Marqibo

Marqibo is a prescription medication used to treat a certain type of acute lymphoblastic leukemia (ALL) which is a type of cancer of the white blood cells.

Marqibo belongs to a group of drugs called vinca alkaloids. It works by slowing or stopping the growth of cancer cells in your body.

This medication comes in a liposome injection and is given directly into a vein (IV) by a healthcare provider. It is usually given once a week.

Common side effects of Marqibo include constipation, nausea, plus weakness, numbness, and pain, usually in the hands and feet (peripheral neuropathy). Marqibo can cause drowsiness. Do not drive or operate heavy machinery until you know how Marqibo affects you. 

Marqibo is a prescription medication used to treat philadelphia chromosome-negative (Ph-) acute lymphoblastic leukemia (ALL) in second or greater relapse or whose disease has progressed following two or more anti-leukemia therapies.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Spectrum Pharmaceuticals, Inc.

Serious side effects have been reported with Marqibo. See the "Marqibo Precautions" section. 

Common side effects of Marqibo include the following:

• constipation
• nausea
• fever
• feeling tired (fatigue)
• weakness, numbness, and pain, usually in the hands and feet (peripheral neuropathy)
• development of fever with other signs of infection (febrile neutropenia)
• diarrhea
• lack of healthy blood cells in the blood (anemia)
• decreased appetite
• difficulty sleeping

This is not a complete list of Marqibo side effects. Ask your doctor or pharmacist for more information. 

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to 1-800-FDA-1088. 

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. No interaction studies have been done with Marqibo, but it is expected to interact with the same medications as its active ingredient vincristine which include:

• medications that block the p­glycoprotein transporter such as amiodarone (Cordarone, Pacerone), azithromycin (Zithromax, Zmax), captopril (Capoten), carvedilol (Coreg), clarithromycin (Biaxin), conivaptan (Vaprisol), cyclosporine (Neoral, Sandimmune, Gengraf), diltiazem (Cardizem), dronedarone (Multaq), erythromycin (EES, Ery­Tab), felodipine (Plendil), itraconazole (Sporanox, Onmel), ketoconazole (Nizoral), lopinavir and ritonavir (Kaletra), quinidine (Cardioquine, Quinact, Duraquin), ranolazine (Ranexa), verapamil (Calan, Isoptin, Covera, Verelan)
• medications that block a protein in the body (CYP3A4) such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan (Vaprisol), delavirdine (Rescriptor), and nefazodone
• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), St John's wort, and nimodipine (Nimotop)

This is not a complete list of Marqibo drug interactions. Ask your doctor or pharmacist for more information.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Marqibo there are no specific foods that you must exclude from your diet.

Before receiving this medication, tell your doctor about all of your medical conditions. Especially tell your doctor if:

• you are allergic to any ingredient in Marqibo
• you suffer from nerve or muscle diseases
• you are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. Marqibo can cause birth defects for the baby if you are already pregnant. Patients should not become pregnant while taking Marqibo. Patients should use effective contraception to prevent pregnancy. 

Report to your healthcare provider immediately if you become pregnant. 

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Marqibo is excreted in human breast milk or if it will harm your nursing baby. Do not breastfeed while taking Marqibo.

Marqibo is for intravenous (into the vein) use only. Your doctor will choose the correct dosage for your situation and in most cases will give the injection in his or her office or clinic.

Marqibo is for intravenous (into the vein) use only. Your doctor will choose the correct dosage for your situation and in most cases will give the injection in his or her office or clinic.

The recommended dose of Marqibo is 2.25 mg/m² intravenously over 1 hour once every 7 days.

Since this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Keep all scheduled appointments with your doctor as well as all laboratory appointments. This medicine may cause a decrease of blood cells. Your doctor may order tests before, during and after your treatment to monitor this side effect.

Drink lots of water while receiving Marqibo treatments, unless you are told not to, to help prevent constipation and dehydration.

Good diet and nutrition will be helpful, as well as eating foods that will help reduce the effects of diarrhea.

People on Marqibo may be at risk of infections, so avoiding crowds or other people with contagious illnesses may help. Always maintain good hygiene and wash hands often.

WARNINGS

• For Intravenous Use Only – Fatal if Given by Other Routes
• Death has occurred with intrathecal use
• Marqibo has different dosage recommendations than vincristine sulfate injection. Verify drug name and dose prior to preparation and administration to avoid overdosage.