Classifications: chelating agent; chemoprotective agent; cardioprotective for doxorubicin; Therapeutic: cardioprotective for doxorubicin
Pregnancy Category: C
250 mg, 500 mg vials for injection
A derivative of EDTA that readily penetrates cell membranes. Dexrazoxane is converted intracellularly to a chelating agent
that interferes with iron-mediated free radical generation thought to be partially responsible for one form of cardiomyopathy.
Cardioprotective effect is related to its chelating activity.
Reduction of cardiomyopathy associated with a cumulative doxorubicin dose of 300 mg/m2.
Chemotherapy regimens that do not contain anthracycline, pregnancy (category C), lactation.
Myelosuppression, elderly; prior radiation or chemotherapy; renal failure or impairment. Safety and efficacy in children
have not been established.
Route & Dosage
Adult: IV 10 parts dexrazoxane to 1 part doxorubicin or 500 mg/m2 for every 50 mg/m2 of doxorubicin
Clcr <40 mL/min: use a 5:1 ratio of dexrazoxane to doxorubicin
- Wear gloves when handling dexrazoxane. Immediately wash with soap and water if drug contacts skin or mucosa.
- Doxorubicin dose MUST be started within 30 min of beginning dexrazoxane.
PREPARE: Direct: Reconstitute by adding 25 or 50 mL of 0.167 M sodium lactate injection (provided by manufacturer) to the 250- or 500-mg vial,
respectively, to produce a 10-mg/mL solution. IV Infusion: Further dilute with NS or D5W in an IV bag to a concentration of 1.35.0 mg/mL for infusion.
ADMINISTER: Direct: Give slow IV push. IV Infusion: Give over 10 min.
- Store reconstituted solutions for 6 h at 15°30° C (59°86° F).
Adverse Effects (≥1%)All:
Adverse effects of dexrazoxane are difficult to distinguish from those of the chemotherapeutic agents. Pain at injection
site, leukopenia, granulocytopenia,
appear to occur more frequently with the addition of dexrazoxane than with placebo.
Not protein bound. Metabolism:
In liver. Elimination:
42% in urine. Half-Life:
Assessment & Drug Effects
- Monitor cardiac function. Drug does not eliminate risk of doxorubicin cardiotoxicity.
- Lab tests: Monitor hepatic, renal, and hematopoietic status throughout course of therapy.
- Note: Adverse effects are likely due to concurrent cytotoxic drugs rather than dexrazoxane.
Patient & Family Education
- Report any of the following to physician: Worsening shortness of breath, swelling extremities, or chest pains.