📋 Indications & Clinical Dosage
*Acute Lymphoblastic & Myeloblastic Leukaemia, Soft tissue and bone sarcomas, Breast carcinoma, Ovarian carcinoma, Lymphomas of both Hodgkin and non-Hodgkin type, Small cell lung cancer, Gastric carcinoma, Bladder carcinoma, Wilmstumour, Neuroblastoma, Bronchogenic, Thyroid carcinoma:*
BY IV INJ: Adult: Monotherapy: 60-75 mg/m2every 21 day. Combination therapy: 40-60 mg/m2every 21-28 days.
💊 Mode of Administration
Administer IV push over 1-2 min or IVP Bolus. Infusion via central venous line recommended. Reconstitute lyophilized powder with NS to a final concentration of 2 mg/ml as follows. Further dilution in D5W or NS is stable for 48 hours at room temperature (25-C) when pro-tected from light. Unstable in solutions with a pH < 3 or > 7.Standard IV Dilution: IVP: Dose/syringe (concentration: 2 mg/ml). IVP Bolus: Dose 50-100 ml D5W or NS.
⛔ Contraindications
Patients with marked myelosuppression, stomatitis.
⚠️ Precautions & Warnings
Cardiac failure. Hematological monitoring re-quired, Cardiac disease, caution in handling; irritant to tissues, elderly, hypertension, previous myocardial irradiation
🔄 Drug Interactions
Heparin.
⚠️ Adverse Reactions / Side Effects
Dehydration, diarrhoea, red colouration of the urine, alopecia, bone-marrow suppression, cardiomyopathy (with higher cumulative doses), extravasation, heart failure, hyperuricaemia, nausea, oral mucositis, renal damage, thromboembolism, tumourlysis
Syndrome, vomiting, elevated bilirubin concentration, supraventricular tachycardia,
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Positive evidence of risk: Avoid
Lactation / Breastfeeding:
Contraindicated. Discontinue breast-feeding
🧪 Compatibility & Storage Stability
Compatibility: Stable in D5W, LR, NS.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.