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Zanosar Warnings and Precautions

Serious problems can occur with Zanosar, so your healthcare provider will need to know your medical history, such as whether you have diabetes or problems with your kidneys or liver. Safety warnings and precautions with Zanosar also pertain to people who have certain allergies and women who are pregnant or nursing.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to receiving Zanosar® (streptozocin) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Diabetes
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Zanosar

Some warnings and precautions to be aware of prior to using this medication include the following:
  • Zanosar can cause severe and potentially life-threatening kidney problems, especially when used in high doses and over extended periods. Your kidney function will be monitored with blood and urine tests before, during, and after treatment. Your healthcare provider may lower your dose or recommend you stop using the medicine if you show signs of kidney damage. Make sure to drink plenty of fluids to stay hydrated during treatment, as this may help reduce your risk for kidney toxicity.
  • In animal studies, some rats developed tumors or cancer when exposed to Zanosar.
  • This medication can be irritating to the skin. You may develop a skin reaction at the injection site, especially if the medication leaks from your vein to the surrounding tissue. Let your healthcare provider know right away if you develop any reactions at the injection site, such as:
    • Burning
    • Stinging
    • Redness
    • Swelling
    • Pain.
  • Some people have developed confusion, extreme sleepiness, lack of energy (lethargy), and depression from this medication. These side effects could interfere with your ability to drive or operate heavy machinery. Therefore, you should avoid these activities until you know how the drug affects you, especially on days you receive your dose.
  • Zanosar can cause liver problems and bone marrow suppression (when the bone marrow does not make adequate amounts of blood cells). Therefore, your healthcare provider will monitor your liver function and your blood cell counts throughout treatment, usually at least once a week. Make sure to keep all of your laboratory and healthcare provider appointments.
  • Zanosar is associated with potentially serious side effects. It should only be used under the supervision of a healthcare provider with experience using chemotherapy medicines. Your healthcare provider will weigh the risks and benefits of using this medicine before making a recommendation for your treatment.
  • Although hospitalization is not required for treatment, it is important that people being treated with this medicine have access to a medical facility that can provide appropriate monitoring and, if necessary, treatment for potentially serious side effects.
  • Zanosar can cause severe nausea, vomiting, and diarrhea. Some people may need to stop using the medicine due to these side effects.
  • Zanosar is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see Zanosar and Pregnancy).
  • It is unknown whether Zanosar passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Zanosar and Breastfeeding).
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