Totect: Adult Dosing

Dosage forms: IV

extravasation, IV anthracycline-assoc.

1000 mg/m^2 IV q24h x2, then 500 mg/m^2 IV q24h x1

Start: ASAP w/in 6h of extravasation; Max: 2000 mg/dose days 1-2, 1000 mg/dose day 3

renal dosing

adjust dose amount

CrCl <40: decr. dose 50%

hepatic dosing

not defined

Totect: Peds Dosing

This information is currently unavailable or not applicable for this drug.

Totect: Contraindications/Cautions

• hypersens. to drug/class/compon.
• avoid pregnancy
• caution if myelosuppression
• caution if cytotoxic drug use
• caution if impaired renal fxn
• caution if impaired liver fxn
• caution in elderly pts

Totect: Drug Interactions

Avoid/Use Alternative

• dimethyl sulfoxide topical

Monitor/Modify Tx

• allopurinol

• azathioprine

• carboplatin

• cidofovir

• cisplatin

• clozapine

• cytotoxic chemotherapy

• dasatinib

• flucytosine

• ganciclovir

• gemtuzumab ozogamicin

• hydroxyurea

• ibritumomab tiuxetan

• imatinib

• interferon alfa 2a

• interferon alfa 2b

• methotrexate

• mitomycin

• oxaliplatin

• procarbazine

• pyrimethamine

• pyrimethamine/sulfadoxine

• trastuzumab

• zidovudine

Totect: Adverse Reactions

Serious Reactions

• thrombocytopenia
• granulocytopenia
• leukopenia
• fetal harm (in utero exposure)

Common Reactions

• nausea/vomiting
• stomatitis
• diarrhea
• myelosuppression
• elevated liver transaminases
• injection site pain

Totect: Safety Monitoring

Pregnancy: D

Lactation: Safety Unknown

Monitoring Parameters: CBC; LFTs

Totect: Pharmacology

Metabolism: intracellular; CYP450: unknown

Excretion: urine 42%; Half-life: 2.1-2.5h

Class: Anti-Toxicity

Mechanism Of Action
exact mechanism of action unknown; may reversibly inhibit topoisomerase II

Totect: Manufacturer/Pricing

Manufacturer: TopoTarget USA Inc. DEA/FDA: Rx

Totect: Patient Education

• Generic Name: dexrazoxane

• Pronounced: dex ray ZOX ane

• Brand Name: Zinecard

What is the most important information I should know about dexrazoxane?

You should not receive this medication if your chemotherapy does not include doxorubicin or a similar medication such as daunorubicin (Cerubidine), epirubicin (Ellence), idarubicin (Idamycin), or mitoxantrone (Novantrone).

Before you receive dexrazoxane, tell your doctor if you are allergic to any drugs, or if you have kidney disease. You may need dose adjustments or special tests during treatment.

Tell your doctor at once if you have serious side effects such as fever, chills, body aches, flu symptoms, easy bruising or bleeding, weakness, or white patches or sores inside your mouth or on your lips.

What is dexrazoxane?

Dexrazoxane is used to protect the heart from harmful side effects caused by doxorubicin (Adriamycin).

Dexrazoxane is used in women who are receiving doxorubicin for metastatic breast cancer.

Dexrazoxane may also be used for purposes not listed in this medication guide.

What should I discuss with my health care provider before receiving dexrazoxane?

You should not receive this medication if your chemotherapy does not include doxorubicin or a similar medication such as:

• daunorubicin (Cerubidine);
• epirubicin (Ellence);
• idarubicin (Idamycin); or
• mitoxantrone (Novantrone);

Before you receive dexrazoxane, tell your doctor if you are allergic to any drugs, or if you have kidney disease. You may need dose adjustments or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether dexrazoxane passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How is dexrazoxane given?

Dexrazoxane is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or cancer treatment setting. Dexrazoxane is usually given 30 minutes before your dose of doxorubicin.

Dexrazoxane can add to the bone marrow lowering effects of chemotherapy. This can weaken your immune system, making it easier for you to get sick from being around others who are ill.

To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your kidney function may also need to be checked with urine tests. Do not miss any scheduled appointments.

What happens if I miss a dose?

Since dexrazoxane is given by a healthcare professional as part of your chemotherapy treatment, it is not likely that you will miss a dose.

Call your doctor if you miss a chemotherapy appointment.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Symptoms of a dexrazoxane overdose are not known.

What should I avoid after receiving dexrazoxane?

Follow your doctor's instructions about any restrictions on food, beverages, or activity after you receive dexrazoxane.

What are the possible side effects of dexrazoxane?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor at once if you have any of these serious side effects:

• fever, chills, body aches, flu symptoms;
• easy bruising or bleeding, weakness; or
• white patches or sores inside your mouth or on your lips.

Less serious side effects may include:

• hair loss;
• nausea, vomiting, diarrhea, loss of appetite;
• tired feeling;
• pain where the medicine is injected;

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect dexrazoxane?

Some cancer medications may be less effective if they are used with dexrazoxane. Tell your doctor if your chemotherapy medications include:

• fluorouracil (5-FU, Adrucil);
• cyclophosphamide (Cytoxan, Neosar).

This list is not complete and there may be other drugs that can interact with dexrazoxane. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist can provide more information about dexrazoxane.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Totect: Pill Pictures

This information is currently unavailable or not applicable for this drug.