Care During Chemotherapy and Beyond
Generic Name: Teniposide
(ten I POE side)
Trade name: Vumon®
Other name: VM-26
Drug type: Teniposide is an anti-cancer ("antineoplastic"
or "cytotoxic") chemotherapy drug. This medication is classified as an "topoisomerase
II inhibitor." (For more detail, see "How this drug works" section below).
What This Drug Is Used For:
- Acute lymphocytic leukemia (particularly in children)
Note: If a drug has been approved for one use, physicians
may elect to use this same drug for other problems if they believe it may be helpful.
How This Drug Is Given:
- Teniposide is given through an infusion into a vein (intravenous, IV).
- Teniposide may be an irritant. An irritant is a chemical that can cause inflammation
of the vein through which it is given. If the medication escapes from the
vein it can cause tissue damage. The nurse or doctor who gives this medication
must be carefully trained. If you experience pain or notice redness or swelling
at the IV site while you are receiving teniposide, alert your health care professional
- The amount of teniposide that you will receive depends on many factors, including
your height and weight, your general health or other health problems, and the type
of cancer or condition being treated. Your doctor will determine your dose
Important things to remember about the side effects of teniposide:
- Most people do not experience all of the side effects listed
- Side effects are often predictable in terms of their onset and duration
- Side effects are almost always reversible and will go away after treatment is complete
- There are many options to help minimize or prevent side effects
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for
patients taking teniposide:
- Low blood counts. Your white and red blood cells and platelets may temporarily
decrease. This can put you at increased risk for infection, anemia and/or
Nadir: Meaning low point, nadir is the point in time between chemotherapy
cycles in which you experience low blood counts.
Onset: 5-7 days
Nadir: 7-10 days
Recovery: 21-28 days
These side effects are less common side effects (occurring in about 10-29%)
of patients receiving teniposide:
- Nausea and vomiting
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
There is a slight risk of developing a secondary blood cancer such as a non-lymphocytic
leukemia years after taking teniposide. Talk to your doctor about this risk.
When to contact your doctor or health care provider:
Seek emergency help immediately and notify your health care provider,
it you experience the following symptoms:
- Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling
of facial features, hives, itching, rapid heartbeat, chills, fever. This
is uncommon but may happen with the first dose. Patients should be monitored
for 60 minutes following the infusion (possible allergic reaction).
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
- Nausea (interferes with ability to eat and unrelieved with prescribed medication)
- Vomiting (vomiting more than 4-5 times in a 24 hour period)
- Diarrhea (4-6 episodes in a 24-hour period)
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools
- Blood in the urine
- Extreme fatigue (unable to carry on self-care activities)
- Mouth sores (painful redness, swelling or ulcers)
Always inform your health care provider if you experience any unusual symptoms.
- Before starting Teniposide treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.). Do not take aspirin, or products containing aspirin
unless your doctor specifically permits this.
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking teniposide.
- Teniposide may be inadvisable if you have had a hypersensitivity (allergic) reaction
to teniposide or Cremophor® (polyoxyethylated castor
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (teniposide may be hazardous to
the fetus. Women who are pregnant or become pregnant must be advised of the
potential hazard to the fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking teniposide.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- You may be at risk of infection so try to avoid crowds or people with colds and
those not feeling well, and report fever or any other signs of infection immediately
to your health care provider.
- Wash your hands often.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed
with 8 ounces of water.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- This medication causes little nausea. But if you should experience nausea,
take anti-nausea medications as prescribed by your doctor, and eat small frequent
meals. Sucking on lozenges and chewing gum may also help.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you are taking
teniposide, to monitor side effects and check your response to therapy. Periodic
blood work to monitor your complete blood count (CBC) as well as the function of
other organs (such as your kidneys and liver) will also be ordered by your doctor.
How This Drug Works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cells no longer have the normal checks and
balances in place that control and limit cell division. The process of cell
division, whether normal or cancerous cells, is through the cell cycle. The
cell cycle goes from the resting phase, through active growing phases, and then
to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells
the cell how to copy itself in division. If the cells are unable to divide,
they die. The faster the cells are dividing, the more likely it is that chemotherapy
will kill the cells, causing the tumor to shrink. They also induce cell suicide
(self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the
type of cells, rate at which they divide, and the time at which a given drug is
likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.
Unfortunately, chemotherapy does not know the difference between the cancerous cells
and the normal cells. The "normal" cells will grow back and be healthy but in the
meantime, side effects occur. The "normal" cells most commonly affected by
chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and
the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea,
and/or hair loss. Different drugs may affect different parts of the body.
Teniposide is a podophyllotoxin and a topoisomerase II inhibitor. The podophyllotoxins
are derived from the May apple plant. Camptothecan analogs are derived from the
Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan
analogs are also known as topoisomerase inhibitors. The plant alkaloids are
cell-cycle specific. This means they attack the cells during various phases
Toposiomerase inhibitors are drugs that interfere with the action of topoisomerase
enzymes (topoisomerase I and II). Topoisomerase enzymes control the manipulation
of the structure of DNA necessary for replication.
- Topoisomerase I inhibitors: Ironotecan, topotecan
- Topoisomerase II inhibitors: Amsacrine, etoposide, etoposide
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org