Usual Adult Dose for Cardiomyopathy Prophylaxis

Zinecard (R):

Dosage ratio of dexrazoxane to doxorubicin is 10:1 (e.g. 500 mg/m2 dexrazoxane to 50 mg/m2 doxorubicin)

• Administer via IV infusion over 15 minutes.
• DO NOT administer via IV push.
• Administer doxorubicin within 30 minutes of completion of dexrazoxane infusion; do not administer doxorubicin before dexrazoxane.

Comments:

• Do not use with the initiation of doxorubicin therapy.

Use(s): Reducing incidence and severity of cardiomyopathy associated with doxorubicin administration in women with metastatic breast cancer who have received a cumulative doxorubicin dose of 300 mg/m2 and who will continue to receive doxorubicin.

Usual Adult Dose for Extravasation

Totect (R):

Recommended doses:
Day one: 1000 mg/m2 IV over 1 to 2 hours
Day two: 1000 mg/m2 IV over 1 to 2 hours
Day three: 500 mg/m2 IV over 1 to 2 hours

Maximum doses:
Day one: 2000 mg
Day two: 2000 mg
Day three: 1000 mg

Comments:

• Product must be diluted with 50 mL of 0.167 M sodium lactate injection solution prior to administration.
• Initiate first infusion as soon as possible and within the first 6 hours of extravasation.
• Start day 2 and 3 treatments at the same hour as the first day (give or take 3 hours).
• Remove cooling features such as ice packs (if used) at least 15 minutes before administration to allow sufficient blood flow to extravasation area.

Use(s): Extravasation resulting from intravenous anthracycline chemotherapy

Renal Dose Adjustments

CrCl under 40 mL/min: Reduce dose by half

Liver Dose Adjustments

Extravasation: Not recommended in hepatic impairment.

• Perform routing liver function tests before each administration if patient has known liver function disorders.

Cardiomyopathy prophylaxis: Since doxorubicin dose reduction is recommended, reduce dose of dexrazoxane proportionally (maintaining the 10:1 ratio).

Precautions

CONTRAINDICATIONS:

• Do not use with non-anthracycline chemotherapy regimens.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available