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teniposide (Rx)Brand and Other Names:vm 26, Vumon

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 10mg/mL
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Antineoplastic

IV: 50-180 mg/sq meter once or twice weekly x4-6 weeks OR 

20-60 mg/sq meter/day x 5 days

Small Cell Lung Cancer

80-90 mg/sq meter/day x 5 days q4-6Weeks 

Other Indications & Uses

Refractory childhood ALL, non-hodgkin's lymphoma

Dosage Forms & Strengths

injectable solution

  • 10mg/mL
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Refractory Childhood ALL

165 mg/sq.meter IV, in combo with cytarabine 300 mg/sq.meter IV, twice/week x8-9 doses, OR 

250 mg/sq.meter IV, in combo with vincristine 1.5 mg/sq.meter IV, once/week x4-8 weeks

Slow infusion (30-60 minutes)

Down syndrome patients: decrease dose by half

Withhold treatment if Plts <50 K/cu.mm or ANC <500/cu.mm

Monitor: BP

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Interactions

Interaction Checker

teniposide and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Alopecia (31%)

            Nausea (4-11%)

            Vomiting (4-11%)

            1-10%

            Hypersensitivity (5%)

            Fever (3%)

            Stomatitis (3%)

            Nephrotoxicity (2%)

            Anorexia (1%)

            Diarrhea (1%)

            Frequency Not Defined

            Infection

            Myelosuppression

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            Warnings

            Black Box Warnings

            The drug should be administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to diagnose and manage complications

            Severe myelosuppression with resulting infection or bleeding may occur

            Hypersensitivity reactions including anaphylaxis-like symptoms may occur with initial dosing or with repeated exposure to teniposide. Epinephrine, with or without corticosteroids and antihistamines, has been used to treat reaction symptoms.

            Contraindications

            Hypersensitivity to teniposide or castor oil

            Platelets <50,000/cu.mm or ANC <500/cu.mm

            Cautions

            Hypersensitivity reaction variably manifested by chills, fever, urticaria, tachycardia, bronchospasm, dyspnea, hypertension or hypotension, rash, and facial flushing may occur with any dose

            Acute CNS depression, hypotension, and metabolic acidosis observed in patients receiving high-dose investigational infusions who were pretreated with antiemetic drugs; thought to be caused by the antiemetic depressant and the alcohol content of high-dose teniposide

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            Pregnancy & Lactation

            Pregnancy Category: D; animal studies observed a decreased sperm count and genetic damage to sperm

            Lactation: not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Semisynthetic podophyllotoxin derivativeInhibits topoisomerase II to cause DNA strand breaks, preventing mitosis

            Absorption

            Peak Plasma: 14.3 mcg/mL

            Distribution

            Protein Bound: >99%

            Metabolism

            Hepatic (major)

            Half-Life: 5-21 hr

            Clearance: 7-17 mL/min/sq.meter

            Excretion: Urine 44%; feces <10%

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            Administration

            IV Incompatibilities

            Y-site: idarubicin

            Additive, Syringe, Y-site: heparin

            IV Preparation

            Must be diluted with either D5W or NS to a final concentration of 0.1, 0.2, 0.4 or 1 mg/mL

            To prevent extraction of the plasticizer DEHP, prepare solutions in non-DEHP-containing containers such as glass or polyolefin

            PVC is not recommended

            Administer 1 mg/mL solutions within 4 hr of preparation to reduce potential for precipitation

            Precipitation may occur at any concentration

            IV Administration

            Irritant

            Slow IV infusion over >30 min

            Rapid infusion may cause hypotension or incr nausea & vomiting

            Flush thoroughly before & after administration

            Incompatible with heparin

            Do not use in-line filter during IV infusion

            Storage

            Store ampules in refrigerator

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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