Thiotepa

Thiotepa is a prescription medication used for the treatment of cancers of the breast, ovary, bladder, and others.

• Thiotepa is available under the following different brand names: Tespa, Thioplex, Triethylenethiophosphoramide, TSPA

Common side effects of thiotepa include:

• fatigue
• weakness
• nausea
• vomiting
• stomach pain
• loss of appetite
• redness or inflammation of the eyes
• puffy eyelids
• dizziness
• headache
• blurred vision
• temporary hair loss
• skin discoloration
• rash or itching
• injection site pain
• decreased menstruation/missed menstrual periods in women and decreased sperm production in men

Serious side effects of thiotepa include:

• hives
• difficulty breathing
• swelling of the face, lips, tongue, or throat
• white patches in or around the mouth
• trouble swallowing or talking
• dry mouth
• bad breath
• altered sense of taste
• confusion
• hallucinations
• headache
• drowsiness
• changes in behavior or personality
• problems with memory, speech, or thought
• seizure
• twitching muscles
• overactive reflexes
• problems with coordination or movement
• blood in the urine
• fever
• chills
• tiredness
• mouth sores
• skin sores
• easy bruising
• unusual bleeding
• pale skin
• cold hands and feet
• lightheadedness
• shortness of breath
• rapid weight gain
• stomach pain or bloating
• dark urine
• yellowing of the skin or eyes (jaundice)

Rare side effects of thiotepa include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Powder for injection

• 15 mg

Bladder Cancer

Adult and geriatric dosage

• 30-60 mg in 30-60 mL NS every week for 4 weeks; retain for 2 hours; if the patient can not retain for 2 hr, dilute and use successive doses in 30 mL of sodium chloride 0.9% instead of 60 mL

Ovarian Cancer

Adult and geriatric dosage

• 0.3-0.4 mg/kg every 1-4 weeks OR 0.2 mg/kg for 4-5 days every 2-4 weeks
• Effusions
  • Intracavitary: 0.6-0.8 mg/kg or 30-60 mg weekly

Leptomeningeal Metastases

Adult and geriatric dosage

• 1-10 mg/m² intrathecal every week to 2 times/week as 1 mg/mL in sterile water for injection

High-dose IV Therapy for Bone Marrow Transplant

Adult and geriatric dosage

• 500 mg/m², up to 1,125 mg/m²

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Thiotepa has severe interactions with no other drugs.
• Thiotepa has serious interactions with following drugs:
  • adenovirus types 4 and 7 live, oral
  • axicabtagene ciloleucel
  • brexucabtagene autoleucel
  • ciltacabtagene autoleucel
  • deferiprone
  • idecabtagene vicleucel
  • influenza virus vaccine quadrivalent, adjuvanted
  • influenza virus vaccine trivalent, adjuvanted
  • lisocabtagene maraleucel
  • palifermin
  • ropeginterferon alfa 2b
  • tisagenlecleucel
  • tofacitinib
• Thiotepa has moderate interactions with at least 30 drugs.
• Thiotepa has minor interactions with the following drugs:
  • vitamin A
  • vitamin E

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Hepatic, renal, and bone marrow damage (maybe used in low doses if benefits are greater than risks)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Thiotepa?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Thiotepa?”

Cautions

• Avoid pregnancy
• May be mutagenic and teratogenic
• Myelosuppression may occur
• Secondary malignancies may develop (potentially carcinogenic)
• Caution in hepatic impairment (may require dose reduction; its use may also be contraindicated depending on the type of hepatic impairment)
• Caution in renal impairment (may require dose reduction; its use may also be contraindicated depending on the type of hepatic impairment)
• Use appropriate precautions for handling and disposal

Pregnancy and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug available. 
• Lactation
  • Not known if excreted in breast milk, do not nurse