Omacetaxine mepesuccinate (Synribo®)

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About This Drug

Omacetaxine is used to treat cancer. It is given as an injection under the skin (subcutaneously).

Possible Side Effects

  • 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.
  • Fever
  • Infection
  • Tiredness and weakness
  • Nausea
  • Loose bowel movements (diarrhea)
  • Injection site reaction. You may get a rash, swelling or bruising or your skin may get red, warm, itchy or painful at the site of your infusion or injection.

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

Warnings and Precautions

  • Severe bone marrow depression, which may be life-threatening
  • Blood sugar levels may change. If you have diabetes, changes may need to be made to your diabetes medication
  • Abnormal bleeding, which may be life-threatening. Symptoms may include coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements,  abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.

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

How to Take Your Medication

  • Talk to your doctor, nurse and/or pharmacist for proper preparation, dosing and administration if you are self-injecting.
  • Missed dose: If you miss a dose, take your next scheduled dose at the next scheduled time, and contact your physician. Do not take 2 doses at the same time and do not double up on the next dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • Storage: Discuss with your nurse or your doctor proper storage for this medicine and how to dispose of unused medicine/needles.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease 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 help decrease 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.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you have diabetes, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.

Food and Drug Interactions

  • There are no known interactions of omacetaxine with food or other medications.
  • 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
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Coughing up blood
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability, rapid and deep breathing
  • Abnormal blood sugar
  • While you are getting this drug, please tell your nurse right away if you get a rash, swelling or bruising or your skin gets red, warm, itchy or painful at the site of your infusion or injection
  • 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. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: Women should not breast feed during treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility risk: In men, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm banking.

Revised May 2018