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Dexrazoxane: Protect Your Heart During Chemotherapy Treatment
Summary or Key Points
Dexrazoxane is a medication used to protect the heart from damage caused by certain chemotherapy drugs and to treat tissue damage from chemotherapy leaks. It is commonly prescribed for patients undergoing cancer treatment. Dexrazoxane is administered intravenously, with dosing carefully tailored to the specific condition being treated. Always consult your healthcare provider before starting or adjusting this medication.
Names of Medication
US Brand Name: Zinecard, Totect
Generic Name: Dexrazoxane
The generic name refers to the chemical composition of the medication, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.
Pharmacologic Category
Cardioprotective Agent
Chemoprotective Agent
Dexrazoxane Dosing
Dexrazoxane is used to treat various cancers, including breast, ovarian, lung, testicular cancers, sarcoma, leukemia, lymphoma, multiple myeloma, neuroblastoma, and Wilms tumor. Dosing varies based on the condition being treated. Always consult your doctor before adjusting your dose. If you need to speak with a healthcare provider, you can schedule a telemedicine appointment with us today.
Breast Cancer (Cardioprotection)
Dexrazoxane is administered at a dose of 500 mg/m2 intravenously, 30 minutes before the chemotherapy drug doxorubicin. It is typically given on the same day as chemotherapy.
Chemotherapy Extravasation (Tissue Damage)
For adults, the recommended dose is 1000 mg/m2 intravenously, administered within 6 hours of the chemotherapy leak. This is followed by 1000 mg/m2 on day 2 and 500 mg/m2 on day 3.
Dosage Forms and Strengths
Injection, powder for reconstitution: 250 mg, 500 mg
Administration Instructions for Dexrazoxane
Dexrazoxane is administered as an intravenous (IV) infusion. It is crucial to follow your healthcare provider’s instructions closely. This medication should be given by a healthcare professional in a clinical setting. For cardioprotection, it is typically administered 30 minutes before chemotherapy. For chemotherapy extravasation, it should be given as soon as possible after the leak occurs.
Adverse Reactions and Side Effects of Dexrazoxane
Like all medications, Dexrazoxane can cause side effects. It’s important to be aware of these potential reactions and contact your healthcare provider if you experience any concerning symptoms.
Common Side Effects (affecting more than 10% of patients)
Nausea and Vomiting: Feeling nauseous or vomiting may occur, especially after receiving the medication.
Fatigue: Many patients report feeling unusually tired or weak after treatment.
Less Common Side Effects (affecting 1-10% of patients)
Fever: A mild fever may develop after receiving the medication.
Low Blood Pressure: Some patients may experience a drop in blood pressure during or after the infusion.
Rare Side Effects (affecting less than 1% of patients)
Allergic Reactions: Severe allergic reactions are rare but can include rash, itching, swelling, and difficulty breathing.
Heart Problems: Although Dexrazoxane is used to protect the heart, in rare cases, it may cause heart issues, such as arrhythmias (irregular heartbeats).
Contraindications for Dexrazoxane
A contraindication refers to a specific situation or condition where a medication should not be used because it may cause harm. In the case of Dexrazoxane, certain conditions may make its use unsafe.
Allergy to Dexrazoxane
If you have a known allergy to Dexrazoxane or any of its ingredients, taking this medication could cause a severe allergic reaction, which may be life-threatening.
Severe Kidney Disease
Dexrazoxane is processed through the kidneys. If you have severe kidney problems, the medication may not be cleared from your body properly, leading to toxic levels.
Pregnancy
Dexrazoxane may harm an unborn baby, so it is not recommended during pregnancy unless the benefits outweigh the risks. More details are provided in the pregnancy section below.
Breastfeeding
Since it is unknown whether Dexrazoxane passes into breast milk, it is generally not recommended while breastfeeding. More information is provided in the breastfeeding section below.
Drug to Drug Interactions with Dexrazoxane
Dexrazoxane can interact with other medications, potentially increasing the risk of side effects or reducing the effectiveness of either drug. It is important to inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medications, and supplements.
Doxorubicin (Adriamycin)
Dexrazoxane is often used with doxorubicin to reduce heart damage caused by doxorubicin, but it may also reduce the effectiveness of doxorubicin in treating cancer. Your healthcare provider will weigh the benefits and risks.
Cyclophosphamide (Cytoxan)
When used together, these medications may increase the risk of bone marrow suppression, leading to a higher chance of infection or bleeding.
