Thiotepa (Injection)

Thiotepa belongs to a group of medicines known as alkylating agents and helps to slow down or stop cancer cells from growing and spreading in the body.


Thiotepa is an anticancer medication that helps halt the growth and multiplication of cancer cells inside the body. It helps treat breast cancer, ovarian cancer, bladder cancer, and other kinds of cancers.

Thiotepa can also serve other purposes not discussed in this medicine guide.

Thiotepa shouldn't be used by a pregnant woman as it may harm the unborn child. So, make sure to prevent pregnancy with birth control while you're taking Thiotepa, whether you're a woman or man. Thiotepa may lead to birth defects if used by either parent. It's also not clear whether breast milk is affected by Thiotepa or if the medication could harm a breastfeeding child, so don't breastfeed while taking this medication.

If you're allergic to Thiotepa, you should not use the medication. To determine whether it's safe to take Thiotepa, tell your physician if you've got kidney or liver disease, lung problems, or heart disease. Also tell your healthcare professional about any other cancer therapies you've recently tried, including radiation and chemotherapy.

Using Thiotepa may up your risk of other kinds of cancer, including leukemia. Speak to your physician about your particular risk.

Conditions treated

  • Breast cancer
  • Ovarian cancer
  • Lymphomas
  • Lymphosarcoma
  • Hodgkin's disease
  • Cancer-related intracavitary effusions

Type of medicine

  • Alkylating agent

Side effects

Here are vital points you should remember about Thiotepa side effects:

  • Most people don't suffer all the side effects mentioned below.
  • Side effects are normally predictable when it comes to their duration and onset.
  • Side effects are generally reversible and will disappear after the completion of treatment.
  • There are lots of options to help prevent or minimize side effects.
  • There is no link between the severity and presence of side effects as well as effectiveness of Thiotepa.
  • The severity of Thiotepa side effects depends on the amount of medicine that's administered. In other words, large doses may bring on more serious side effects.

The following Thiotepa side effects are quite common (more than 30%) in patients using Thiotepa:

  • Low blood counts

Red and white blood cells may decrease temporarily. This can increase your risk for infection, bleeding, and/or anemia.

Onset: 7 to 10 days
Nadir: 14 days
Recovery: 28 days

  • Hair loss

The following Thiotepa side effects are less common (around 10-29%) in patients using Thiotepa.

  • Nausea and vomiting (more frequent in high doses, and mild in normal doses)
  • Mouth sores (in high-dose treatments)
  • Bronzing on skin and skin rash, flaking, peeling, and redness (in high-dose treatments)
  • Allergic reactions such as hives, skin rash and (rarely) serious allergic reactions, shortness of breath, and tightness of throat
  • Bladder irritation and bleeding (rare), following intravesical administration
  • Thiotepa may affect your fertility. Please discuss this matter with your healthcare professional.

The following Thiotepa side effects are delayed:

  • There's a slight chance of developing cancer of the blood like leukemia after years of Thiotepa use. Speak to your healthcare provider about this risk.

This is not a complete list of Thiotepa side effects. Some rare side effects (affecting less than 10 percent of people) aren't listed here. You should, however, inform your doctor if you suffer any unusual symptoms.

When to call on your healthcare provider:

Seek emergency help right away and notify your doctor if you suffer these symptoms:

  • Shortness of breath
  • Wheezing
  • Difficult breathing
  • Closing up of throat
  • Swelling of facial parts
  • Hives (sign of allergic reaction)

Contact your healthcare professional right away if you suffer any of these symptoms, day or night:

  • Fever (38 degrees C) or higher
  • Chills (potential signs of infection)

The following symptoms will need medical intervention, but aren't an emergency. Call your healthcare giver within a day of noticing any of these side effects:

  • Blood in urine
  • Unusual bruising or bleeding
  • Black/tarry stools, or bloody stools
  • Extreme tiredness (inability to perform self-care activities)
  • Burning or pain during urination
  • Vomiting (for more than four or five times a day)
  • Mouth sores (swelling or ulcers, painful redness)
  • Nausea (affects appetite and untreated by prescribed medication)
  • Signs of infection like swelling or redness, painful swallowing, painful urination, or coughing up mucus

Always let your healthcare professional know if you feel any unusual symptoms.


