This page tells you about the chemotherapy drug thiotepa and its possible side effects. There is information about
- What thiotepa is
- How thiotepa works
- How you have thiotepa
- Tests during treatment
- About side effects
- Common side effects
- Occasional side effects
Thiotepa is a chemotherapy drug and has the brand name Tepadina. It is a treatment for various types of cancer including
- Breast cancer
- Brain tumours
- Ovarian cancer
- Hodgkin lymphoma
- High grade non Hodgkin lymphoma
- Germ cell tumours
Thiotepa is a type of drug called an alkylating agent. These work by sticking to one of the cancer cell's DNA strands. The cell cannot then divide into 2 new cells. DNA is the genetic code that is in the heart of all animal and plant cells. It controls everything the cell does.
Thiotepa is a clear liquid that you have into your bloodstream. You have it through a central line. This is a long, plastic tube that gives the drug directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it. Each treatment usually takes 2 to 4 hours.
You can read our information about having chemotherapy into a vein.
The treatment plan for thiotepa depends on which type of cancer you have.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with thiotepa below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having thiotepa with other drugs.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Women may stop having periods (amenorrhoea) but this may only be temporary
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
- Dizziness, headaches and blurred vision – don't drive or operate machinery if you have this
- Fits (seizures)
- Feeling or being sick is usually moderate and most likely to start within 12 hours of having treatment – this is usually easily controlled with anti sickness injections and tablets, so tell your doctor if you still have sickness as there will be other medicines you can try
- Sensation of tingling, prickling or numbness in the skin
- Heart beat changes or a heart attack – let your doctor or nurse know straight away if you have sudden sharp chest pain or breathlessness
- Diarrhoea – drink plenty of fluids and let your doctor or nurse know if it gets severe or lasts more than 3 days
- A sore mouth and mouth ulcers
- Abdominal (tummy) pain or cramps due to inflammation of the bowel
- Loss of appetite
- Higher blood sugar levels – if you have diabetes you may need to check your blood sugar levels more often than usual
- Skin changes such as a rash, itching, darkening or flaking of your skin – these will disappear within a few months of finishing treatment
- Hair usually thins but complete hair loss is very rare
- Back, muscle or joint pain
- Changes in lung tissue that may cause a cough or breathlessness
- Yellowing of the skin and whites of the eyes – let your doctor or nurse know straight away if you have this
- Loss of hearing
- Higher blood pressure than usual
- Weight gain
- Fluid build up leading to swelling in the body
- Inflammation around the drip site caused by the drug leaking into the tissues – tell your nurse or doctor straight away if you have any stinging or burning, leakage of fluid, or redness or swelling around your drip site during or after treatment
- Sore, red eyes – your nurse can give you eye drops to soothe them
- Difficulty remembering things
- Difficulty passing urine
- Low production of hormones including testosterone (male sex hormone), thyroid hormones and pituitary hormones
- Confusion – let your nurse know if you have this
Between 1 and 10 in every 100 people have one or more of these effects.
- An allergic reaction – tell your doctor or nurse straight away if you have a sudden cough or have wheezing, difficulty breathing, itching or a rash
- A build up of fluid in the lungs causing breathlessness
- Blood in the urine – tell your doctor or nurse straight away if you have this
- Kidney changes that are unlikely to cause symptoms – they will usually go back to normal when treatment finishes
- Clouding of the lens of the eye (cataracts)
- A stroke or mini stroke (bleeding in the brain) – let your nurse or doctor know straight away if you have facial weakness, arm weakness, or speech problems
- Bowel blockage – let your nurse or doctor know straight away if you stop passing bowel movements and have sudden tummy pain or cramps
- Bleeding into the stomach – let your nurse or doctor know straight away if you vomit blood or have sudden sharp pain in your chest
- Muscle weakness or lack of coordination
Fewer than 1 in 100 people have these effects
- A second cancer some years after thiotepa treatment. Your doctor will discuss this with you
- Inflammation and peeling of the skin
- A stomach or duodenal ulcer
- Inflammation of the heart muscle (myocarditis) – you will have regular heart checks for this
- A severe skin reaction called Stevens Johnson syndrome, which is a painful inflammation of the eyes, eyelids and skin
High dose thiotepa is given before a bone marrow transplant or stem cell transplant. You may have the side effects mentioned above and they may be more severe than with lower doses.
You may also have
- Numbness or tingling in the fingers and toes – you may have trouble with fiddly tasks such as doing up buttons. This can start a few days or weeks after treatment and usually goes away within a few months of the treatment finishing
- Complete hair loss
- A high temperature, weakness and chills
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant while you are having treatment and for a few months afterwards. Men should not father a child for a year afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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