Fluorouracil (Adrucil)
This combination may increase the risk of side effects like low white blood cell counts, which can raise your risk of infection.
Cisplatin (Platinol)
Combining Dexrazoxane with cisplatin may increase the risk of kidney damage, so your healthcare provider may monitor your kidney function closely.
Dexrazoxane in Pregnancy
Is it Safe to Take Dexrazoxane During Pregnancy?
Dexrazoxane is generally not recommended during pregnancy due to the potential risk it poses to the developing baby. Animal studies have shown that Dexrazoxane can lead to birth defects and developmental issues. If you are pregnant or planning to become pregnant, it is essential to discuss this with your healthcare provider. They will carefully weigh the potential benefits and risks of using Dexrazoxane in your specific situation. If you are already taking Dexrazoxane and discover you are pregnant, contact your healthcare provider immediately for guidance.
Dexrazoxane While Breastfeeding
Is it Safe to Take Dexrazoxane While Breastfeeding?
It is not yet clear whether Dexrazoxane passes into breast milk. Due to the potential for serious side effects in a nursing infant, this medication is generally not recommended while breastfeeding. If you are currently breastfeeding or planning to breastfeed, consult your healthcare provider. They may suggest alternative treatments or advise you to stop breastfeeding while taking Dexrazoxane.
Estimated Cost of Dexrazoxane Medication
The cost of a 30-day supply of Dexrazoxane without insurance can vary significantly. With a GoodRx coupon, the estimated price ranges from $1,000 to $2,500. Prices may differ depending on the pharmacy and location, so it’s a good idea to check with your local pharmacy for the most accurate pricing information.
Possible Alternatives to Dexrazoxane
If Dexrazoxane is not suitable for you, or if you are exploring other treatment options, there may be alternatives available depending on your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these alternatives in more detail.
Breast Cancer
For patients with breast cancer, alternatives to Dexrazoxane for reducing heart damage from chemotherapy may include lifestyle changes, such as regular cardiovascular exercise, or medications like beta-blockers or ACE inhibitors. Discuss these options with your healthcare provider to determine the best approach for your situation.
Ovarian Cancer
In cases of ovarian cancer, other protective agents, such as amifostine, may help reduce the side effects of chemotherapy. Additionally, maintaining a healthy diet and engaging in regular exercise can support your overall health during treatment. Be sure to discuss these options with your provider.
Lung Cancer
For lung cancer patients, reducing the chemotherapy dose or switching to a different treatment regimen may be an option. Speak with your healthcare provider about other medications that may help protect your heart during treatment.
Testicular Cancer
In the case of testicular cancer, alternative chemotherapy regimens may be considered if Dexrazoxane is not appropriate. Your healthcare provider can help you explore these alternatives and determine the best course of action.
Sarcoma
For patients with sarcoma, lifestyle changes such as quitting smoking and maintaining a healthy weight may help reduce the risk of heart damage from chemotherapy. Your provider may also recommend other medications to protect your heart during treatment.
Leukemia
In some cases of leukemia, reducing the dose of anthracycline chemotherapy or using alternative agents may be an option. Discuss these possibilities with your healthcare provider to find the most suitable approach for your treatment.
Lymphoma
For lymphoma patients, other medications, such as cardioprotective agents, may help reduce the risk of heart damage. Your healthcare provider can guide you through these options and help you make an informed decision.
Multiple Myeloma
If Dexrazoxane is not a viable option for you, your provider may suggest alternative chemotherapy regimens or supportive medications to protect your heart during treatment for multiple myeloma.
Neuroblastoma
For pediatric patients with neuroblastoma, reducing the chemotherapy dose or using other protective agents may be considered. It is important to discuss these options with your healthcare provider to ensure the best possible care for your child.
Wilms Tumor
In cases of Wilms tumor, alternative chemotherapy regimens or dose adjustments may be considered to reduce the risk of heart damage. Your healthcare provider can help you explore these options and determine the most appropriate treatment plan.
Recent Updates on Dexrazoxane Research
Recent studies continue to investigate Dexrazoxane’s effectiveness in reducing heart damage caused by anthracycline chemotherapy. A 2022 study found that Dexrazoxane significantly lowered the risk of heart failure in patients receiving high doses of doxorubicin. Additionally, ongoing research is examining Dexrazoxane’s use in pediatric cancer patients to prevent long-term heart damage. While these studies are promising, further research is needed to fully understand the long-term benefits and risks of Dexrazoxane across different patient populations.
