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Dexrazoxane

Generic Name: dexrazoxane (dex ray ZOX ane)
Brand Name: Totect, Zinecard

Medically reviewed on April 2, 2018.

What is dexrazoxane?

Dexrazoxane is used to protect the heart and other tissues from harmful side effects caused by certain cancer medications.

The Zinecard brand of dexrazoxane is used in women who are receiving doxorubicin for metastatic breast cancer.

The Totect brand of dexrazoxane is used in men or women to treat a condition called extravasation (es-TRA-va-ZAY-shun). Extravasation happens when an injected medicine escapes from the blood vessels and circulates into tissues in the body. Serious tissue damage can occur when extravasation happens during injection of certain cancer medications.

Dexrazoxane may also be used for purposes not listed in this medication guide.

Important Information

You should not receive Totect if you are pregnant. It could harm the unborn baby. If possible before you receive Totect, tell your doctor if you are pregnant. It is not known whether Zinecard will harm an unborn baby.

You should not receive this medication if your chemotherapy does not include doxorubicin or a similar medication such as daunorubicin (Cerubidine), epirubicin (Ellence), idarubicin (Idamycin), or mitoxantrone (Novantrone).

Before you receive dexrazoxane, tell your doctor if you have liver or kidney disease, or if you are pregnant or breast-feeding.

Tell your doctor at once if you have serious side effects such as fever, chills, body aches, flu symptoms, easy bruising or bleeding, or sores your mouth or throat.

In an emergency situation it may not be possible before you are treated to tell your caregivers about your health conditions or if you are pregnant or breast feeding. Make sure any doctor caring for you afterward knows that you have received Totect.

Before taking this medicine

You should not receive Zinecard if your chemotherapy does not include doxorubicin or a similar medication such as:

  • daunorubicin (Cerubidine);

  • epirubicin (Ellence);

  • idarubicin (Idamycin); or

  • mitoxantrone (Novantrone);

If possible before you receive dexrazoxane, tell your doctor if you have:

  • liver disease;

  • kidney disease; or

  • if you are pregnant or breast-feeding.

Zinecard is rated as FDA pregnancy category C. It is not known whether Zinecard will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Totect is rated as FDA pregnancy category D. Do not use Totect if you are pregnant. It could harm the unborn baby. If possible before you receive Zinecard, tell your doctor if you are pregnant.

It is not known whether dexrazoxane passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using dexrazoxane.

In an emergency situation, it may not be possible before you are treated with Totect to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medication.

How is dexrazoxane given?

Dexrazoxane is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting.

Totect is usually started within 6 hours after extravasation, and continued once daily for 3 days.

Zinecard is usually started 30 minutes before you receive your doxorubicin injection.

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 this medication is not causing harmful effects, your blood cells and kidney function will need to be tested often. Do not miss any follow up visits to your doctor for blood or urine tests.

What happens if I miss a dose?

Since dexrazoxane is given by a healthcare professional as part of your chemotherapy treatment, you are not likely to miss a dose.

Call your doctor if you miss a chemotherapy appointment.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid after receiving dexrazoxane?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Dexrazoxane side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor at once if you have any of these serious side effects:

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin; or

  • bruising, swelling, warmth, redness, oozing, or bleeding of any surgical incision.

Less serious side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Dexrazoxane dosing information

Usual Adult Dose for Cardiomyopathy Prophylaxis:

Zinecard (R):

Dosage ratio of dexrazoxane to doxorubicin is 10:1 (e.g. 500 mg/m2 dexrazoxane to 50 mg/m2 doxorubicin)
-Administer via IV infusion over 15 minutes.
-DO NOT administer via IV push.
-Administer doxorubicin within 30 minutes of completion of dexrazoxane infusion; do not administer doxorubicin before dexrazoxane.

Comments:
-Do not use with the initiation of doxorubicin therapy.

Use(s): Reducing 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.

Usual Adult Dose for Extravasation:

Totect (R):

Recommended doses:
Day one: 1000 mg/m2 IV over 1 to 2 hours
Day two: 1000 mg/m2 IV over 1 to 2 hours
Day three: 500 mg/m2 IV over 1 to 2 hours

Maximum doses:
Day one: 2000 mg
Day two: 2000 mg
Day three: 1000 mg

Comments:
-Product must be diluted with 50 mL of 0.167 M sodium lactate injection solution prior to administration.
-Initiate first infusion as soon as possible and within the first 6 hours of extravasation.
-Start day 2 and 3 treatments at the same hour as the first day (give or take 3 hours).
-Remove cooling features such as ice packs (if used) at least 15 minutes before administration to allow sufficient blood flow to extravasation area.

Use(s): Extravasation resulting from intravenous anthracycline chemotherapy

What other drugs will affect dexrazoxane?

Some cancer medications may be less effective if they are used with dexrazoxane. Tell your doctor if your chemotherapy medications include:

This list is not complete and other drugs may interact with dexrazoxane. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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