Blinatumomab

Other Name: Blincyto®

About This Drug

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

Possible Side Effects

  • Infection
  • Fever, which can be in the setting of decreased white blood cells and put you at an increased risk of infections.
  • Headache
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug. Sometimes you may be given medication to stop or lessen these side effects. 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 24 hours after your infusion. If this happens, call 911 for emergency care. 
  • Bone marrow depression, This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding. 

Note: Each of the side effects above was reported in 20% or greater of patients treated with blinatumomab. Not all possible side effects are included above.

Warnings and Precautions

  • Severe infections, including viral, bacterial, and fungal, as well as catheter-related infections, which can very rarely be life-threatening.
  • Inflammation of your pancreas, which can very rarely be life-threatening.
  • Cytokine release syndrome (CRS): Some types of cancer drugs can cause CRS because of the effects of the drug in your body. If this happens you may feel very sick and have a fever, headache, nausea, or feel weak. This syndrome can very rarely be life-threatening. You may also have changes to your blood pressure.  Because of this, your blood pressure and pulse will be checked while you are getting this drug. Tell your doctor or nurse right away if you have any of these symptoms while you are getting this drug and for the first 24 hours after getting this drug: fever, chills, or shaking chills, feeling dizzy or lightheaded, have a headache and/or have nausea or throwing up.
  • Changes in your central nervous system can happen which can rarely be life-threatening. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, have hallucinations (see or hear things that are not there), seizures, trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, and coma. If you start to have any of these symptoms let your doctor know right away.
  • Tumor lysis: This drug may act on the cancer cells very quickly. This may affect how your kidneys work and can rarely be life-threatening.
  • Changes in your liver function, which can very rarely cause liver failure. 

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information

  • This drug may impair your ability to drive or use machinery. Use caution and tell your nurse or doctor if you feel dizzy, confused, and/or very sleepy.
  • Talk to your doctor before receiving any vaccinations during your treatment. Vaccinations are not recommended while receiving blinatumomab.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • To decrease your risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To decrease your risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Infusion reactions may happen for 24 hours after your infusion. If this happens, call 911 for emergency care.
  • Cytokine release syndrome may happen for 24 hours after your infusion. If this happens, call 911 for emergency care.
  • Check the site of your catheter for redness, tenderness, warmth, swelling or abnormal drainage
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain. 

Food and Drug Interactions

  • There are no known interactions of blinatumomab 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.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain 
  • Signs of cytokine release syndrome such as: fever, chills, or shaking chills, feeling dizzy or lightheaded, have a headache and/or have nausea or throwing up
  • Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures
  • Hallucinations
  • Trouble understanding or speaking
  • Headache that does not go away
  • Blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Symptoms of a seizure such as confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. If you or your family member suspects you are having a seizure, call 911 right away.
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Redness, tenderness, drainage, warmth around the catheter site
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug may have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 48 hours after treatment. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: Women should not breast feed during treatment and for 48 hours after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk to your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised November 2017