Idarubicin
Cytostatic · Cytotoxic anthracycline antibiotic
Indications
Advanced breast cancer after failure of front-line chemotherapy; acute leukaemias.
Dosage
Adults & Elderly: Refer to individual protocols. Leukaemia: IV: Induction: 12 mg/m²/day for 3 days. Consolidation: 10-12 mg/m²/day for 2 days. Children: Leukaemia: IV: 10-12 mg/m² every day for 3 day every 3 wk. Solid tumours: IV: 5 mg/day for 3 days every 3 wk. Advanced breast cancer after failure of first-line chemotherapy (not including anthracyclines)-monotherapy: Oral: 45 mg/m² for 1 dose, repeat treatment every 3-4 wks, alternatively 15 mg/m² daily for 3 consecutive days, repeat treatment every 3-4 wks; max 400 mg/m² per course.
Administration
IV: Administer as slow push over 3-5 min, preferably into the side of a freely-running saline or dextrose infusion or as intermittent infusion over 10-15 min into a free-flowing IV soln of NS or D5W; also occasionally administered as a bladder lavage. Do not administer IM or SC. Flush well with a heparin-free solution before and after idarubicin administration. Compatibility: Stable in D5NS, D5W, LR, NS, SWFI; incompatible with bacteriostatic water. Prolonged contact with any solution of an alkaline pH will result in degradation of the drug. Stability: Store under refrigeration at 2°C-8°C (36°F-46°F) and protect from light. Retain in carton until the time of use. Preservative-free, use solution within 24 hours of opening the vial.
Adverse Effects
Alopecia, skin rash, GI upset, headache, discolouration of urine, myelosuppression, anaemia, elevation of liver enzymes, ECG abnormalities, CHF, infections, blood dyscrasias, anorexia, arrhythmia, reduced LVEF, mucositis/stomatitis, elevated LFTs, urine discolouration, fever, haemorrhage. Reports of thromboembolism, secondary leukaemia. Inj only: local reactions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Caution advised or effect undetermined. Contraindications: Severe renal or hepatic impairment, uncontrolled infection, severe myocardial insufficiency, recent MI, severe arrhythmia, persistent myelosuppression, previous treatment with maximum cumulative doses of other anthracyclines or anthracenediones. Precautions: Monitor LVEF before and regularly during treatment, esp in patients receiving high cumulative doses or with risk factors for cardiotoxicity. Monitor haematology profile before and during each treatment cycle. Active GI disease. Monitor renal and hepatic function before and during treatment. Risk of tumour lysis syndrome; assess blood uric acid, potassium, calcium phosphate and creatinine levels after initial treatment. Risk of irreversible infertility in men.
Interactions
Live vaccines, trastuzumab, other cardiotoxic or cardioactive agents, phenytoin, cyclosporin.
Advice to Patient
This medication is administered intravenously. Report immediately if there is redness/swelling/pain/itching/burning at infusion site or chest pain, palpitations, swelling of extremities, fast heartbeat, difficulty in breathing. Contact prescriber if there is fever, chills, unusual bruising or bleeding, unrelieved nausea, vomiting, diarrhoea, change in urinary pattern, purulent vaginal discharge, increased fatigue, stomach pain, unhealed mouth sores, blood in stools, yellowing of eyes or skin, difficulty in breathing, swelling of extremities, unrelieved diarrhoea. Avoid alcohol intake during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Take small, frequent meals to maintain good nutritional status. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber.
Pharmacokinetics
Metabolism: Hepatic and extrahepatic. Bioavailability: Oral: 20%-40%. Half-life elimination: Plasma: 20-22 hrs. Active metabolite: 45 hrs. Terminal: 15 hrs. Active metabolite: 72 hrs. Time to peak, plasma: Oral: 4 hrs. Excretion: Faeces (mainly). Urine (small amounts).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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