dexrazoxane hydrochloride at a glance
Medicine class
Cardioprotective agent and topoisomerase II inhibitor
Licensed role
Reducing cumulative anthracycline-related heart damage in selected adults with advanced or metastatic breast cancer
How it is given
Intravenous infusion prepared and administered by trained healthcare staff
Important monitoring
Blood counts, kidney function and anthracycline-related heart monitoring
What is dexrazoxane hydrochloride used for?
The selected product has a narrow licensed role. Specialist use outside this licence also occurs under defined NHS arrangements.
Licensed: prevention of chronic cumulative heart toxicity from further anthracycline treatment in selected adults with advanced or metastatic breast cancer previously exposed to substantial amounts of doxorubicin or epirubicin.
In England, NHS England commissions non-licensed use under defined criteria for some children and young people receiving high cumulative anthracycline or related treatment.
How does dexrazoxane hydrochloride work?
The precise heart-protective mechanism is not fully understood. Dexrazoxane inhibits topoisomerase II and may reduce DNA injury in heart cells. Its metabolites also bind iron, which may limit anthracycline-related oxidative damage.
dexrazoxane hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 500 mg
How to take dexrazoxane hydrochloride
Dexrazoxane is not taken at home. Trained staff reconstitute and dilute the cytotoxic powder, then give it into a vein.
Tell the oncology team about allergies and all prescribed, pharmacy-bought, herbal or complementary products.
Report pain, burning, redness or swelling around the infusion site immediately.
Food does not affect administration because it is given intravenously.
dexrazoxane hydrochloride side effects
Common or expected effects
- Low red or white blood-cell counts, sometimes with infection risk
- Nausea, vomiting or a sore mouth
- Weakness, tiredness or feeling unwell
- Hair loss
- Diarrhoea, constipation, abdominal discomfort or reduced appetite
- Headache, dizziness, tingling or numbness
- Infusion-site inflammation or discomfort
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling, wheezing, breathing difficulty, low blood pressure or collapse
- Fever, sore throat or frequent infections suggesting marked bone-marrow suppression
- Unexpected bleeding or bruising suggesting a low platelet count
- Painful limb swelling, sudden chest pain, breathlessness or coughing blood suggesting a blood clot
- Acute myeloid leukaemia has been reported uncommonly
dexrazoxane hydrochloride in pregnancy
Human pregnancy data are inadequate, while animal studies found embryo-fetal harm. It should only be used during pregnancy when a specialist considers it clearly necessary. Effective contraception is required for both women and men as directed by the oncology team.
dexrazoxane hydrochloride while breastfeeding
Breastfeeding is contraindicated during treatment because transfer into milk is unknown and serious effects in an infant are possible. Discuss feeding plans with the oncology and maternity teams.
dexrazoxane hydrochloride interactions
The oncology team should review medicines and vaccination plans before treatment.
Yellow fever vaccine
Concomitant use is contraindicated because potentially fatal generalised vaccine infection may occur.
Other live attenuated vaccines
Avoid where possible because immunosuppression may permit serious systemic infection; an inactivated alternative may be suitable.
Phenytoin
Cytotoxic treatment may reduce phenytoin absorption and worsen seizure control, so the combination is not recommended.
Common questions about dexrazoxane hydrochloride
Answers are fully visible for fast scanning and source review.
What is dexrazoxane hydrochloride used for?
The selected product is licensed to reduce cumulative anthracycline-related heart damage in selected adults with advanced or metastatic breast cancer.
Is it chemotherapy?
It is a cytotoxic topoisomerase II inhibitor, but here its intended role is heart protection alongside anthracycline chemotherapy rather than cancer treatment.
Does it replace heart monitoring?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.