+ -Text Size

Pentostatin

(pen-toe-stat-in)

Trade/other name(s): Nipent, deoxycoformycin, 2'-Deoxycoformycin, dCF

Why would this drug be used?

Pentostatin is used to treat hairy cell leukemia and other types of cancer.

How does this drug work?

Pentostatin is part of a general group of chemotherapy drugs known as antibiotics. It stops the growth of cancer cells, which causes cells to die.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, infections, or if you have had kidney stones. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Pentostatin should not be used with fludarabine or nelarabine because the side effects can be made worse. Vidarabine may also cause this problem.

Any drugs or supplements that interfere with blood clotting can raise the risk of bleeding during treatment with pentostatin. These include:

  • vitamin E
  • non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and many others
  • warfarin (Coumadin)
  • ticlopidine (Ticlid)
  • clopidogrel (Plavix)

Note that many cold, flu, fever, and headache remedies contain aspirin or ibuprofen. Ask your pharmacist if you aren't sure what's in the medicines you take.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Pentostatin is given by an injection in a vein over 5 to 30 minutes. The dose depends on your weight, how well your kidneys are working, and your blood counts.

Precautions

Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether. Keep all your appointments for lab work and doctor visits.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

This drug may lower your red blood cell count. If this occurs, it is usually a few weeks after starting treatment. A low red blood cell count (known as anemia) can cause shortness of breath, or make you to feel weak or tired all the time. Your doctor may give you medicines to help prevent or treat this condition, or you may need to get blood transfusions.

Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor's OK. Pentostatin may affect your immune system. This could make vaccinations ineffective, or could even lead to serious infections if you get a live virus vaccine during or soon after treatment. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.

You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor. Tell your doctor if the drugs don't work to stop your vomiting.

If you notice weakness, changes in vision or hearing, tingling of hands or feet, confusion, clumsiness, trouble walking, seizure, trouble breathing, or severe rash, call your doctor right away.

Heart failure occasionally can happen with this medicine, with symptoms such as shortness of breath, trouble breathing, swelling, or dizziness. Get in touch with your doctor right away if these symptoms occur.

Avoid pregnancy during and for at least a few months after treatment, since exposure to this drug may harm the fetus. Talk with your doctor about this.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • low white blood cell count with increased risk of infection*
  • low platelet count with increased risk of bleeding*
  • low red blood cell count (anemia) with symptoms like tiredness and shortness of breath*
  • nausea*
  • vomiting*
  • tiredness and sleepiness, which can progress to coma
  • rash, itching*

Less common

  • eye irritation
  • cough
  • hoarseness
  • loss of appetite
  • pain
  • dizziness
  • confusion*

Rare

  • mild kidney or liver damage (usually improves after treatment is stopped)
  • heart failure with symptoms such as shortness of breath, swelling in the feet and legs, fluid retention*
  • severe allergic reaction, with symptoms such as dizziness, rash or hives, shortness of breath, swelling in the mouth or throat
  • lung problems, especially in patients who have had bleomycin or lung radiation
  • death due to infection or other cause

*See the "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1991.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.

Last Medical Review: 02/11/2010
Last Revised: 02/11/2010