blinatumomab
Other Name: Blincyto®
mixed into larger bags of fluids
- For treating a type of blood cancer called acute lymphoblastic leukemia (ALL).
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Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
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Neurological problems, for example, nerve problems or seizures
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Previous radiation and chemotherapy for leukemia or,
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Any allergies
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Remember to:
- Tell your health care team about all of the other medications you are taking.
- Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
Talk to your health care team about:
- How this medication may affect your sexual health.
- How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
- If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until 48 hours after your last treatment dose. Talk to your health care team about which birth control options are best for you.
- Do not breastfeed while on this medication and for at least 48 hours after the last dose.
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Blinatumomab is given as injection through IV (injected into a vein). Your infusion will start on day 1 at the hospital and continue there until your health care team decides it is ok for you to continue at home. You will receive a continuous infusion of blinatumomab for 28 days followed by 2 weeks off (when the medication is not given). Talk to your health care team about your treatment schedule
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You will be given this treatment along with other medications to help prevent a reaction and some side effects.
To Prevent Tumor Lysis Syndrome (TLS)
TLS can happen when a large number of cancer cells die quickly and your body cannot get rid of them fast enough. TLS can make you very sick. Ask your health care team if you are at risk for TLS.
If you are at risk for TLS, you may be given medications before your blinatumomab treatment to help prevent it.
These are called anti-uricemics (such as allopurinol), or others.
To Prevent Allergic Reaction
You will be given a corticosteroid (such as dexamethasone) before your treatment to help prevent allergic reactions before they start.
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Will this medication interact with other medications or natural health products?
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This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
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Tell your health care team about all of your:
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prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)
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natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
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Check with your health care team before starting or stopping any of them.
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If you are taking a blood thinner (such as warfarin), your health care team may need extra blood tests and may change your dose.
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What should I do if I feel unwell, have pain, a headache or a fever?
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
- 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 (100.4°F) or higher for at least one hour.
- 38.3°C (100.9°F) or higher at any time
If you do have a fever:- Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
- Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
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Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
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Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
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What to DO while on this medication:
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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
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DO tell your health care team about any serious infections that you have now or have had in the past
What NOT to DO while on this medication:
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DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel dizzy, confused or experience seizures while on blinatumomab,
The following table lists side effects that you may have when getting blinatumomab. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on blinatumomab.
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Fever, chills You have a fever if your temperature taken in your mouth (oral temperature) is:
OR
When neutrophils are low, you are at risk of getting an infection more easily. Ask your health care team for the Neutropenia (Low white blood cell count) pamphlet for more information. What to look for?
If your health care team has told you that you have low neutrophils:
If you have a fever: If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you MUST get emergency medical help right away. |
Low platelets in the blood When platelets are low, you are at risk for bleeding and bruising. Ask your health care team for the Low Platelet Count pamphlet for more information. What to look for?
What to do? If your health care team has told you that you have low platelets:
If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. |
Talk to your health care team if you have any signs of bleeding. If you have bleeding that doesn’t stop or is severe, you MUST get emergency medical help right away. |
Allergic reaction (May be severe) What to look for?
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Get emergency medical help right away for severe symptoms |
Headache; mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Liver problems Your health care team may check your liver function with a blood test. Liver changes do not usually cause any symptoms.
What to do? If you have any symptoms of liver problems, get emergency medical help right away. |
Get emergency medical help right away |
Mild swelling What to look for?
What to do?
If you have swelling:
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Talk to your health care team if it does not improve or if it is severe |
Cough and feeling short of breath What to look for?
What to do?
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Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away |
Rash; dry, itchy skin What to look for?
What to do? To prevent and treat dry 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. |
Talk to your health care team if it does not improve or if it is severe |
Cytokine release syndrome (May be severe) Cytokine release syndrome (CRS) can happen when your immune system releases a large amount of proteins called cytokines. This can make you very sick. If you have CRS, your health care team will need to do blood tests and monitor you more closely. What to look for?
What to do?
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Talk to your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
Low blood pressure What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe |
Trouble Sleeping Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe |
Talk to your health care team if it does not improve or if it is severe |
Tremors (shaking) What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe. |
Talk to your health care team if it does not improve or if it is severe |
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:
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Severe headache, dizziness, passing out, confusion, hallucinations.
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Seizures
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New changes in your senses, such as hearing, trouble with face movements or swallowing
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Muscle twitching, severe weakness or cramping, irregular heartbeat
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New lower back pain, changes in urination (peeing) such as less urine (pee) than usual
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Sudden increase in body weight or swelling in legs or feet, swollen lymph nodes
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Severe belly pain, including pain in the centre of your belly that may extend to your back
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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June 2022 Modified Side effects section
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.