Ixabepilone should not be used with capecitabine if blood tests show you have liver problems. Using these 2 medications together may increase the risk of severe (sometimes fatal) immune problems and serious infection.
Read the Patient Information Leaflet provided by your pharmacist before you start using ixabepilone. If you have any questions, consult your doctor or pharmacist.
This medication is usually given by injection into a vein over 3 hours by a health care professional. It is usually given every 3 weeks. You will need blood tests (complete blood count) before each appointment. Your doctor will adjust the dosage and how often you receive the medication based on the blood tests.
Your doctor will direct you to take 2 types of antihistamines (e.g., diphenhydramine and ranitidine) by mouth 1 hour before your treatment to prevent or lessen a severe allergic reaction. Your doctor may give you another medication (a corticosteroid such as dexamethasone) and give ixabepilone over more than 3 hours if you had a severe reaction during your last treatment.
The dosage is based on your medical condition, body size, and response to treatment.
Pain/redness/swelling at the injection site, weakness, tiredness, muscle/joint pain, nausea, vomiting, diarrhea, loss of appetite, headache, dizziness, or drowsiness may occur. Nausea and vomiting may be severe in some patients. Your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Many people using this medication have serious side effects. However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.
This medication can lower your body's ability to fight an infection. Tell your doctor promptly if you develop any signs of an infection such as painful urination, fever, chills, or persistent sore throat.
Painful sores on the lips, mouth, and throat may occur. To decrease the risk, limit hot foods and drinks, brush your teeth carefully, avoid using mouthwash that contains alcohol, and rinse your mouth frequently with cool water.
Tell your doctor right away if you have any serious side effects, including: swollen hands/ankles/feet, fainting, pale skin, easy/unusual bruising/bleeding, sudden weight gain, signs of a loss of too much body water (e.g., decreased urination, increased thirst, dry mouth).
You may lessen these types of nerve problems by avoiding cold drinks and ice and by dressing warmly. Tell your doctor immediately if your nerve problems begin to interfere with your normal daily activities (e.g., walking, writing, eating).
Treatment with ixabepilone may sometimes cause your hands/feet to develop a skin reaction called hand-foot syndrome (palmar-plantar erythrodysesthesia), especially when this drug is given with capecitabine. You can prevent or reduce these problems by protecting your hands and feet from a great deal of heat or pressure. Avoid unnecessary exposure to heat (e.g., hot dishwater, long hot baths). Avoid pressure on elbows, knees, and soles of feet (e.g., leaning on elbows, kneeling, long walks). Wear loose clothing. Depending on how severe your hand-foot syndrome is, your doctor may prescribe a medication to reduce the symptoms or decrease/delay your next treatment. If you experience pain/swelling/redness, blisters, or numbness of the hands/feet that affects your usual activities, tell your doctor immediately.
Get medical help right away if any of these rare but very serious side effects occur: fast/irregular heartbeat, shortness of breath, chest pain, bloody/black stools, vomit that looks like coffee grounds, vision changes, seizures, sudden confusion.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), face flushing, tight feeling in chest, severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Before using ixabepilone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as polyoxyethylated castor oil), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, diabetes, heart problems (e.g., chest pain, heart failure, heart attack), liver problems, bone marrow problems (e.g., low white count, anemia), nerve problem (peripheral neuropathy).
This medication contains alcohol. It may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose. Wash your hands well to prevent the spread of infections.
To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.
This medication is not recommended for use during pregnancy. It may harm an unborn baby. If you become pregnant or think you may be pregnant, tell your doctor immediately. It is recommended that women of child-bearing age and men using this medication use 2 effective forms of birth control (e.g., condoms and birth control pills) to prevent pregnancy. Consult your doctor for more information.
It is not known if ixabepilone passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
See also Warning section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: drugs that cause a reaction with alcohol (e.g., disulfiram, metronidazole), drugs affecting liver enzymes that remove ixabepilone from your body (e.g., azole antifungals such as itraconazole/ketoconazole, macrolide antibiotics such as clarithromycin/erythromycin, anti-HIV medications such as delavirdine/ritonavir/saquinavir, rifamycins including rifabutin, St. John's wort, anti-seizure medicines such as carbamazepine/phenytoin).
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., levetiracetam), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone).
Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Laboratory and/or medical tests (e.g., complete blood count, liver function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor to establish a new dosing schedule.
Not applicable. This medication is given in a clinic and will not be stored at home.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised August 2013. Copyright(c) 2013 First Databank, Inc.
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