This medicine is administered by a healthcare professional through an injection into a vein in a hospital setting. In some cases, Thiotepa is injected straight into the tumor. Let your nurse or doctor know immediately if you experience pain, redness, or burning at the injection area.

For bladder cancer treatment, Thiotepa is normally administered into the bladder via a catheter (tube). Your doctor may tell you to minimize fluid intake for 8-12 hours before you're given the medication. The solution is normally left alone for two hours and then drained away through the catheter. Your doctor may ask you to switch positions every fifteen minutes while the medication is in your bladder. This is to ensure that it treats all areas of your bladder.

If you're taking Thiotepa to prevent the rejection of your cell stem transplant, make sure to get 2 doses of Thiotepa 12 hours apart. Skin problems may develop during treatment. To reduce the chance of skin problems, have a shower or bath and change any dressings or bandages at least two times daily until 2 days after stopping treatment. You should also change your beddings every day while receiving treatment.

The dosage and frequency of taking injections will be determined by your response to treatment and the medical problem. Your doctor will carry out blood tests to work out the best dose for you. If your platelet or white blood cell numbers are low, your doctor may need to reschedule your next dose.

Learn how to use, handle, and dispose of medical and chemotherapy products safely. Be sure to talk to your pharmacist, and wear gloves and carefully wash your hands after handling Thiotepa. Avoid getting this medicine on your skin or in your eyes. If it gets in your eyes, wash them properly with water and call your doctor. If it comes into contact with your skin, clean the affected area well with water and soap.

If you think someone has overdosed on Thiotepa and has severe symptoms like troubled breathing or passing out, call 911. Or you can call your nearest poison control center as soon as possible at 1-800-222-1222.

Medical and/or lab tests (for example kidney tests, liver tests, complete blood counts) should be carried out while you're receiving this medicine and for weeks after your last Thiotepa dose to check your progress or to test for side effects. For more details, contact your doctor.

To get the most out of Thiotepa, it's important to take each planned dose of Thiotepa as prescribed. Keep all your lab or medical appointments. In case of a missed dose, call your doctor to start a new dosing plan.


Tell your healthcare professional about all other drugs you take, especially:

  • Drugs that compromise your immune system (e.g. other cancer medications or steroids)
  • Cyclosporine (Gengraf, Neoral, Sandimmune)
  • Azathioprine (Imuran), Etanercept (Enbrel), Leflunomide (Arava)
  • Muromonab (Orthoclone), Basiliximab (Simulect)
  • Tacrolimus (Prograf), Sirolimus (Rapamune)
  • Mycophenolate Mofetil (CellCept)

Some products that can interact with Thiotepa include drugs that can harm your immune system (e.g chemotherapy drugs and corticosteroids like prednisone), live virus vaccines (flu vaccine inhaled via the nose, polio vaccine), as well as aspirin and other nonsteroidal anti-inflammatory drugs (e.g. ibuprofen).

Check all medicine labels carefully (for both prescription and nonprescription drugs) since many have fever or pain relievers, such as aspirin, naproxen, or ibuprofen that can increase your chance of bleeding. If your doctor has prescribed low-dose aspirin for stroke/heart attack prevention, continue taking it. For more details, talk to your pharmacist or physician.

Thiotepa can get into body fluids such as urine, stool, and vomit. A healthcare provider should wear latex gloves while cleaning body fluids, changing diapers, or handling contaminated laundry or trash. They should wash their hands prior to and after taking off gloves. Wash your soiled linens and clothes separately from other clothes.

