Usual Adult Dose for Colorectal Cancer

IN COMBINATION WITH LEUCOVORIN, OR IN COMBINATION WITH LEUCOVORIN AND OXALIPLATIN OR IRINOTECAN:
400 mg/m2 by IV bolus on Day 1, followed by 2400 to 3000 mg/m2 as a continuous IV infusion over 46 hours every 2 weeks

WHEN ADMINISTERED IN A BOLUS DOSING REGIMEN IN COMBINATION WITH LEUCOVORIN:
500 mg/m2 by IV bolus on Days 1, 8, 15, 22, 29, and 36 in 8-week cycles

Use: Adenocarcinoma of the colon and rectum

Usual Adult Dose for Breast Cancer

ADMINISTERED AS A COMPONENT OF A CYCLOPHOSPHAMIDE-BASED MULTIDRUG REGIMEN:
500 or 600 mg/m2 IV on Days 1 and 8 every 28 days for 6 cycles

Use: Adenocarcinoma of the breast

Usual Adult Dose for Stomach Cancer

ADMINISTERED AS A COMPONENT OF A PLATINUM-CONTAINING MULTIDRUG CHEMOTHERAPY REGIMEN:
200 to 1000 mg/m2 IV as a continuous infusion over 24 hours; the frequency of dosing in each cycle and the length of each cycle will depend on the dose of fluorouracil and the specific regimen administered

Use: Gastric adenocarcinoma

Usual Adult Dose for Pancreatic Cancer

ADMINISTERED IN COMBINATION WITH LEUCOVORIN OR AS A COMPONENT OF A MULTIDRUG CHEMOTHERAPY REGIMEN THAT INCLUDES LEUCOVORIN:
400 mg/m2 by IV bolus on Day 1, followed by 2400 mg/m2 IV as a continuous infusion over 46 hours every 2 weeks

Use: Pancreatic adenocarcinoma

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Withhold therapy for the following:

• Angina, myocardial infarction/ischemia, arrhythmia, or heart failure in patients with no history of coronary artery disease or myocardial dysfunction
• Hyperammonemic encephalopathy
• Acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances
• Grade 3 or 4 diarrhea
• Grade 2 or 3 palmar-plantar erythrodysesthesia (hand-foot syndrome)
• Grade 3 or 4 mucositis
• Grade 4 myelosuppression

• Cardiac toxicity
• Hyperammonemic encephalopathy
• Acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances

Precautions

CONTRAINDICATIONS:

• None

Dialysis

Data not available

Other Comments

Administration advice:

• This drug is recommended for administration either as an IV bolus or as an IV infusion.
• Do not inject the entire contents of the vial directly into patients.
• Individualize the dose and dosing schedule based on tumor type, the specific regimen administered, disease state, response to treatment, and patient risk factors.

• All dosages are based on patient's actual body weight; however, the estimated lean body weight is used if the patient is obese or if there has been a spurious weight gain due to ascites or other forms of abnormal fluid retention.
• Use is contraindicated in patients who are in a poor nutritional status, have depressed bone marrow function, and those with potentially serious infections.
• This drug is highly toxic with a narrow margin of safety.
• It is recommended that patients be hospitalized during treatment.
• This drug is irritating to the skin; avoid contact with the skin and mucous membranes.

• It is recommended that patients be hospitalized during treatment.
• This drug is irritating to the skin; avoid contact with the skin and mucous membranes.

Frequently asked questions

• Does duct tape really remove warts?