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Teniposide

(teh-nip-uh-side)

Trade/other name(s): Vumon, VM-26

Why would this drug be used?

This drug is used to treat acute lymphoblastic leukemia (ALL), especially in children. Your doctor may also use it to treat other types of cancer.

How does this drug work?

Teniposide is a chemotherapy drug. It is a type of plant alkaloid known as a podophyllotoxin. It is thought to work by blocking the action of an enzyme in cells called topoisomerase II. Cells need this enzyme to keep their DNA in the proper shape when they are dividing into 2 cells. Blocking this enzyme leads to breaks in the DNA, which leads to cell death. Because cancer cells divide faster than normal cells, they are more likely than normal cells to be affected by this drug.

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 liver disease (including hepatitis), kidney disease, heart disease, diabetes, high blood pressure, gout, or infections. 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 problems with the fetus if taken at the time of conception or during pregnancy. Men and women who are taking this drug should use some kind of birth control during treatment. Check with your doctor about what kinds of birth control can be used with this medicine. In pregnant women, treatment with this drug should be used only if the potential benefit to the mother outweighs the risk to the fetus.
  • If you are breast-feeding. While no studies have been done, this drug may pass into breast milk and affect the baby. Breast-feeding is not recommended during treatment with this drug.
  • If you think you might want to have children in the future. This drug may affect fertility. 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

Some drugs, such as tolbutamide, sodium salicylate, or sulfamethizole, may increase blood levels of teniposide if taken at the same time.

Research on interactions with other drugs may be incomplete at this time. Check with your doctor, nurse, or pharmacist about your other medicines, 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 some 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?

Teniposide is given as an infusion into a vein, over at least 30 to 60 minutes. It is most commonly given every day or every other day for 5 days, followed by several weeks off. The dose depends on your body size, the type of cancer being treated, and other factors. Your doctor or nurse will probably give you anti-nausea medicine to take before each dose of teniposide. Follow their instructions carefully.

Precautions

This drug can cause allergic reactions in some people. Symptoms include chills, fever, flushing or red skin, tightness in the throat or chest, feeling lightheaded or dizzy (due to low blood pressure), itching, hives (welts on the skin), fast heartbeat, coughing, wheezing, shortness of breath, or swelling of the face, tongue, or throat. Some people also noticed headache and confusion. Tell your doctor or nurse right away if you notice any of these symptoms while getting the drug.

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 probably 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.

This drug may cause sores in the mouth or on the lips, which often occur within the first few weeks after starting treatment. This can cause mouth pain, bleeding, or even trouble eating. Your doctor or nurse can suggest ways to reduce this, such as changing the way you eat or how you brush your teeth. If needed, your doctor can prescribe medicine to help with the pain.

Teniposide may lower your blood pressure, especially if given by infusion over a short period of time. Symptoms might include feeling dizzy, lightheaded, or even fainting. Tell your doctor or nurse right away if you notice any of these symptoms. Your blood pressure will likely be checked regularly during treatment.

Your doctor will likely test your blood before and during your treatment, to check for the effects of the drug on blood counts or on blood chemistry. 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 doctor visits and lab tests.

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.

Rarely, some people get a condition called metabolic acidosis, which may have symptoms like weakness, fast breathing, headache, or confusion. Some people can feel very short of breath and have nausea or vomiting.

Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor’s OK. This drug may affect your immune system, which could make vaccinations ineffective, or could even lead to serious infections. 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.

In rare cases during an intravenous (IV) infusion, the drug may leak out of the vein and under the skin, where it may damage the tissue, causing pain, open sores, and scarring. Tell the nurse right away if you notice redness, pain, or swelling at or near the IV site.

Because of the way this drug acts on cells in the body, it may increase your long-term risk of getting a second type of cancer, such as leukemia. This is rare, but if it does occur it would likely be years after the drug is used. If you are getting this drug, your doctor feels this risk is outweighed by the risk of what might happen if you do not get this drug. You may want to discuss these risks with your doctor.

Possible side effects

You probably will 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 blood platelet count with increased risk of bleeding*
  • Low red blood cell count (anemia), with tiredness, weakness, or shortness of breath
  • Mouth sores*
  • Nausea/vomiting*
  • Diarrhea

Less common

  • Hair loss or thinning, including face and body hair
  • Infection
  • Bleeding*

Rare

  • Low blood pressure*
  • Fever
  • Rash
  • Allergic reactions (may include chills, fever, rapid heart rate, trouble breathing, dizziness)*
  • Increased risk of a second cancer*
  • Death due to allergic reaction, severe infection

*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 1992.

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: 11/29/2011
Last Revised: 11/29/2011