Not to be used in chronic inflammatory bowel disease &/or obstruction. Delayed diarrhoea; grade 3 & 4 neutropenia; nausea, vomiting; acute cholinergic syndrome; asthma; interstitial pulmonary disease, pulmonary infiltrates; infections, dehydration; myocardial ischaemic events; thromboembolic events eg, pulmonary embolism, venous & arterial thromboembolism; hypotension, circulatory failure. Patients w/ previous abdominal &/or pelvic RT, baseline hyperleucocytosis, performance status ≥2, extensive prior irradiation; underlying cardiac disease, other known risk factors for cardiac disease or previous cytotoxic chemotherapy; smoking, HTN, hyperlipidaemia. Monitor CBC wkly during treatment. Perform hepatic function test at baseline & prior to each cycle. Avoid extravasation & monitor for signs of inflammation at infusion site. Women. Not to be taken by patients w/ fructose intolerance. Avoid use w/ live or live attenuated vaccines; strong CYP3A4 inhibitors (eg, ketoconazole) or inducers (eg, rifampicin, carbamazepine, phenobarb, phenytoin, St. John's wort). Concomitant use w/ pneumotoxic drugs, radiation therapy, colony-stimulating factors. May affect ability to drive & use machines. Renal insufficiency. Women of childbearing potential must use effective contraception during & for 1 mth after last dose; men must use effective contraception during & for 3 mth after last dose. Not recommended in dialysis patients. Not to be used during pregnancy & lactation. Childn. Elderly.
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