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dexrazoxane

V03AF02

Forms & Strengths

Lyophilized powder for injection: 250 mg
Lyophilized powder for injection: 500 mg

Adult Dosing

Cardioprotection in anthracycline therapy: IV infusion at a 10:1 ratio to doxorubicin dose (e.g., 500 mg/m2 dexrazoxane to 50 mg/m2 doxorubicin)
Treatment of anthracycline extravasation: IV infusion of 1000 mg/m2 (max 2000 mg) on day 1, repeated on days 2 and 3

Pediatric Dosing

Safety and efficacy not established in pediatric patients for cardioprotection
Extravasation dosing adapted from adult data in clinical trials, but lacks robust pediatric labeling

Indications

Reduction of the 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
Treatment of accidental extravasation resulting from anthracycline infusion

Mechanism of Action

Intracellularly hydrolyzed to an active ring-opened chelating agent (ICRF-198)
Binds to iron, preventing the iron-dependent generation of oxygen free radicals that mediate anthracycline-induced cardiotoxicity
Acts as a catalytic inhibitor of topoisomerase II

Contraindications

Do not use with non-anthracycline chemotherapy regimens
Hypersensitivity to dexrazoxane

Adverse Reactions

Myelosuppression (leukopenia, neutropenia, thrombocytopenia)
Nausea and vomiting
Injection site pain and phlebitis
Elevated transaminases and bilirubin
Increased risk of secondary malignancies (e.g., acute myeloid leukemia)

Drug Interactions

May enhance the myelosuppressive effects of other chemotherapeutic agents
May potentially reduce the antitumor efficacy of anthracyclines when given concurrently (though controversial in specific settings)
Do not mix with other drugs in the same IV infusion bag or line

Curated Content: Needs Vetting Before Put to Clinical Use