Instructions

This medicine is given as an IV injection into a vein.

This medicine should be given by a trained health care provider.

Drink plenty of water while on this medicine.

Avoid getting medicine on the skin or in the eyes. If this happens, wash the skin with soap and water. For eyes, open eyelid and flush with plenty of water and tell your doctor right away.

If you miss a dose, contact your doctor for instructions.

Drug interactions can change how medicines work or increase risk for side effects. Tell your health care providers about all medicines taken. Include prescription and over-the-counter medicines, vitamins, and herbal medicines. Speak with your doctor or pharmacist before starting or stopping any medicine.

Your doctor may prescribe other medications to reduce side effects. Follow instructions carefully.

Keep using this medicine for the full number of days that it is prescribed. Do not stop the medicine even if you start to feel better.

Keep all appointments for medical exams and tests while on this medicine.

Cautions

Tell your doctor and pharmacist if you ever had an allergic reaction to a medicine.

May cause mouth sores. Brush teeth gently. Avoid products containing alcohol. Rinse mouth with a mixture of water and baking soda or salt.

Some patients with weak hearts may have worsening of symptoms. If you notice difficulty breathing, weight gain, or swelling of your legs or ankles, let your doctor know right away.

Some patients on this medicine have developed severe, life-threatening infections. Please speak with your doctor about the risks and benefits of using this medicine.

This medicine may increase the risk of cancer. Ask your doctor about the benefits and risks.

This medicine is associated with an increased risk of serious heart problems and heart attack. Please speak with your doctor about the risks and benefits of using this medicine. Contact your doctor immediately if you experience chest pain or difficulty breathing.

There is an increased risk of bleeding while on this medicine, please tell your doctor or nurse if you notice any excessive bleeding or bruising.

Contact your doctor if you notice a change in the amount or darkening of your urine.

This medicine may reduce your body's ability to fight infections. Avoid contact with people with colds, flu or other infections. Contact your doctor if you develop fever, cough, sore throat, or chills.

Speak with your health care provider before receiving any vaccinations.

Do not breastfeed while on this medicine. You may safely start breastfeeding 2 weeks after stopping treatment.

This medicine can hurt a new baby in the womb. If you become pregnant while on this medicine, tell your doctor immediately. Your doctor may switch you to a different medicine.

Women must use reliable forms of birth control while taking this medicine and for 7 months after stopping to prevent pregnancy.

Men with a female partner who is of childbearing age must use a condom during sexual activity while taking this medicine and for 4 months after stopping to prevent pregnancy.

If you have had a heart attack or a stroke within the past 6 months, talk to your doctor before using this medicine.

Side Effects

The following is a list of some common side effects from this medicine. Please speak with your doctor about what you should do if you experience these or other side effects.

• decreased appetite
• constipation or diarrhea
• hair loss
• nausea and vomiting
• stomach upset or abdominal pain

Call your doctor or get medical help right away if you notice any of these more serious side effects:

• bleeding or bruising
• chest pain
• confusion
• weakened heart; fluid in lungs
• coughing up blood or vomit that looks like coffee grounds
• swelling of the legs, feet, and hands
• feeling cold or numb, especially in arms and legs
• fever or chills
• pain, redness, swelling or blistering on hands, feet or elbows
• fast or irregular heart beats
• pain, redness, swelling near injection
• mouth sores or irritation
• seizures
• shortness of breath
• sore throat
• dark, tarry stool
• unusual or unexplained tiredness or weakness
• blood in urine
• sudden or unexplained weight gain

A few people may have an allergic reaction to this medicine. Symptoms can include difficulty breathing, skin rash, itching, swelling, or severe dizziness. If you notice any of these symptoms, seek medical help quickly.