Thiotepa

What is Thiotepa

Thiotepa is an alkylating agent indicated for the treatment of superficial papillary carcinoma of the urinary bladder, ovarian cancer, breast cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, and controlling intracavitary effusions secondary to diffuse or localized neoplastic diseases of various serosal cavities.

Thiotepa was originally approved by the FDA in 1959.

In 2017, Thiotepa (Tepadina) was approved by the FDA to reduce the risk of graft rejection when used in conjunction with high-dose busulfan and cyclophosphamide as a preparative regimen for allogeneic hematopoietic progenitor cell transplantation for pediatric patients with class 3 beta-thalassemia.

Brand Name

TEPADINA

Indications

  1. bladder cancer
  2. bone marrow transplant rejection
  3. breast cancer
  4. carcinomatous meningitis
  5. Hodgkin lymphoma
  6. non-Hodgkin’s lymphoma (NHL)
  7. ovarian cancer
  8. pericardial effusion
  9. peritoneal effusion
  10. pleural effusion
  11. soft-tissue sarcoma
  12. stem cell transplant preparation

Side Effects

  1. abdominal pain
  2. alopecia
  3. amenorrhea
  4. amnesia
  5. anaphylactic shock
  6. anaphylactoid reactions
  7. anemia
  8. anorexia
  9. aphasia
  10. ascites
  11. bleeding
  12. blurred vision
  13. bone marrow suppression
  14. bradycardia
  15. breast cancer
  16. capillary leak syndrome
  17. cardiac arrest
  18. coma
  19. confusion
  20. conjunctivitis
  21. contact dermatitis
  22. cranial nerve palsies
  23. cystitis
  24. delirium
  25. depression
  26. diarrhea
  27. dizziness
  28. drowsiness
  29. dysphagia
  30. dyspnea
  31. dysuria
  32. elevated hepatic enzymes
  33. elevated hepatic enzymes
  34. encephalopathy
  35. enterocolitis
  36. exfoliative dermatitis
  37. fatigue
  38. fever
  39. gastritis
  40. GI bleeding
  41. graft-versus-host disease (GVHD)
  42. hallucinations
  43. headache
  44. hearing loss
  45. heart failure
  46. hematuria
  47. hemorrhagic cystitis
  48. hepatomegaly
  49. hyperbilirubinemia
  50. hyperbilirubinemia
  51. hyponatremia
  52. hypotonia
  53. immunosuppression
  54. infection
  55. infection
  56. influenza
  57. injection site reaction
  58. intracranial bleeding
  59. laryngeal edema
  60. leukemia
  61. leukoencephalopathy
  62. lymphoma
  63. maculopapular rash
  64. malaise
  65. memory impairment
  66. nausea
  67. neurotoxicity
  68. neutropenia
  69. new primary malignancy
  70. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  71. papilledema
  72. pericardial effusion
  73. pericarditis
  74. pneumonitis
  75. post-transplant lymphoproliferative disorder (PTLD)
  76. prolonged bleeding time
  77. pruritus
  78. ptosis
  79. pulmonary hypertension
  80. pulmonary toxicity
  81. rash
  82. renal failure (unspecified)
  83. respiratory arrest
  84. seizures
  85. sinusitis
  86. sinusoidal obstruction syndrome (SOS)
  87. spermatogenesis inhibition
  88. Stevens-Johnson syndrome
  89. stomatitis
  90. stomatitis
  91. stroke
  92. subdural hematoma
  93. suicidal ideation
  94. thrombocytopenia
  95. toxic epidermal necrolysis
  96. tremor
  97. urinary retention
  98. urticaria
  99. veno-occlusive disease (VOD)
  100. visual impairment
  101. vomiting
  102. weakness
  103. weight gain
  104. wheezing

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing
  • serum creatinine/BUN

Contraindications

  • anemia
  • bleeding
  • bone marrow suppression
  • breast-feeding
  • coma
  • contraception requirements
  • encephalopathy
  • hepatic disease
  • infection
  • infertility
  • intracranial bleeding
  • male-mediated teratogenicity
  • neonates
  • neutropenia
  • new primary malignancy
  • pregnancy
  • pregnancy testing
  • radiation therapy
  • renal impairment
  • reproductive risk
  • seizures
  • sepsis
  • serious rash
  • sinusoidal obstruction syndrome (SOS)
  • thrombocytopenia
  • vaccination
  • veno-occlusive disease (VOD)

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing
  • serum creatinine/BUN

Contraindications

  • anemia
  • bleeding
  • bone marrow suppression
  • breast-feeding
  • coma
  • contraception requirements
  • encephalopathy
  • hepatic disease
  • infection
  • infertility
  • intracranial bleeding
  • male-mediated teratogenicity
  • neonates
  • neutropenia
  • new primary malignancy
  • pregnancy
  • pregnancy testing
  • radiation therapy
  • renal impairment
  • reproductive risk
  • seizures
  • sepsis
  • serious rash
  • sinusoidal obstruction syndrome (SOS)
  • thrombocytopenia
  • vaccination
  • veno-occlusive disease (VOD)
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