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

Medically reviewed by Last updated on May 29, 2020.

What is Totect?

Totect (dexrazoxane) is used to protect the heart and other tissues from harmful side effects caused by certain cancer medications.

Totect 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. Dexrazoxane can harm an unborn baby or cause birth defects if the mother or father is using this medicine. Tell your caregivers if you are pregnant, or if you are a man and your partner is able to get pregnant.

Tell your doctor at once if you have signs of infection such as fever, chills, sore throat, easy bruising or bleeding, skin sores, or warmth and redness of any surgical incision.

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

Tell your doctor if you have ever had:

Totect can harm an unborn baby or cause birth defects if the mother or the father is receiving this medicine. Women should use effective birth control to prevent pregnancy while receiving Totect and for at least 6 months after the last dose. Men should use birth control during treatment and for at least 3 months after the last dose. Tell your doctor right away if a pregnancy occurs during this time.

This medicine may affect fertility (ability to have children) in men. However, it is important to use birth control to prevent pregnancy because dexrazoxane may harm the baby if a pregnancy does occur.

You should not breast-feed while you are using dexrazoxane. Women receiving Totect should continue to not breast-feed for at least 2 weeks after the last dose.

How is Totect given?

Totect is given as an infusion into a vein. A healthcare provider will give you this injection.

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

Totect dosing information

Usual Adult Dose of Totect for Extravasation:

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

-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: Extravasation resulting from intravenous anthracycline chemotherapy

What happens if I miss a dose?

Since Totect is given by a healthcare professional, you are not likely to miss a dose.

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 Totect?

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

Totect side effects

Get emergency medical help if you have signs of an allergic reaction to Totect: hives; difficult breathing; feeling light-headed; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fever, chills, tiredness, mouth sores, skin sores;

  • easy bruising, unusual bleeding;

  • sore throat, cough, trouble breathing; or

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

Common Totect side effects may include:

  • nausea, vomiting;

  • fever;

  • infection after a surgery; or

  • pain where the medicine was injected.

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.

What other drugs will affect Totect?

Tell your doctor about all your other medicines, especially:

This list is not complete. Other drugs may interact with dexrazoxane, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

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

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