How is FOLOTYN administered?

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FOLOTYN is given once a week over a period of 6 weeks, with no treatment during the 7th week. These 7-week treatment cycles with FOLOTYN can be continued for as long as you and your healthcare team agree that the treatment is working for you and is being tolerated.

FOLOTYN is an “outpatient” treatment so you do not need to be hospitalized. It is administered as an intravenous (IV) infusion that can last up to 5 minutes. That means that a healthcare professional will insert a needle and FOLOTYN will be delivered into your vein through a small tube.

While you are taking FOLOTYN, you should also take vitamin B₁₂ and folic acid, two important nutrients that may help to reduce your chances of mucositis and low blood counts.

Your healthcare team will instruct you to take folic acid by mouth every day starting 10 days before your first dose of FOLOTYN. Your doctor will tell you when it is okay to stop taking folic acid.

You will also receive a vitamin B₁₂ injection (into a muscle) prior to your first dose of FOLOTYN, as well as every 8-10 weeks while you are getting treatment with FOLOTYN. Subsequent vitamin B12 injections may be given the same day as treatment with FOLOTYN. You will also have weekly blood tests, so that your healthcare team can monitor your health.

Cycle 1: Outpatient Dosing Schedule

Week 1	3 to 5 min. treatment
Week 2	3 to 5 min. treatment
Week 3	3 to 5 min. treatment
Week 4	3 to 5 min. treatment
Week 5	3 to 5 min. treatment
Week 6	3 to 5 min. treatment
Week 7	No treatment

It is important to take vitamin B₁₂ and folic acid, as directed by your doctor.

IMPORTANT SAFETY INFORMATION ABOUT FOLOTYN

Low Blood Cell Counts: Patients may experience low blood cell counts. Your doctor will do weekly blood tests to check your blood counts.
Low Platelet Count: Lower platelets may cause unusual bleeding, such as nosebleeds, or abnormal bruising. Talk to your doctor right away if this happens.
Low White Blood Cell Count: : Lower white blood cell counts can reduce the body's defenses against infection. If you have any of the following signs or symptoms of infection (fever, chills, cough, shortness of breath, pain or burning on urination), tell your doctor right away. Serious illness or death could result if such infections are not treated when white blood cell counts are very low.
Low Red Blood Cell Count: Lower red blood cell counts may make you feel weak, feel tired, and get tired easily. You may appear pale and be short of breath. Contact your doctor if you experience any of these symptoms following treatment with FOLOTYN.
Mucositis Patients may develop mucositis, which is redness and/or sores in the mucous membranes including the mouth, lips, throat, and other areas along the digestive tract and genitals. Discomfort or pain due to mucositis may occur as early as a few days after treatment with FOLOTYN. Talk with your doctor about ways to reduce your risk of developing mucositis, and/or ways to maintain nutrition and control the discomfort if you develop it. It is important to take folic acid and vitamin B12 during your treatment with FOLOTYN. Your doctor will give you specific instructions for vitamin supplementation.
Severe Skin Reactions: Severe skin reactions may happen after treatment with FOLOTYN, which can be fatal. Tell your doctor right away if you have of any of the following skin reactions: rash, peeling and loss of skin, sores, or blisters.
Tumor Lysis Syndrome (TLS): FOLOTYN can cause the fast breakdown of certain types of cancer cells. This can lead to TLS. Your doctor may do blood tests to check you for TLS and treat you for TLS if needed.
Pregnancy and Nursing: Tell your doctor if you are pregnant or plan to become pregnant. FOLOTYN can harm your unborn baby. FOLOTYN has not been studied in pregnant women. Tell your doctor if you are breastfeeding or plan to breast-feed. It is not known if FOLOTYN will pass into your breast milk. Talk to your doctor about whether you should discontinue breast-feeding.
Fever: Some patients may experience nausea, vomiting, abdominal pain, and/or diarrhea. Medicines can be given that may reduce or eliminate these symptoms. If you experience any of these symptoms, tell your doctor.
Loss of too much fluid from the body (dehydration): If you feel tired and weak this could be a sign of dehydration. Follow your doctor's instructions for what to do to help prevent or treat dehydration.
Shortness of breath: Tell your doctor if this is a problem for you.
Nausea, Vomiting, Diarrhea and Constipation: : Patients may experience nausea, vomiting, abdominal pain, diarrhea, and/or constipation. Medicines can be given that may help reduce these symptoms. If you experience any of these symptoms, tell your doctor.
Other side effects may include:
- Dizziness, lightheadedness, and fainting spells
- Fatigue, weakness, and lethargy
- Rash, itching or swelling
- Loss of appetite and weight loss
- Joint and muscle pain
These are not all of the potential side effects of FOLOTYN. If you have any side effect that bothers you or that doesn't go away, be sure to talk with your healthcare professional.

Tell your doctor about you medical conditions, including liver and kidney problems.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Some medicines may affect how FOLOTYN works, and FOLOTYN may affect how other medicines work. Especially tell your doctor if you take: sulfamethoxazole trimethoprim (Bactrim®, Septra®, Septra DS, Sulfatrim Pediatric, Sulfamethoprim, Sulfamethoprim-DS), non-steroidal anti-inflammatory drugs (NSAIDs), probenecid (Probalan, Col-Probenecid). Ask your doctor or pharmacist if you are not sure if your medicine is listed above. Know the medicines you take. Keep a list of them and show it to your doctor or pharmacist each time you start a new medicine.

Please see patient information within the full Prescribing Information for FOLOTYN.