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Denileukin Diftitox

Other Names: Ontak™

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About this drug

Denileukin diftitox is used to treat cancer. It is given in the vein (IV).

Possible Side Effects (More Common)

  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
  • Headache
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours of your treatment and may last up to 48 hours. Medicines are available to stop or lessen these side effects.
  • Loose bowel movements (diarrhea) that may last for a few days
  • Fever
  • Shivering and trembling
  • Rash
  • Decreased appetite (decreased hunger)
  • Weakness that interferes with your daily activities
  • Muscle, joint and back pain
  • Fatigue
  • Swelling of the face, hands, legs, ankles and/or feet
  • Cough
  • Changes in your liver function. Your doctor will check your liver function as needed.
  • Blurred vision or other changes in eyesight
  • While you are getting this drug in your vein (IV), you may have a reaction. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. Tell your doctor or nurse right away if you have any of these or other symptoms any time during the infusion

Possible Side Effects (Less Common)

  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Feeling short of breath
  • Constipation (not able to move bowels)
  • Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This occurs if the drug leaks out of the vein and into nearby tissue.
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed.
  • High blood pressure. Your doctor will check your blood pressure as needed.

Food and Drug Interactions

There are no known interactions of denileukin diftitox with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

Infusion Reactions

While you are getting this drug in your vein (IV), you may have a reaction to the drug. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.

These reactions may happen for up to 48 hours after your infusion. Call 911 for emergency care.

Less serious reactions to this drug may also happen. You will be given medicines to help stop or lessen these symptoms. Your vital signs will be checked during the infusion and for up to 24 hours after the infusion. Tell your doctor or nurse right away if you have any of these symptoms any time during the infusion and/or for the first 48 hours after getting this drug.

  • Fever, chills, or shaking chills
  • Feeling dizzy or lightheaded
  • Headache
  • Nausea or throwing up

Reproduction Concerns

  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Treating Side Effects

  • Ask your doctor or nurse about medicine that is available to stop or lessen nausea, throwing up, loose bowel movements, constipation, fever, headache, or muscle, joint, and/or back pain.
  • Monitor for weight gain, new or worsening swelling, and decreased blood pressure. Your doctor will check these before each time you get this drug.
  • Monitor albumin level. Your doctor will check the amount of albumin in your blood as needed before you get this drug.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Do not put anything on a rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash is bothersome.
  • While getting this drug in your vein, tell your nurse right away if you have pain, redness, or swelling at the site of the IV infusion.
  • Tell your doctor or nurse right away if you have any of the infusion reaction symptoms at any time during the infusion and/or for the first 48 hours after getting this drug.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Shivering and trembling
  • Bleeding or bruising that is not normal
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain in your lower back or side
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired or weak, unusual itching, or yellowing of the eyes or skin

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Decreased urine
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Revised April 2014