Pentostatin Brand Name– Nipent
What is Pentostatin
Pentostatin is a synthetic purine nucleoside antimetabolite. It is indicated for the treatment of hairy-cell leukemia in patients with active disease that is previously untreated or refractory to alpha-interferon therapy.
Using a dose that is higher than the FDA-approved dosage is not recommended due to the potential for severe renal, hepatic, pulmonary, and nervous system toxicity.
Additionally, the use of pentostatin in combination with fludarabine resulted in severe or fatal pulmonary toxicity in patients with refractory chronic lymphocytic leukemia; therefore, the use of pentostatin and fludarabine is not recommended.
Indications
- chronic lymphocytic leukemia (CLL)
- cutaneous T-cell lymphoma (CTCL)
- graft-versus-host disease (GVHD)
- graft-versus-host disease (GVHD) prophylaxis
- hairy-cell leukemia
- mycosis fungoides
- stem cell transplant preparation
For the treatment of hairy-cell leukemia
NOTE: Pentostatin has been designated as an orphan drug by the FDA for the treatment of hairy-cell leukemia.
for the treatment of hairy-cell leukemia in patients with active disease that is previously untreated or refractory to alpha-interferon therapy
Side Effects
- abdominal pain
- acne vulgaris
- agranulocytosis
- alopecia
- amblyopia
- amenorrhea
- amnesia
- anemia
- angina
- anorexia
- anxiety
- aplastic anemia
- arthralgia
- asthenia
- ataxia
- AV block
- bleeding
- bradycardia
- bronchospasm
- cardiac arrest
- chest pain (unspecified)
- chills
- confusion
- conjunctivitis
- constipation
- cough
- depression
- diarrhea
- dizziness
- drowsiness
- dysarthria
- dysgeusia
- dyspepsia
- dysphagia
- dyspnea
- elevated hepatic enzymes
- emotional lability
- erythema
- exfoliative dermatitis
- fatigue
- fever
- flatulence
- furunculosis
- gingivitis
- glossitis
- gout
- hallucinations
- headache
- hearing loss
- heart failure
- hemolytic anemia
- hemolytic-uremic syndrome
- hepatotoxicity
- hostility
- hypercalcemia
- hyperhidrosis
- hyperkinesis
- hypertension
- hyponatremia
- hypotension
- ileus
- impotence (erectile dysfunction)
- infection
- insomnia
- lacrimation
- laryngeal edema
- leukopenia
- libido decrease
- maculopapular rash
- muscle paralysis
- myalgia
- nausea
- nephrolithiasis
- nephrotoxicity
- neuritis
- neurotoxicity
- new primary malignancy
- otalgia
- paresthesias
- pericardial effusion
- peripheral edema
- petechiae
- pharyngitis
- phlebitis
- photophobia
- photosensitivity
- pruritus
- pulmonary edema
- pulmonary embolism
- pulmonary toxicity
- rash
- renal failure (unspecified)
- retinopathy
- rhinitis
- seizures
- sinusitis
- stomatitis
- syncope
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- tinnitus
- urticaria
- vasculitis
- vertigo
- visual impairment
- vomiting
- xerophthalmia
- xerosis
Monitoring Parameters
- CBC with differential
- serum creatinine/BUN
Contraindications
- anemia
- bone marrow suppression
- breast-feeding
- hepatotoxicity
- infection
- infertility
- nephrotoxicity
- neurotoxicity
- neutropenia
- pregnancy
- pulmonary toxicity
- renal impairment
- requires an experienced clinician
- serious rash
- thrombocytopenia
- use with fludarabine
Interactions
- Alpha interferons
- Amlodipine; Celecoxib
- Antithymocyte Globulin
- Azelastine; Fluticasone
- Bacillus Calmette-Guerin Vaccine, BCG
- Basiliximab
- Beclomethasone
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Carbamazepine
- Celecoxib
- Ciclesonide
- Clozapine
- Corticosteroids
- Cortisone
- Cyclophosphamide
- Cyclosporine
- Deflazacort
- Dexamethasone
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Echinacea
- Efalizumab
- Esomeprazole; Naproxen
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Filgrastim, G-CSF
- Fludarabine
- Fludrocortisone
- Flunisolide
- Flurbiprofen
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocodone; Ibuprofen
- Hydrocortisone
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Influenza Virus Vaccine
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Interferon Alfa-n3
- Interferon Alfacon-1
- Intranasal Influenza Vaccine
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Live Vaccines
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Measles/Mumps/Rubella Vaccines, MMR
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methotrexate
- Methylprednisolone
- Mometasone
- Muromonab-CD3
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Palifermin
- Pegfilgrastim
- Peginterferon Alfa-2a
- Peginterferon Alfa-2b
- Penicillamine
- Piroxicam
- Platelet Inhibitors
- Prednisolone
- Prednisone
- Rofecoxib
- Rotavirus Vaccine
- Rubella Virus Vaccine Live
- Smallpox and Monkeypox Vaccine, Live, Nonreplicating
- Smallpox Vaccine, Vaccinia Vaccine
- Sulindac
- Tbo-Filgrastim
- Tolmetin
- Triamcinolone
- Tuberculin Purified Protein Derivative, PPD
- Typhoid Vaccine
- Valdecoxib
- Varicella-Zoster Virus Vaccine, Live
- Vigabatrin
- Yellow Fever Vaccine, Live
