• Reducing incidence and severity of cardiomyopathy from doxorubicin in women with metastatic breast cancer who have already received a cumulative dose of doxorubicin >300 mg/m² and who will continue to receive doxorubicin therapy to maintain tumor control.
• Treatment of extravasation resulting from IV anthracycline chemotherapy.

Contraindicated in:

• Any other type of chemotherapy except other anthracyclines (doxorubicin-like agents)
• Hepatic impairment (for treatment of extravasation only)
• OB: Pregnancy
• Lactation: Lactation.

Use Cautiously in:

• Renal impairment (CCr <40 mL/min) (↓ dose)
• Women of reproductive potential and men with female partners of reproductive potential
• Pedi: Safety and effectiveness not established in children.

GU: ↓ fertility (males).

Hemat: leukopenia, neutropenia, thrombocytopenia.

Local: pain at injection site.
Misc: (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)HYPERSENSITIVITY REACTIONS , MALIGNANCY.

Drug-Drug:

• Myelosuppression may be ↑ by antineoplastics or radiation therapy.
• Antitumor effects of concurrent combination chemotherapy with fluorouracil and cyclophosphamide may be ↓ by dexrazoxane.

(Generic available)

• Lyophilized powder for injection: 250 mg/vial; 500 mg/vial;

Cardioprotective

• IV (Adults): 10 mg of dexrazoxane/1 mg doxorubicin.

Extravasation Treatment

• IV (Adults): 1000 mg/m² (maximum 2000 mg) given on days 1 and 2, and followed by a dose of 500 mg/m² (maximum 1000 mg) on day 3.

Totect

• Acts as an intracellular chelating agent.

• Diminishes the cardiotoxic effects of doxorubicin.
• Decreased damage from extravasation of anthracyclines.

Therapeutic Classification: cardioprotective agents

Absorption: IV administration results in complete bioavailability.

Distribution: Well distributed to tissues.

Metabolism/Excretion: Some metabolism occurs; 42% eliminated in urine.

Half-life: 2.1–2.5 hr.

Zinecard

(cardioprotective effect)

• Explain the purpose of the medication to the patient.
• Emphasize the need for continued monitoring of cardiac function.
• Dexrazoxane may cause fetal harm. Advise females of reproductive potential to use highly effective contraception during and for 6 mo after last dose of dexrazoxane and to avoid breast feeding during and for 2 wk after last dose. Advise males with female partners of reproductive potential to use highly effective contraception during and for 3 mo after last dose. Advise patient to notify health care professional immediately if pregnancy is suspected. May impair fertility in males.

dex-ra-ZOX-ane