Your child needs to take the medicine called teniposide (say: ten-i-POE-side). This information sheet explains what teniposide does, how to give it, and what side effects or problems your child may have when they take this medicine.
What is teniposide?
Teniposide is a medicine used to kill cancer cells. You may hear teniposide called VM-26 or by its brand name, Vumon. Teniposide comes in an injection form.
Before giving teniposide to your child
Tell your child's doctor if your child has ever reacted badly to teniposide or any other drug, food (specifically castor oil), preservatives, or colouring agents.
Talk with your child's doctor or pharmacist if your child has any of the following conditions.
Precautions may need to be taken with this medicine if your child has:
- low blood counts
- low levels of albumin
- infection or recent exposure to infection (for example chickenpox)
- kidney or liver problems
- Down syndrome
How will your child get teniposide?
Teniposide is a clear, light yellow liquid that a nurse will give by needle into your child's vein. Usually your child will get this medicine in the hospital clinic or on the nursing unit.
The nurse will watch your child's blood pressure during the infusion. Teniposide can cause low blood pressure.
What are the possible side effects of teniposide?
Your child may have some of these side effects while they take teniposide. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or they bother your child:
- nausea (upset stomach) and vomiting (throwing up)
- diarrhea (watery bowel movements)
- sores in the mouth or on the lips
- hair loss
Call your child's doctor during office hours if your child has any of these side effects:
- unusual tiredness
- skin rash
- yellow eyes or skin
- swelling of the face, fingers, feet, or lower legs
- decreased urination (peeing)
- tingling or numbness in hands or feet
Most of the following side effects are not common, but they may be a sign of a serious problem.
Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:
- fever and chills
- flushing of the face, lips, or tongue
- rapid heartbeat
- shortness of breath or trouble breathing
- tightness in the chest
- wheezing
- cough or hoarseness
- lower back or side pain
- painful or difficult urination (peeing)
- unusual bleeding or bruising
- black, tarry stools
- blood in urine or stools
- pinpoint red spots on skin
- feeling faint, light-headed, or dizzy
After your child stops receiving teniposide, it may still cause side effects.
These delayed effects may include certain types of cancer (leukemia).
Check with your doctor immediately if any of the following signs occur, even after teniposide treatment has stopped:
- yellow eyes or skin
- stomach pain
- cough or a hoarse voice
- black, tarry stools
- blood in urine or stools
- unusual bleeding or bruising
- lower back or side pain
- diarrhea
What safety measures should you take when your child is using teniposide?
The nurse will watch your child for an hour to see if they are having an allergic reaction to teniposide. If you see signs of an allergic reaction, tell the nurse immediately. Signs of an allergic reaction are:
- chills and fever
- flushing of the face
- sweating
- hives
- rapid heartbeat
- shortness of breath or trouble breathing
- tightness in chest, chest pain
- wheezing
- feeling faint, light-headed, or restless
The next time your child gets teniposide, they will get some medicine to help prevent the allergic reaction. As well, teniposide can be given more slowly.
If teniposide leaks out of the vein through which it is being given, it can cause severe damage. Tell the nurse right away if you notice redness, pain, or swelling at the place of injection.
Your child will receive medicine to prevent upset stomach and throwing up caused by teniposide.
Your child may lose their hair. It will grow back once your child is no longer receiving teniposide. Its color and texture may change. Use a gentle shampoo and a soft brush.
Teniposide may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your nurse or pharmacist can review this with you. Avoid store-bought mouthwash, as it may sting and cause dry mouth.
Teniposide can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the white blood cell count is low:
- Avoid people with infections, such as a cold or the flu.
- Avoid places that are very crowded with large groups of people.
- Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
- You and your child shouldn't touch your child's eyes or inside their nose without washing hands first.
- Your child's nurse will review with you what to do in case of fever.
Teniposide can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:
- Be careful not to cut your child when using a razor, fingernail scissors or toenail clippers.
- Be careful when shaving or waxing.
- Your child should avoid contact sports where bruising or injury could occur.
- Your child should not receive a permanent tattoo or any kind of body piercing.
- Do not give products that contain acetylsalicylic acid (ASA or Aspirin) or ibuprofen (such as Advil) unless your doctor tells you it is okay. These medicines may increase the risk of bleeding while getting teniposide.
Vaccinations
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child and anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) vaccine and chickenpox vaccine.
Fertility
There is a chance that teniposide may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that they use birth control while receiving teniposide. Tell the doctor right away if your child may be pregnant.
After receiving teniposide, your child may not be able to have children or have more difficulty having children. Your child's doctor will discuss this in more detail with you and your child.
What other important information should you know about teniposide?
- Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).
- Keep a list of all medications your child is on and show this list to the doctor or pharmacist.
- Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
Keep teniposide out of your child’s sight and reach and locked up in a safe place. If your child takes too much teniposide, call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.