In the U.S.—

In Canada—

• Antineoplastic

Streptozocin ( strep-toe-ZOE-sin) belongs to the group of medicines known as alkylating agents. It is used to treat cancer of the pancreas.

Streptozocin seems to interfere with the growth of cancer cells, which are eventually destroyed. It also directly affects the way the pancreas works. Since the growth of normal body cells may also be affected by streptozocin, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with streptozocin, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Streptozocin is to be given only by or under the immediate supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For streptozocin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to streptozocin.

Pregnancy—Tell your doctor if you are pregnant or if you intend to have children. There is a chance that this medicine may cause birth defects if either the male or the female is receiving it at the time of conception or if it is taken during pregnancy. Studies in rats and rabbits have shown that streptozocin causes birth defects or miscarriage. In addition, many cancer medicines may cause sterility which could be permanent. Although this has not been reported with this medicine, the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving streptozocin. Tell your doctor right away if you think you have become pregnant while receiving streptozocin.

Breast-feeding—Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. Because streptozocin may cause serious side effects, breast-feeding is generally not recommended while you are receiving it.

Children—There is no specific information comparing use of streptozocin in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of streptozocin in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving streptozocin, it is especially important that your health care professional know if you are taking any of the following:

• Anti-infectives by mouth or by injection (medicine for infection) or
• Carmustine (e.g., BiCNU) or
• Cisplatin (e.g., Platinol) or
• Combination pain medicine containing acetaminophen and aspirin (e.g., Excedrin) or other salicylates (with large amounts taken regularly) or
• Cyclosporine (e.g., Sandimmune) or
• Deferoxamine (e.g., Desferal) (with long-term use) or
• Gold salts (medicine for arthritis) or
• Inflammation or pain medicine except narcotics or
• Lithium (e.g., Lithane) or
• Methotrexate (e.g., Mexate) or
• Penicillamine (e.g., Cuprimine) or
• Plicamycin (e.g., Mithracin) or
• Tiopronin (e.g., Thiola)—Increased risk of harmful effects on the kidney

• Phenytoin (e.g., Dilantin)—May interfere with the effects of streptozocin

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Diabetes mellitus (sugar diabetes)—May be worsened

• Infection—Streptozocin can decrease your body's ability to fight infection

• Kidney disease or
• Liver disease—Effects of streptozocin may be increased because of slower removal from the body

While you are receiving streptozocin, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

This medicine usually causes nausea and vomiting, which may be severe. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Dosing—

The dose of streptozocin will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's size, and whether or not other medicines are also being taken. If you are receiving streptozocin at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of streptozocin, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for any unwanted effects.

While you are being treated with streptozocin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Streptozocin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other people living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have recently taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

If streptozocin accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the health care professional right away if you notice redness, pain, or swelling at the place of injection.

Along with their needed effects, medicines like streptozocin can sometimes cause unwanted effects such as kidney problems and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Streptozocin has been shown to cause tumors (some cancerous) in animals. Discuss these possible effects with your doctor.

Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your health care professional immediately if any of the following side effects occur shortly after the medicine is given:

• Less common
  • Anxiety, nervousness, or shakiness;  chills, cold sweats, or cool, pale skin;  drowsiness or unusual tiredness or weakness;  fast pulse;  headache;  pain or redness at place of injection;  unusual hunger 
  
  

Check with your doctor immediately if the following side effects occur any time while you are being treated with this medicine:

• Rare
  • Black, tarry stools;  blood in urine or stools;  cough or hoarseness;  fever or chills;  lower back or side pain;  painful or difficult urination;  pinpoint red spots on skin;  unusual bleeding or bruising 
  
  

Check with your health care professional as soon as possible if any of the following side effects occur:

• More common
  • Swelling of feet or lower legs;  unusual decrease in urination 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• More common
  • Nausea and vomiting (usually occurs within 2 to 4 hours after receiving dose and may be severe) 
  
  

• Less common
  • Diarrhea 
  
  

After you stop receiving streptozocin, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time, check with your doctor if you notice either of the following side effects:

• More common
  • Decrease in urination;  swelling of feet or lower legs 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.