What is Dexrazoxane?
Dexrazoxane protects the heart, lungs, and other organs from the side effects of certain cancer drugs. Totect brand dexrazoxane can help men and women alike treat extravasation (es-TRA-va-ZAY-shun). Extravasation occurs when injected medicines escape from blood vessels and circulate into body tissues. Extravasation can cause serious tissue damage when certain cancer drugs are injected. Dexrazoxane can also be used to prevent heart problems caused by chemotherapy in women receiving doxorubicin as part of metastatic breast cancer. Dexrazoxane can only be given after you've received enough doxorubicin to equal a specific total dose. This medication guide does not list all possible uses of dexrazoxane.
Side effects of Dexrazoxane
If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: hives, difficulty breathing, feeling lightheaded, or swelling of your lips, face, tongue, or throat.
Dexrazoxane can cause serious side effects. If you experience:
- Fever, chills, tiredness, mouth sores, skin sores;
- Easy bruising and unusual bleeding
- A sore throat, a cough, trouble breathing
- Any surgical incision that is bruising, swelling, or oozing
Side effects of dexrazoxane include:
- Nausea, vomiting;
- Fever;
- Infection after surgery
- Pain where the medication was injected.
There may be other side effects. Call your physician immediately if experiencing side effects; alternatively, the FDA can be reached at 1-800-FDA-1088 in order to report these problems.
Warnings
Dexrazoxane may harm the unborn child or cause birth defects when either the mother or father uses it. Inform your caregivers of your pregnancy or if your partner can get pregnant if you're a man.
Zinecard should not be given if you are not receiving doxorubicin (or a similar medication such as daunorubicin) or a comparable medication (such as daunorubicin, epirubicin, idarubicin, and mitoxantrone). If you notice any signs of infection, such as a fever, chills, or a sore throat, Also, bruising and bleeding are easy; there may be skin sores or a reddening of the surgical incision.
Before you take this drug
If your chemotherapy doesn't include doxorubicin or similar medications such as:
- Daunorubicin (Cerubidine, Daunoxome);
- Epirubicin
- Idarubicin (Idamycin);
- Mitoxantrone (Novantrone).
Notify your doctor immediately of any of the following issues:
- Heart problems
- Liver disease
- Kidney disease is a serious condition.
Dexrazoxane may harm the unborn child or cause birth defects when the mother or father are taking this medicine. To prevent pregnancy, women should use an effective contraceptive while on dexrazoxane as well as for 6 months following the last dose. Men should use birth control during treatment and at least three months after the final dose. If you become pregnant during this period, tell your doctor immediately. This medication may have an effect on men's fertility. It is still important to use birth control to avoid pregnancy, as dexrazoxane can harm a baby if it does happen. Dexrazoxane should not be used while breastfeeding. After receiving Totect, women should not breastfeed for at least two weeks.
How to take Dexrazoxane?
Dexrazoxane infusions are given into the vein. This injection will be given by a healthcare provider.
Totect should be started as soon as possible after the extravasation and repeated once daily over a period of 3 days. Dexrazoxane should be started at least 15 minutes prior to receiving your doxorubicin injection. Dexrazoxane will not be given along with the first dose of doxorubicin. It is only administered after you have received a total dose of doxorubicin. Dexrazoxane may increase the bone marrow suppressive effects of chemotherapy. Your risk for infections increases - potentially even life-threatening ones - by being exposed to different environments, even at your workplace, where people might bring germs with them from elsewhere. You will need to be examined by your doctor on a regular schedule.
Details on dosage
Adult dose for cardiomyopathy prevention:
Zinecard (R):
The dosage ratio between dexrazoxane and doxorubicin should be 10:1 (e.g. Dexrazoxane 500 mg/m2 to 50 mg/m2 of doxorubicin
-Administer by IV infusion for 15 minutes.
Do not administer via IV push.
Do not administer doxorubicin prior to dexrazoxane.
Comments:
Do not use it when starting doxorubicin treatment.
Use(s): Reduce the incidence and severity of cardiomyopathy in women with metastatic breast cancer who have received 300 mg/m2 cumulative doses of doxorubicin and will continue to take doxorubicin.
Adult dose for extravasation:
Totect R:
Recommended dosages
Day one: 1000 mg/m2 IV in 1 to 2 hours
Day two: 1000 mg/m2 IV in 1 to 2 hours
Day three: 500 mg/m2 IV every 1 to 2 hours
Maximum doses:
Day One: 2000 mg
Day two: 2000 mg
Day three: 1,000 mg
Comments:
Before administration, the product must be diluted in 50 mL of sodium lacetate injection solution (0.167 M).
Begin the first infusion within 6 hours after extravasation.
Start the second and third treatments at the exact same time as the first (plus or minus 3 hours).
Remove cooling devices such as icepacks (if used) 15 minutes prior to administration. This will allow blood to flow freely to the extravasation site.
Use(s): Extravasation following intravenous anthracycline therapy
What happens if I miss the dose?
You are unlikely to miss a dexrazoxane dose, as it is administered by your healthcare provider as part of the chemotherapy treatment. If you miss your chemotherapy appointments, call your doctor to get instructions.
What happens if I overdose?
Call 1-800-222-1222 for poison help or seek immediate medical attention.
What should be avoided?
Avoid being around people who are sick. Should any signs or symptoms suggestive of infection emerge, seek medical assistance immediately.
Interaction with other drug
Inform your healthcare provider of any medications taken outside the clinic such as:
- Other cancer medications
- Dimethyl sulfoxide (DMSO).
This list is incomplete. Dexrazoxane may be affected by other drugs, such as prescription and over-the-counter medicines, vitamins, and herbal products. This list does not encompass all possible drug interactions.
