dexrazoxane (dex-ra-zox-ane) Totect, Zinecard

 Indications

Reducing incidence and severity of cardiomyopathy

from doxorubicin in women with metastatic breast cancer

who have already received a cumulative dose of

doxorubicin 300 m g/m2. Treatment of extravasation

resulting from IV anthracycline chemotherapy.

Action

Acts as an intracellular chelating agent. Therapeutic

Effects: Diminishes the cardiotoxic effects of doxorubicin.

Decreased damage from extravasation of anthracyclines.

Pharmacokinetics

Absorption: IV administration results in complete

bioavailability.

Distribution: Unknown.

Metabolism and Excretion: Some metabolism

occurs; 42% eliminated in urine.

Half-life: 2.1–2.5 hr.

TIME/ACTION PROFILE (cardioprotective

effect)

ROUTE ONSET PEAK DURATION

IV rapid unknown unknown

Contraindications/Precautions

Contraindicated in: Any other type of chemotherapy

except other anthracyclines (doxorubicin-like

agents); May cause fetal harm.

Use Cautiously in: CCr 40 mL/min (doseprequired);

Lactation: Lactation; Pedi: Safety and effectiveness

not established.

Adverse Reactions/Side Effects

Hemat: myelosuppression. Local: pain at injection

site. Misc: MALIGNANCY.

Interactions

Drug-Drug: Myelosuppression may beqby antineoplastics

or radiation therapy. Antitumor effects

of concurrent combination chemotherapy with fluorouracil

and cyclophosphamide may bepby dexrazoxane.

Route/Dosage

Cardioprotective

IV (Adults): 10 mg of dexrazoxane/1 mg doxorubicin.

Renal Impairment

IV (Adults):pdose by 50%.

Extravasation Protection

IV (Adults): 1000 mg/m2 (maximum 2000 mg) given

on days 1 and 2, and followed by a dose of 500 mg/m2

(maximum 1000 mg) on day 3.

Renal Impairment

IV (Adults CCr 40 mL/min):pdose by 50%.

Availability (generic available)

Injection (Zinecard): 250 mg/vial, 500 mg/vial. Injection

(Totect): 500 mg/vial.