The doctor will be aware of this and may give the patient other medicines to stop this happening.
If the patient experiences any unusual symptoms from the nervous system, mention it to the doctor. This is because when used in patients at doses four times greater than the recommended dose, severe central nervous system (brain and spinal cord) effects including blindness, coma and death have been reported.
Tell the doctor if there are any changes to the patient's skin either while receiving this medicine or after having finished the course of therapy. The doctor should check the seriousness of the skin changes. If the patient has skin cancer, the damaged areas of the skin may become worse when using this medicine.
Men and women who may still be fertile, must use a reliable form of contraception during, and for at least 6 months after stopping treatment.
Check with a doctor about any vaccinations the patient may need, because live vaccinations should be avoided during and after treatment with Fludalym.
Driving and Using Machines: The effect of treatment with Fludalym on the ability to drive or use machines has not been evaluated. Fludalym may although influence the ability to drive and use machineries since side effects like tiredness, weakness, agitation, seizures and visual disturbances have been observed.