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MARQIBO
Leukemias, lymphomas, and other hematologic cancers
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Drug Name:

MARQIBO Rx

Generic Name and Formulations:
Vincristine sulfate liposome injection; after preparation, each vial contains 0.16mg/mL; for IV infusion.

Company:
Spectrum Pharmaceuticals, Inc.

Therapeutic Use:

Indications for MARQIBO:

Philadelphia chromosome-negative (Ph–) acute lymphoblastic leukemia (ALL) in second or greater relapse or has progressed following ≥2 anti-leukemia therapies.

Adult:

2.25mg/m2 IV over 1hr once every 7 days. Dose modifications for peripheral neuropathy: see full labeling.

Children:

Not established.

Contraindications:

Demyelinating conditions, including Charcot-Marie-Tooth syndrome. Intrathecal administration (death has occurred).

Warnings/Precautions:

For IV use only; fatal if given by other routes. Discontinue and treat if extravasation is suspected. Preexisting neuromuscular disorders. Monitor for symptoms of neuropathy before and during therapy; if occurs or worsens, delay, reduce or discontinue dose. Monitor CBCs prior to each dose; if Grade 3 or 4 myelosuppression develops, consider dose modification or reduction. Monitor for tumor lysis syndrome; manage if occurs. Institute a prophylactic bowel regimen to mitigate potential constipation, bowel obstruction, and/or paralytic ileus; consider dietary fiber intake, hydration, stool softeners. Monitor liver function tests; if hepatotoxicity occurs, reduce or interrupt dosing. Elderly. Pregnancy (Cat. D); avoid. Nursing mothers: not recommended.

Interactions:

Drugs known to interact with non-liposomal vincristine sulfate (eg, phenytoin: increased seizure risk). Avoid concomitant strong CYP3A inhibitors (eg, ketoconazole, itraconazole, voriconazole, posaconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, rito­navir, saquinavir, telithromycin) or strong CYP3A4 inducers (eg, dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, St. John’s Wort). Avoid concomitant potent P-gp inhibitors or inducers.

Pharmacological Class:

Vinca alkaloid.

Adverse Reactions:

Constipation, nausea, pyrexia, fatigue (may be severe; adjust dose or discontinue), peripheral neuropathy, febrile neutropenia, diarrhea, anemia, decreased appetite, insomnia.

Elimination:

Fecal.

Generic Availability:

NO

How Supplied:

Kit—1, 3 (vials + supplies)

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