Dinutuximab

What is dinutuximab?

Dinutuximab is an anticancer medicine used in the treatment of neuroblastoma, a cancer of the nervous system. Dinutuximab is a liquid given into a vein (IV) during a long infusion (at least 10 hours but up to 20 hours) for 4 days in a row.

Dinutuximab can pose a health hazard to caregivers. All caregivers should take safety precautions while giving this drug. For 48 hours after this drug is given, the patient’s body fluids can contain the drug. During that 48-hour period, caregivers should follow safety guidelines when handling the patient’s vomit, blood, urine, and bowel movements, including diapers. These guidelines include wearing gloves when cleaning up body fluids. For a complete list of safety precautions, see “Do you know… Protecting caregivers from drug hazards.”

Possible side effects of dinutuximab

Early (during the infusion)

• Pain, which can be general, severe, or burning, tingling and numbness
• Rash, itching
• Fever
• Diarrhea
• Loss of appetite (not as hungry as usual)
• Nausea (upset stomach) or vomiting (throwing up)
• Swelling in face, lips, hands, ankles, or feet
• Decrease in blood pressure
• Trouble breathing

Later (usually more than a day after treatment starts)

• Weight gain
• Itching and hives
• Nausea and vomiting
• Electrolyte changes
• Vision changes
• Infection

If you have any of these side effects, tell the doctor right away:

• Signs of bleeding: vomiting blood or vomit that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; vaginal bleeding that is not normal; bruises without a reason or that get bigger; or any bleeding that you cannot control.
• Signs of electrolyte problems: mood changes, confusion, muscle pain or weakness, a heartbeat that does not feel normal, seizures, not feeling hungry, or very bad nausea or vomiting.
• Signs of infection: fever, chills, bad sore throat, ear or sinus pain, cough, more mucus or change in color of mucus, pain with passing urine, mouth sores, or wound that will not heal.
• Signs of kidney problems: changes in the amount of urine passed, blood in the urine, or a big weight gain.
• Blurred eyesight, change in pupil size, loss of eyesight, or other eye or eyesight changes; if bright lights bother your eyes.
• Fast heartbeat, feeling very tired or weak, pale skin, swelling, or severe headache.
• Signs of an allergic reaction, including itching, skin redness, severe chills, shortness of breath, low blood pressure, or pain in the chest, side, or back.

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for dinutuximab

• Because dinutuximab may cause birth defects, do not take this medicine if you are pregnant. Both men and women who are taking dinutuximab should use effective birth control methods. Contact one of your caregivers at St. Jude if you are sexually active or think you may be pregnant.
• It is not known whether dinutuximab passes into breast milk. This medicine might cause serious harm to a nursing infant. Women who are taking dinutuximab should not breast-feed a baby.
• Tell dentists, surgeons, and other doctors that you are using this drug. If you have nausea or loose stools (diarrhea), vomiting, or do not feel hungry, talk with the doctor. There may be ways to lessen these side effects.
• The doctor may ask you to take diphenhydramine (Benadryl®) and acetaminophen (Tylenol®) before dinutuximab is given to prevent the flu-like side effects that can occur.
• Dinutuximab can cause nausea and vomiting. The doctor may prescribe medicine to keep you from feeling sick and throwing up after you receive dinutuximab.
• You may have a greater chance of getting infections. Avoid crowds and people with infections, colds, or flu. Clean your hands often.
• You may bleed more easily. Make sure you are careful to avoid injury. Use a soft toothbrush while brushing the teeth.
• Talk with the doctor before getting any vaccines, including a flu shot. Receiving vaccines while on this drug may either increase the chance of a bad infection or make the vaccine not work as well.
• Your doctor will do lab tests at regular visits to check the effects of this medicine. Keep all appointments.
• Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.