Don't have a "live"vaccine when taking Thiotepa. That vaccine may not be effective and may not completely protect you from infection. Live vaccines include polio, measles, typhoid, nasal flu (influenza), varicella (chickenpox), rotavirus, rubella, zoster (shingles), and mumps.

Thiotepa may interact with other drugs, including over-the-counter and prescription drugs, vitamins, and herbal medicines. Let all your healthcare givers know about all drugs you're currently using and any drug you stop or start using.


If you're allergic to Thiotepa, tell your pharmacist and doctor. Also tell them if you've got any other allergies. Thiotepa may have inactive substances, which can trigger allergies or other issues. Consult your pharmacist for additional information.

Before taking Thiotepa, tell your healthcare providers about your medical past, especially of bone marrow problems (such as low numbers of white blood cells or platelets from previous radiation/chemotherapy treatment), liver disease, and kidney disease.

Thiotepa can leave you more susceptible to diseases or may exacerbate any current conditions. Don't come into contact with people suffering from communicable diseases (such as flu, chickenpox, and measles). Consult your physician if you've been exposed to a disease or for more information.

Don't receive vaccinations or immunization without the permission of your doctor. Stay away from people who have received live vaccines recently (such as flu vaccine via the nose).

To reduce your chance of getting bruised, cut, or hurt, be careful when using sharp objects like nail cutters and razors, and avoid physical activities like contact sports.

Before undergoing surgery, tell your dentist or doctor about all medications you use (for example, herbal medicines, over-the-counter drugs, and prescription drugs).

Tell your healthcare giver if you plan to conceive or if you're pregnant. You shouldn't try to get pregnant while taking Thiotepa. It may endanger an unborn child. Women should find reliable birth control methods while using this medicine and for six months after discontinuing treatment. They should also have a pregnancy test prior to commencing treatment.

Men should also find reliable birth control options while taking Thiotepa and for a year after quitting treatment. If you get pregnant, immediately discuss with your physician the pros and cons of using Thiotepa in your condition.

It's not yet clear whether Thiotepa gets into a nursing mother's milk. Due to the potential risk to the newborn, breastfeeding while taking Thiotepa is not recommended. Please have a consultation with your doctor to determine whether you can breastfeed while using Thiotepa.

For adults aged 60 and over, careful monitoring is required. It may be necessary to reduce their dose.

For children, severe precaution is necessary before administration. This is because there's increased chance of CNS toxicity (e.g. intracranial hemorrhage, seizure). The medication's safety and efficacy hasn't been established in newborns.


Not applicable. Thiotepa is administered in a clinic environment and is not kept at home.


Take at least 2-3 quarts of liquid every day, unless your doctor instructs you otherwise.

Remember, you may be susceptible to infection, so make sure you stay away from large crowds or people not feeling well and those with colds. And be sure to report fever or other signs and symptoms of infection to your healthcare provider right away.

It's important to wash your hands frequently. To help prevent or treat mouth sores, make use of a soft toothbrush. Rinse twice a day with 1 teaspoon of a brine solution and/or one baking soda teaspoon.

To minimize bleeding, use a soft toothbrush and an electric razor, and avoid any form of physical activities or contact sports that could lead to injury.

This medication can make you a little bit nauseous. If you experience nausea, use anti-nausea medicines as directed by your physician, and eat small meal portions frequently. You can also chew gum or suck on lozenges.

Avoid exposure to the sun by wearing protective clothing and a sun protection of SPF 15 or above.

In general, minimize your consumption of alcoholic drinks or avoid drinking altogether. Talk about this with your physician.

You may experience dizziness or drowsiness. Do not drive or engage in activities that require attentiveness until you find out your response to Thiotepa.

Get lots of rest and maintain proper nutrition. If you experience some side effects or symptoms, make sure to tell your healthcare providers about them. They can prescribe medicines and/or provide effective recommendations for managing such problems.

Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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