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idarubicin

L01DB06

Forms & Strengths

Lyophilized powder for injection: 5 mg
Solution for injection: 1 mg/mL

Adult Dosing

Acute myeloid leukemia (AML) induction: 12 mg/m²/day IV for 3 days
Combination therapy with cytarabine: 10-12 mg/m²/day IV for 3 days
Acute lymphocytic leukemia (ALL): 10 mg/m²/day IV for 3 days

Pediatric Dosing

Safety and efficacy in pediatric patients not well established
AML induction (off-label): 10-12 mg/m²/day IV for 3 days

Indications

Treatment of acute myeloid leukemia (AML) in adults
Second-line treatment of acute lymphocytic leukemia (ALL) in children and adults

Mechanism of Action

Anthracycline antineoplastic antibiotic
Intercalates between DNA base pairs and inhibits topoisomerase II, causing DNA strand scission and inhibition of DNA/RNA synthesis

Contraindications

Hypersensitivity to idarubicin or other anthracyclines
Severe baseline myocardial insufficiency or history of severe anthracycline-induced cardiac toxicity
Severe baseline myelosuppression unless medically warranted

Adverse Reactions

Severe bone marrow suppression (leukopenia, thrombocytopenia, anemia)
Cardiotoxicity (acute ECG changes, chronic heart failure, decreased ejection fraction)
Alopecia, severe mucositis, nausea, vomiting, diarrhea
Injection site reactions, tissue necrosis upon extravasation
Secondary malignancies (treatment-related myeloid leukemia)

Drug Interactions

Other cardiotoxic agents or prior anthracycline therapy increases risk of cumulative heart failure
Myelosuppressive agents compound bone marrow suppression
Live vaccines may result in severe or fatal infections due to immunosuppression
Strong CYP3A4 inhibitors/inducers may alter clearance, though primarily eliminated via biliary excretion and hepatic reduction to idarubicinol

Curated Content: Needs Vetting Before Put to Clinical Use