Idarubicin Disease Interactions

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

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Idarubicin can cause myocardial toxicity leading to congestive heart failure. Patients with preexisting heart disease or prior anthracycline therapy are at increased risk of congestive heart failure. Close clinical monitoring of cardiac function, such as an electrocardiogram and/or determination of left ventricular ejection fraction, prior to each course of therapy is recommended.

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Idarubicin undergoes extensive extrahepatic metabolism and is primarily eliminated by biliary excretion. The pharmacokinetic disposition of idarubicin has not been studied in leukemia patients with hepatic impairment. It is thought that the metabolism of idarubicin would be decreased in moderate to severe hepatic dysfunction and lead to increased systemic drug levels and toxicity. Therapy with idarubicin should be administered cautiously and dosage reduction considered in patients with compromised hepatic function. Idarubicin injection should not be administered if bilirubin level exceeds 5 mg %. Clinical monitoring of hepatic function is recommended prior to and during therapy.

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Idarubicin induces severe myelosuppression at therapeutic doses. Therapy with idarubicin should be withheld in patients whose bone marrow function is severely depressed by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. If the need outweighs the risk, extreme caution should be exercised in administering idarubicin. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitory of hematopoietic function is recommended.

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Impaired renal function can affect the disposition of idarubicin. Therapy with idarubicin should be administered cautiously and dosage modification considered in patients with compromised renal function. Clinical monitoring of renal function is recommended prior to and during therapy.

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Treatment with idarubicin may cause hyperuricemia as a result of rapid lysis of tumor cells. Levels of serum uric acid should be monitored and appropriate therapy should be initiated before starting therapy.

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