📋 Indications & Clinical Dosage
*Recurrent superficial bladder tumours (bladder instillation), Bladder carcinoma:*
BY IV INJ: Adult: 20-40 mg/dose every 6-8 week (consult product literature).
*Chronic lymphatic leukaemia, chronic myelogenous leukaemia, Gastric, colorectal, lung, pancreatic, liver, cervix, endometrium, head & neck and breast cancer:*
BY IV INJ: Adults & Elderly: Monotherapy: 20 mg/m2 every 6-8 week. Combination therapy: 10 mg/m2 every 6-8 week.
💊 Mode of Administration
Slow IV push or by slow (15-30 min) infusion via a freely-running dextrose or saline infusion. Consider using a central venous catheter. Further dilution to 20-40 mcg/ml in NS or Sodium Lactate. Dilute powder with SWFI or 0.9% sodium chloride to a concentration of 0.5-1 mg/ml.
⛔ Contraindications
Thrombocytopenia, coagulation disorder, increased bleeding tendency.
⚠️ Precautions & Warnings
Monitor renal and hepatic function and haematology, bone marrow depression, children.
🔄 Drug Interactions
Other antineoplastics (since alkaloids, doxorubicin).
⚠️ Adverse Reactions / Side Effects
Alopecia, bone marrow damage, bone-marrow suppression, hyperuricaemia, lung fibrosis, nausea, oral mucositis, renal damage, thromboembolism, tumourlysis syndrome, vomiting, extravasation, bone-marrow toxicity
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Positive evidence of risk: Avoid
Lactation / Breastfeeding:
Contraindicated. Discontinue breast-feeding
🧪 Compatibility & Storage Stability
Compatibility: Stable in LR.
📚 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.