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Indication & Dosage |
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| Intravenous |
| MULTIPLE MYELOMA |
| Adult:
As a single agent: 60-90 mg/m2 every 3-4 wk. May divide dose over 2-3 days if desired. May admin as an inj over 3-5 minutes or as an infusion over up to 30 minutes. Max (total cumulative dose limit): 0.9-1 g/m2. For palliative care: 12.5-25 mg/m2 once wkly. |
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| Intravenous |
| LYMPHOMA |
| Adult:
As a single agent: 60-90 mg/m2 every 3-4 wk. May divide dose over 2-3 days if desired. May admin as an inj over 3-5 minutes or as an infusion over up to 30 minutes. Max (total cumulative dose limit): 0.9-1 g/m2. For palliative care: 12.5-25 mg/m2 once wkly. |
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| Intravenous |
| ACUTE LEUKAEMIAS |
| Adult:
As a single agent: 60-90 mg/m2 every 3-4 wk. May divide dose over 2-3 days if desired. May admin as an inj over 3-5 minutes or as an infusion over up to 30 minutes. Max (total cumulative dose limit): 0.9-1 g/m2. For palliative care: 12.5-25 mg/m2 once wkly. |
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| Intravenous |
| STOMACH CARCINOMA |
| Adult:
As a single agent: 60-90 mg/m2 every 3-4 wk. May divide dose over 2-3 days if desired. May admin as an inj over 3-5 minutes or as an infusion over up to 30 minutes. Max (total cumulative dose limit): 0.9-1 g/m2. For palliative care: 12.5-25 mg/m2 once wkly. |
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| Intravenous |
| ADJUVANT TREATMENT OF AXILLARY-NODE POSITIVE BREAST CANCER |
| Adult:
As part of regimen containing cyclophosphamide and 5-fluorouracil: 60 mg/m2 on days 1 and 8 of each 28-day cycle. Repeat for 6 cycles. Alternatively, 100 mg/m2 on day 1 and repeated every 21 days for 6 cycles. |
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| Intravesical |
| LOCAL TREATMENT OF BLADDER CARCINOMA |
Adult:
As 0.1% solution (in normal saline or sterile water): 50 mg wkly for 8 wk; may reduce to 30 mg in 50 ml if chemical cystitis develops. For carcinoma in-situ: May increase dose to 80 mg in 50 ml wkly. For prevention of recurrence in patients who have undergone transurethral resection: 50 mg wkly for 4 wk, followed by 50 mg once a mth for 11 mth; retain solution in the bladder for 1 hr during each admin.
Patients with heavy pre-treatment, preexisting bone marrow depression, or the presence of neoplastic bone marrow infiltration: Starting dose of 75-90 mg/m2. Dosage modifications after the 1st treatment cycle: Nadir platelet counts < 50,000/mm2, ANC < 250/mm2, neutropenic fever, or grades 3 or 4 nonhaematogenic toxicity: Reduce day 1 dose in subsequent cycles to 75% of the day 1 dose in the current cycle. Day 1 chemotherapy in subsequent courses of treatment should be delayed until platelet counts are exceeding 100,000/mm3, ANC exceeding 1500/mm3, and nonhaematogenic toxicities have recovered to almost grade 1. In addition, for patients receiving divided dose (day 1 and day 8) regimen: Day 8 platelet counts 75,000-100,000/mm3 and ANC 1000-1499/mm3: dose should be 75% of the day 1 dose. Day 8 platelet counts <75,000/mm3, ANC <1000/mm3 or grade 3 or 4 nonhaematologic toxicity: Omit day 8 dose. |
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| Precautions |
Previous extensive radiotherapy, bone infiltration by tumour, severe renal and hepatic dysfunction. May cause tumor lysis syndrome or radiation recall. Elderly women >70 yr. CV disease, hypertensive cardiomyopathy; monitor hematological and cardiac function regularly. Extravasation during IV admin may result in severe local tissue necrosis. Do not give via IM/SC routes as extravasation can lead to severe local necrosis. |
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| Adverse Drug Reactions |
Myelosuppression; cardiotoxicity, alopoecia; mucositis; hyperpyrexia; lethargy; amenorrhoea; nausea and vomiting; diarrhoea; fever; rash, skin changes, anorexia; anaphylaxis; photosensitivity; premature menopause; skin and nail hyperpigmentation; harmless reddish appearance of urine for 1-2 days. |
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| Interactions |
Paclitaxel and other anthracyclines. Cimetidine, heparin. Antineoplastic drugs, cardiotoxic drugs, radiation, hepatoactive drugs. |
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