This medication may make you feel generally unwell. This is not uncommon as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your care team tells you to stop.
Before having surgery or dental work, talk to your care team to make sure it is ok. This medication can increase the risk of poor healing of your surgical site or wound. You will need to stop this medication for 3 weeks before surgery or dental work. After surgery, wait at least 2 weeks before restarting this medication. Make sure the surgical site or wound is healed enough before restarting this medication. Talk to your care team if questions.
This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.
Avoid taking medications that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your care team. These medications may hide a fever.
This medication may increase your risk to bruise or bleed. Call your care team if you notice any unusual bleeding.
Be careful brushing or flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medication.
This medication may increase your risk for jaw problems. Tell your care team right away if you have severe pain in your jaw. Tell your care team if you have any pain that does not go away or that gets worse.
Talk to your care team if you may be pregnant. Serious birth defects can occurs if you take this medication during pregnancy and for 4 months after the last dose. You will need a negative pregnancy test before starting this medication. Contraception is recommended while taking this medication and for 4 months after the last dose. You care team can help you find the option that works for you.
Do not breastfeed while taking this medication and for 4 months after the last dose.
This medication may make cause infertility. Talk to your care team if you are concerned about your fertility.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blurred vision
burning, numbness, tingling, or painful sensations
confusion
dark urine
darkening of the skin
decreased urination
difficulty with breathing or swallowing
dizziness
fainting
headache
increase in heart rate
lightheadedness
loss of appetite
mental depression
nausea or vomiting
nervousness
pain in the chest, groin, or legs, especially the calves
pounding in the ears
rapid breathing
redness, swelling, or pain of the skin
scaling of the skin on the hands and feet
severe, sudden headache
skin rash or ulcers
slow or fast heartbeat
slurred speech
stomach pain
sudden loss of coordination
sudden, severe weakness or numbness in the arm or leg
sunken eyes
thirst
unsteadiness or awkwardness
unusual tiredness or weakness
vision changes
weakness in the arms, hands, legs, or feet
wrinkled skin
yellow eyes or skin
Less common
Bleeding gums
bloody, black, or tarry stools
coughing up blood
heavy jaw feeling
increased menstrual flow or vaginal bleeding
indigestion
loosening of a tooth
nosebleeds
pain, swelling, or numbness in the mouth or jaw
paralysis
prolonged bleeding from cuts
red or dark brown urine
severe stomach pain, cramping, or burning
trouble breathing
vomiting of material that looks like coffee grounds, severe and continuing
Rare
Disturbed color perception
double vision
halos around lights
night blindness
overbright appearance of lights
seizures
tunnel vision
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Belching
bleeding after defecation
change in taste
changes in hair color
decreased appetite
decreased weight
difficulty having a bowel movement
difficulty with moving
fear
hair loss or thinning of the hair
hoarseness
lack or loss of strength
loss of taste
muscle pain, spasm, or stiffness
pain in the joints
rash
stomach discomfort, upset, or pain
swelling or inflammation of the mouth
uncomfortable swelling around the anus
voice changes
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.