Marqibo Warnings and Precautions

Specific Precautions and Warnings for Marqibo

Some warnings and precautions to be aware of prior to using this medication include the following:
  • Marqibo has caused death when given as an injection into the spine (an intrathecal injection). It is only approved for intravenous (IV) use, and should not be given in other ways.
  • Let your healthcare provider know right away if you experience burning, redness, or swelling around the site where the medication is entering your body (the injection site). This could be a sign of a potentially serious situation in which the medication leaks outside the vein. If this happens, your healthcare provider will stop your dose, and give you appropriate treatment to prevent any damage to your skin and surrounding area from the leaking medication.
  • Marqibo can cause nerve problems (neuropathy), which may become worse the longer you receive the medication. Your healthcare provider will monitor you closely, and may adjust your dose, delay treatment, or stop treatment altogether if you develop nerve problems. Let your healthcare provider know immediately if you develop signs of neuropathy, such as:
    • Numbness, tingling, pricking, or burning sensations in your hands or feet
    • Changes in how sensitive your skin is to touch, heat, cold, or pain
    • Joint or muscle pain
    • Muscle weakness or spasms
    • Decreased reflexes
    • Pain in your face, jaw, or head
    • Dizziness or fainting, especially when rising from a seated or lying position
    • Difficulty walking or speaking
    • Constipation
    • An inability to urinate.
  • This medication can make you extremely tired. Do not drive, operate heavy machinery, or perform any other activity that requires alertness until you know how the medication affects you. Let your healthcare provider know if you are particularly tired. Your dosage may need to be adjusted.
  • Marqibo can cause potentially serious constipation and intestinal blockage. Your healthcare provider will advise you on ways to manage constipation, including staying well hydrated, consuming a diet high in dietary fiber, and taking medicines to soften your stool. Seek immediate medical care if you have any signs of intestinal blockage, such as:
    • Abdominal (stomach) pain
    • Bloating
    • Fullness
    • Persistent nausea, vomiting, or diarrhea.
  • There have been reports of liver problems, and death from liver problems, in people treated with this medication. Your healthcare provider will monitor your liver function using blood tests during treatment, and adjust your dose or stop treatment if you start to develop liver damage. Let your healthcare provider know if you have any signs of liver problems, such as:
    • Yellowing of the skin or whites of the eyes (jaundice)
    • Upper-right abdominal (stomach) pain
    • Loss of appetite.
  • Marqibo can cause bone marrow suppression (when the bone marrow is unable to produce adequate amounts of blood cells), which can lead to abnormally low white blood cells, red blood cells, and platelets. As a result, you will have an increased risk for potentially serious infections, anemia, and bleeding problems. Your healthcare provider will check your blood cell counts, with blood tests, before each dose. Let your healthcare provider know if you have signs of bone marrow suppression, such as:
    • Signs of low platelets, such as:
      • Any abnormal bleeding or bruising
      • Blood in your urine or stools
      • Black, tarry stools
      • Small red or purple spots under the skin
    • Signs of anemia, such as:
      • Fatigue
      • Weakness
      • Shortness of breath
      • Pale skin
    • Signs of infection, such as:
      • Fever
      • Chills
      • Sore throat
      • Cough
      • Burning or pain when urinating.
  • Marqibo can cause a potentially serious problem known as tumor lysis syndrome. Tumor lysis syndrome occurs when cancer cells are rapidly destroyed and release their contents into the bloodstream faster than the body can clear them. This can ultimately lead to kidney failure, an abnormal heart rhythm, and seizures. Your healthcare provider will monitor you for tumor lysis syndrome and give you medicines to treat it if necessary.
  • Marqibo is a pregnancy Category D medication, which means it may harm an unborn child. Talk to your healthcare provider about the risks and benefits of using this medication during pregnancy (see Marqibo and Pregnancy).
  • It is unknown if Marqibo passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving Marqibo (see Marqibo and Breastfeeding).
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