Discontinue use if severe hypersensitivity reactions, cystoid macular oedema occur. Not to be administered as intracerebral, intrapleural or intraperitoneal inj; in patients w/ pre-treatment neutrophil count <1.5 x 109
cells/L (1,500 cells/mm3
) or platelet count <100 x 109
cells/L. Premed w/ corticosteroids (eg, dexamethasone), antihistamines (eg, diphenhydramine or promethazine) & H2
-receptor antagonist (eg, cimetidine or ranitidine) before every treatment cycle. Exclude bowel perforation in patients w/ abdominal pain. Preexisting neuropathy; CNS, other effects of alcohol; interstitial pneumonia; pseudomembranous colitis; severe mucositis. Perform baseline cardiac assessment including history, physical exam, ECG, echocardiogram &/or MUGA scan; prompt & complete ophth exam in patients w/ visual impairment. Monitor cardiac function during treatment eg, every 3 mth. Ensure correct position of indwelling catheter to avoid extravasation, necrosis &/or thrombophlebitis. May affect ability to drive & use machines. Hepatic & renal impairment. May impair fertility. Women of childbearing potential should use effective contraception during & at least 6 mth after last dose. Male patients should not father a child during & at least 3 mth after last dose. Not to be used during pregnancy & lactation. Elderly. Not recommended in childn <18 yr.