dexrazoxane at a glance
Medicine class
Detoxifying agent for antineoplastic treatment; handled as a cytotoxic medicine.
Licensed use
Treatment of anthracycline extravasation in adults.
Administration
Prepared and given by intravenous infusion in hospital under specialist supervision.
Key monitoring
The affected area, blood-cell counts and relevant liver and kidney tests are monitored.
What is dexrazoxane used for?
Uses include:
Licensed: treating accidental leakage of anthracycline chemotherapy into surrounding tissue in adults, to limit local tissue injury.
Outside the licence: preventing anthracycline-related heart damage in selected specialist cancer protocols, including some protocols for children and young people.
How does dexrazoxane work?
Dexrazoxane enters cells and is converted into compounds that bind iron, reducing iron-dependent oxidative injury caused by anthracyclines. It also inhibits topoisomerase II. Both actions may help protect tissue after anthracycline extravasation, although their relative contribution is uncertain.
dexrazoxane preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 20 mg/mL
How to take dexrazoxane
Dexrazoxane is not taken by mouth. Trained staff reconstitute and dilute it before giving it through a vein away from the extravasation site.
It is administered in hospital under an experienced cancer specialist.
Cooling packs are removed beforehand to restore adequate blood flow to the affected area.
The affected area is examined regularly until it has resolved.
dexrazoxane side effects
Common or expected effects
- Nausea or vomiting
- Pain, redness, swelling, hardening or vein inflammation at the infusion site
- Reduced white blood cells or platelets
- Infection or fever
- Diarrhoea or mouth inflammation
- Tiredness, sleepiness or dizziness
- Reduced appetite
- Temporary changes in liver blood tests
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling, wheezing, breathing difficulty, low blood pressure or loss of consciousness
- Serious infection associated with low white blood cells
- Unexpected bleeding associated with low platelets
- A blood clot, which may cause limb pain or swelling, chest pain or sudden breathlessness
dexrazoxane in pregnancy
There are no adequate human pregnancy data, and animal findings suggest potential fetal harm. Use during pregnancy is reserved for situations where a specialist considers it clearly necessary. Effective contraception is required for sexually active people who could conceive or father a child during treatment and afterwards as directed by the specialist. Report a pregnancy immediately.
dexrazoxane while breastfeeding
Breastfeeding is contraindicated during treatment because transfer into milk is unknown and serious effects in the infant are possible. Discuss feeding plans with the oncology team.
dexrazoxane interactions
Give the oncology team a complete medicines and vaccination history. Important interactions include:
Yellow fever vaccine
Concomitant use is contraindicated because of the risk of severe, potentially fatal vaccine-related infection.
Other live attenuated vaccines
Avoid where possible because immunosuppression can permit serious systemic infection; an inactivated alternative may be appropriate.
Dimethyl sulfoxide (DMSO)
Do not apply DMSO to anthracycline extravasation when dexrazoxane is being used because combined treatment may worsen local injury.
Common questions about dexrazoxane
Answers are fully visible for fast scanning and source review.
What is dexrazoxane used for in the UK?
The selected UK product is licensed to treat anthracycline chemotherapy that has accidentally leaked from a vein into surrounding tissue in adults. Specialist teams may also use it outside this licence to reduce anthracycline-related heart damage.
Is dexrazoxane chemotherapy?
It is classified as a detoxifying agent but has cytotoxic properties, so hospitals prepare, administer and dispose of it using anticancer-medicine precautions.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.