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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

blinatumomab

( blin-a-too-moo-mab )
Funding:
New Drug Funding Program
  • Blinatumomab – Relapsed or Refractory Pediatric Acute Lymphoblastic Leukemia
  • Blinatumomab - Relapsed or Refractory Acute Lymphoblastic Leukemia (Ph+ BCP-ALL)
  • Blinatumomab - Relapsed or Refractory Acute Lymphoblastic Leukemia (Ph- BCP-ALL)
Other Name(s): Blincyto®
Appearance: solution mixed into larger bags of fluids

Medication Information Sheet
blinatumomab (blin-a-too-moo-mab)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Blincyto

 

Appearance:
solution

mixed into larger bags of fluids

 

What is this medication for?
  • For treating a type of blood cancer called ALL (acute lymphoblastic leukemia) in patients who have not responded to previous treatment, or the ALL has come back after previous treatment.
What should I do before I have this medication?
  • Tell your health care team if you have or had significant medical condition(s) such as:

    • Neurological problems, for example, nerve problems or seizures

    • Kidney problems

    • Previous radiation and chemotherapy for leukemia or,

    • Any allergies

  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.

How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.

  • If there is any chance that you or your partner may become pregnant, you and your partner together must: 

    • Use 2 effective forms of birth control at the same time while receiving this drug: Keep using birth control until at least 48 hours after the last dose. Discuss with your healthcare team.

  • Do not breastfeed while using this drug and for at least 48 hours after the last dose.

  • This medication may affect fertility (ability to get pregnant)

How is this medication given?
  • Blinatumomab is given as an injection through a vein as a continuous infusion over 28 days, followed by 2 weeks when the medication is not given.

  • Before you receive blinatumomab, you will be given a medicine (corticosteroid) to help reduce side effects (drug-related reactions and cytokine release syndrome).

What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain or fever:

    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
       
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

  • Do not drive, operate heavy machinery or perform any other tasks or actions that call for alertness while taking blinatumomab because blinatumomab may cause dizziness, seizures, and confusion.
     
  • Tell your health care team if you may need any vaccinations.  Some vaccines cannot be given before, during, and for months after treatment with blinatumomab.
What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to doWhen to contact doctor?
Very Common Side Effects (in 50 or more out of 100 people)

Fever, chills

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.
     
  • You may have fever, chills and muscle pain without any signs of infection, such as a sore throat, cough or skin rash.
  • It may happen at any time after you receive your treatment and it usually goes away as your body gets used to the medication.
  • Contact your health care team if these feelings bother you.

While you are getting treatment:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often to prevent infection.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

 

Side effects and what to doWhen to contact doctor?
Common Side Effects (in 25 to 49 out of 100 people)

Allergic reaction 

  • The most common symptoms include fever, flushing, itchiness, rash, swollen lips, face or tongue, wheezing, chest and throat tightness.
  • It may occur during or shortly after the medication is given to you. Let your health care team know right away if this happens to you.
  • You may be given medicines to prevent or treat this reaction
Get emergency medical help right away

Headache; mild joint, muscle pain or cramps 

  • Take your pain medication as prescribed by your doctor.
  • You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
  • Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
  • Rest often and try light exercise as it may help.
Contact your health care team if no improvement or if severe

Low platelets in the blood

  • Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
  • Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

Get emergency medical help right away

 

Side effects and what to doWhen to contact doctor?
Less Common Side Effects (in 10 to 24 out of 100 people)

Mild swelling in arms and legs; puffiness

To help prevent swelling :

  • Eat a low-salt diet.
  • Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

Contact your health care team if no improvement or if severe

Abnormal liver lab tests

  • You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. Talk to your health care team if this happens.
  • Your doctor may monitor your liver regularly with a blood test.
Contact your health care team if no improvement or if severe

Cough; feeling short of breath

You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose.

Contact your health care team if no improvement or if severe

Rash; dry, itchy skin

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

  • Use skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
Contact your health care team if no improvement or if severe

Cytokine release syndrome

You may have fever, chills, redness, low blood pressure (dizziness, fainting), tiredness, body swelling and trouble breathing.

Get emergency medical help right away

Low blood pressure; dizziness

  • It may happen when the medication is being given to you. Let your healthcare team know right away if it occurs.
  • Check your blood pressure regularly.
  • If you feel dizzy or unwell you should lay down to avoid falling. Try to get up and move slowly once you feel better.
  • Do not drive a motor vehicle or operate machinery if you feel dizzy.
Contact your health care team if no improvement or if severe

Trouble falling asleep

  • This may be caused by one of your medications and may improve once your body gets used to the medication or when your treatment ends.
  • Talk to your doctor if this bothers you.
Contact your health care team if no improvement or if severe

Tremors (shaky movements)

Contact your health care team as soon as possible

     

    Other rare, but serious side effects are possible. If you experience ANY of the following, speak to your health care provider or get emergency medical help right away:

    • Severe headache, dizziness, passing out, seizures, confusion, hallucinations.

    • Tingling, numb fingers and toes or trouble doing up buttons, writing, picking up small objects, or have pain or trouble moving.

    • Muscle twitching, severe weakness or cramping, irregular heartbeat, feeling restless.

    • Kidney problems such as lower back pain, body swelling, passing little or no urine, or recent unusual weight gain.

    • Pain in the centre of your belly that may extend to your back.

    • Effects on the nerves in your head or face, leading to weakness or changes in senses such as hearing.

     

    For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

    The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

    A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.