Moderate hypoplasia of bone marrow, resulting in anemia, leukopenia, pancytopenia, thrombocytopenia, or agranulocytosis may occur. Eosinophilia and aplastic anemia also reported. Bone marrow toxicity can be irreversible and may be fatal in immunosuppressed patients (use with extreme caution in bone marrow depression, including patients with hematologic disease and those who currently or previously received treatment with radiation or drugs associated with bone marrow depression). Allergic reactions (including anaphylaxis) reported rarely. Use with extreme caution in impaired renal function (increased risk of adverse effects).