Therapeutic: cardioprotective agents
Pharmacologic: chelating agents
Reduce 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. Treatment of extravasation resulting from IV anthracycline chemotherapy.
Acts as an intracellular chelating agent. Therapeutic Effects: Diminishes the cardiotoxic effects of doxorubicin. Decreased damage from extravasation of anthracyclines.
Adverse Reactions/Side Effects
Hemat: myelosuppression. Local: pain at injection site.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Monitor signs of cardiomyopathy such as shortness of breath, dizziness, fatigue, fainting, palpitations, and peripheral/abdominal edema due to fluid accumulation. Increased signs may indicate a lack of drug effects in protecting the heart; notify the physician or nursing staff immediately.
Monitor IV injection site for pain, swelling, and irritation. Report prolonged or excessive injection-site reactions to the physician.
Because of myelosuppression, advise patient to guard against infection (frequent hand washing, etc.), and to avoid crowds and contact with persons with contagious diseases.
Absorption: IV administration results in complete bioavailability.
Metabolism and Excretion: Some metabolism occurs; 42% eliminated in urine.
Contraindicated in: Any other type of chemotherapy except other anthracyclines (doxorubicin-like agents).
Use Cautiously in: CCr <40 mL/min (dose reduction required); OB: Pregnancy, lactation, or children (safety not established).
Drug-Drug: Myelosuppression may be ↑ by antineoplastics or radiation therapy. Antitumor effects of concurrent combination chemotherapy with fluorouracil and cyclophosphamide may be ↓ by dexrazoxane.
IV (Adults): 10 mg of dexrazoxane/1 mg doxorubicin.
IV (Adults): decrease dose by 50%.
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.