Generic Name: dexrazoxane (dex ray ZOX ane)Brand Names: Totect, Zinecard
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.
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.
idarubicin (Idamycin); or
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.
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.
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.
Symptoms of a dexrazoxane overdose are not known.
Follow your doctor's instructions about any restrictions on food, beverages, or activity after you receive dexrazoxane.
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:
nausea, vomiting, diarrhea, loss of appetite;
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. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Cardiomyopathy Prophylaxis:
Dexrazoxane (marketed as Zinecard)For use in reducing 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 therapy to maintain tumor control:The recommended dosage ratio of dexrazoxane:doxorubicin is 10:1 (for example: 500 mg/m2 dexrazoxane:50 mg/m2 doxorubicin).After completing the infusion of dexrazoxane, and prior to a total elapsed time of 30 minutes (from the beginning of the dexrazoxane infusion), the intravenous injection of doxorubicin should be given.
Usual Adult Dose for Extravasation:
Dexrazoxane (marketed as Totect)For use in the treatment of extravasation resulting from IV anthracycline chemotherapy:Dexrazoxane should be given once daily for three consecutive days. The first infusion should be initiated as soon as possible and within the first six hours after extravasation.The recommended doses are:Day one: 1000 mg/m2Day two: 1000 mg/m2Day three: 500 mg/m2The maximum recommended doses are:Day one: 2000 mgDay two: 2000 mgDay three: 1000 mgThe dose should be administered as an intravenous infusion over 1 to 2 hours in a large caliber vein in an extremity/area other than the one affected by the extravasation.Cooling procedures such as ice packs, if used, should be removed from the area at least 15 minutes before dexrazoxane administration in order to allow sufficient blood flow to the area of extravasation. Treatment on day 2 and day 3 should start at the same hour (plus or minus 3 hours) as on the first day.
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.