Adult Dosing
Germ cell testicular cancer
- 1.2 g/m2/day slow IV over 30 minutes, for 5 consecutive days; may repeat cycles q3 wks
- Administer mesna to prevent hemmorrhagic cystitis
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- <10 mL/min: Reduce dose by 25%
- Hemodialysis: Dose adjustments not defined
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Urotoxic side effects such as hemorrhagic cystitis have occurred in association with the use of this drug. Obtain urinalysis prior to each dose of this drug. Withheld doses until complete resolution on presence of hematuria (>10 RBCs/high power field). Provide further administration with vigorous oral or parenteral hydration
- Severe myelosuppression have occurred on using this drug in combination with other chemotherapeutic agents. Obtain WBC count, platelet count and hemoglobin at appropriate intervals. Unless important avoid administration of this drug in patients with a WBC count <2000/mcl and/or a platelet count < 50,000/mcl. Regularly examine urine for red cells which may precede hemorrhagic cystitis
- Neurologic manifestations such as somnolence, confusion, hallucinations and in some instances, coma, have occurred following therapy with this drug. Discontinue therapy on occurrence of such events. Maintain supportive therapy until complete resolution of such events
- Therapy is associated with fetal damage on administration to pregnant woman. Apprised patients about the potential hazard to the fetus if this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug
- Remain alert for possible combined drug actions
- Therapy is associated with interfering with normal wound healing
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Active infections
- Myelosuppressive agent use
- Bone marrow depression (extreme caution required)
- Long term use
- Geriatric population
- Other chronic debilitating illness
- Pediatric population
Pregnancy Category:D
Breastfeeding: Most sources consider breastfeeding to be contraindicated with antineoplastic therapy. According to manufacturer's data a decision should be made for discontinuing nursing or discontinuing the drug taking into account the importance of the drug to the mother.
