Treosulfan

Treosulfan (pronounced tree-o-sul-fan) is a chemotherapy drug that is given as a treatment for some types of cancer. It is most commonly used to treat ovarian cancer. This information describes treosulfan, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy and about your type of cancer.

If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.

• What treosulfan looks like
• How it is given
• Possible side effects
• Less common side effects
• Additional information
• Things to remember about treosulfan capsule

What treosulfan looks like

• Treosulfan is available as white capsules of 250mg.
• It is also available as a colourless fluid, after being dissolved from powder.

How it is given

Treosulfan may be given:

• as capsules (orally). The capsules should be swallowed whole with plenty of water
• as a drip (infusion) through a fine tube (cannula) inserted into the vein. It may also be given through a central line, which is inserted under the skin into a vein near the collarbone, or into a PICC line, which is inserted into a vein in the crook of the arm
• by injection into a vein (intravenously) through a cannula
• by injection into the abdominal cavity (intraperitoneally)

Possible side effects

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given treosulfan, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common and less common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.

Lowered resistance to infection Treosulfan can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given, and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal levels before your next cycle of chemotherapy is due.

Contact your doctor or the hospital straightaway if:

• Your temperature goes above 38ºC (100.5ºF)
• You suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.

Bruising or bleeding Treosulfan can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.

Anaemia (low number of red blood cells) While having treatment with treosulfan you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these are a problem.

Skin changes Treosulfan can cause a rash, which may be itchy. Your doctor can prescribe medicine to help with this. Your skin may darken due to excess production of pigment. This usually returns to normal a few months after the treatment has finished.

Tiredness and feeling weak It is important to allow yourself plenty of time to rest.

Less common side effects

Nausea (feeling sick) and vomiting If you do feel sick it may begin soon after the treatment is given and can last for about a day. Your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled or continues tell your doctor, who can prescribe other anti-sickness drugs that may be more effective.

Hair loss It is very unusual to lose your hair. Some people notice that their hair becomes a little thinner, but not usually enough to be noticeable to other people.

Irritation of the bladder It is important to drink plenty of fluids for up to 24 hours after your chemotherapy to help prevent any irritation.

Additional information

If treosulfan leaks into the tissue around the vein it can damage the tissue in that area. If you notice any stinging or burning around the vein while the drug is being given, or any leakage of fluid from the cannula site, it is very important that you tell the doctor or nurse immediately.

If the area around the injection site becomes red or swollen at any time you should either tell the doctor or nurse on the ward, or if you are at home, ring the clinic or ward and ask to speak to the doctor or nurse.

Other medicines Some other medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.

Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.

Contraception It is not advisable to become pregnant or father a child while taking treosulfan, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.

Things to remember about treosulfan capsules

• Store the capsules in the original packaging, at room temperature away from direct sunlight.
• It is important to take your capsules at the right times. You must take them as directed by your doctor
• Keep the capsules in a safe place where children cannot reach them, as treosulfan could harm them
• If your doctor decides to stop the treatment, return any remaining capsules to the pharmacist. Do not flush them down the toilet or throw them away
• If you are sick just after taking the capsule let your doctor know, as you may need to take another one. Do not take another capsule without first informing your doctor
• If you forget to take a capsule do not take a double dose. Let your doctor know and keep to your regular dose schedule.