Teniposide Dosage

Usual Adult Dose for Acute Lymphoblastic Leukemia

Patients failing induction therapy with a cytarabine-containing regimen:
165 mg/m2 IV over at least 30 to 60 minutes and 300 mg/m2 cytarabine IV twice weekly for 8 to 9 doses

Patients refractory to vincristine/prednisone-containing regimens:
250 mg/m2 IV over at least 30 to 60 minutes and 1.5 mg/m2 vincristine IV weekly for 4 to 8 weeks with 40 mg/m2 prednisone orally for 28 days

Use: For induction therapy in patients with refractory childhood acute lymphoblastic leukemia (ALL) in combination with other approved anticancer agents

Usual Pediatric Dose for Acute Lymphoblastic Leukemia

Patients failing induction therapy with a cytarabine-containing regimen:
14 days and older:
165 mg/m2 IV over at least 30 to 60 minutes and 300 mg/m2 cytarabine IV twice weekly for 8 to 9 doses

Patients refractory to vincristine/prednisone-containing regimens:
14 days and older:
250 mg/m2 IV over at least 30 to 60 minutes and 1.5 mg/m2 vincristine IV weekly for 4 to 8 weeks with 40 mg/m2 prednisone orally for 28 days

Use: For induction therapy in patients with refractory childhood acute lymphoblastic leukemia (ALL) in combination with other approved anticancer agents

Renal Dose Adjustments

Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Caution recommended.

Liver Dose Adjustments

Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Caution recommended.

Dose Adjustments

Patients with both Down syndrome and leukemia may be especially sensitive to myelosuppressive chemotherapy; therefore, initial dosing should be reduced in these patients. It is suggested that the first course should be given at half the usual dose. Subsequent courses may be administered at higher doses depending on the degree of myelosuppression and mucositis encountered in earlier courses.

Precautions

US BOXED WARNINGS:

• This drug is cytotoxic and should be administered under the supervision of a physician experienced in the use of cancer chemotherapeutic agents. Appropriate management of therapy and complications is possible only when adequate treatment facilities are readily available.
• Severe myelosuppression with resulting infection or bleeding may occur.
• Hypersensitivity reactions (e.g., anaphylaxis-like symptoms) may occur. Epinephrine, with or without corticosteroids and antihistamines, has been

used to alleviate symptoms.

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients
• Hypersensitivity to polyoxyl 35 castor oil

Safety and efficacy have not been established in patients younger than 14 days.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• This drug should be administered with non-DEHP containing IV administration sets.
• Hypotension has been reported following rapid IV administration; it is recommended that the solution be administered over at least a 30- to 60-minute period. This drug should not be given by rapid IV injection.

Storage requirements:

• Store the unopened ampules under refrigeration 2C to 8C (36F to 46F).
• Retain in original package to protect from light.

Reconstitution/preparation techniques:

• To prevent extraction of the plasticizer DEHP [di(2-ethylhexyl) phthalate], solutions of this drug should be prepared in non-DEHP containing large volume parenteral (LVP) containers such as glass or polyolefin plastic bags or containers.
• Caution should be exercised in handling and preparing the solution of this drug.
• Several guidelines on proper handling and disposal of anticancer drugs have been published.
• Skin reactions associated with accidental exposure to this drug may occur. To minimize the risk of dermal exposure, always wear impervious gloves when handling ampules. If the solution contacts the skin, immediately wash the area thoroughly with soap and water. If it contacts mucous membranes, the membranes should be flushed immediately and thoroughly with water.
• The manufacturer product information should be consulted for further information.

IV compatibility:

• Dextrose 5% injection
• Sodium chloride 0.9% injection

General:

• Contact of undiluted drug with plastic equipment or devices used to prepare solutions for infusion may result in softening or cracking and possible drug product leakage. This effect has not been reported with diluted solutions.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer