- Non-small cell lung cancer; metastatic breast cancer
- Being studied for other types of cancers; being studied in children
THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.
- Available as a 10 mg/mL solution; (clear solution and may become yellow to light amber)
- Refrigerate vials; unopened vials stable 72 hrs at room temperature. Protect from light
- Diluted to 1.5-3 mg/mL, stable in syringe 24 hours refrigerated or room temperature
- Diluted to 0.5-2 mg/mL, stable in minibag/buretrol 24 hrs refrigerated or room temp
- Stable in D5W for 7 days and NS for 3 days in fridge at a concentration of 0.5 mg/mL
- Solutions Compatible: D5W, NS
- Additive/buretrol Compatible: no information
- Y-site Compatible: calcium gluconate, ceftazidime, dexamethasone, diphenhydramine, hydrocortisone, hydromorphone, ifosfamide, metoclopramide, morphine, KCl, ondansetron
- Incompatible: sodium bicarbonate, cefuroxime
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct | YES, certified RN only Usual dilution: 1.5-3 mg/mL Infusion time: 6-10 minutes into tubing of running IV, then flush line with 75-125 mL D5W or NS |
| IV Intermittent Infusion | YES Usual dilution: 0.5-2 mg/mL Infusion time: 6-20 minutes, then flush line with 75-125 mL D5W or NS |
| IV Continuous Infusion | YES |
| Intrathecal Injection | ABSOLUTE CONTRAINDICATION; WILL RESULT IN FATALITY |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
20-35 mg/m2 weekly
- Total dose per 3-week cycle: 50-60 mg/m2
DOSAGE IN HEPATIC DYSFUNCTION:
|
Bilirubin (micromol/L) |
% Usual Dose |
|
36-50 |
50% |
|
>50 |
25% |
- See individual protocols for dose reduction in myelosuppression
- See individual protocols for dose modification in neurotoxicity
- No dose adjustment necessary in renal failure
Immediate (within a few minutes to hours):
- Nausea, vomiting (mild to moderate emetogenic potential)
- Diarrhea
- Injection site reaction
- Dyspnea (rare)
VESICANT: extreme irritation with extravasation. If extravasation occurs, see Treatment of Infiltrated Vesicant or Irritant Drugs Guidelines on CHEOnet.
Delayed (within a few days to weeks):
- Neurotoxicity (sensory) including constipation (less than vincristine and vinblastine)
- Bone marrow depression (nadir: 7-10 days)
- Pain
- SIADH (rare)
- Transient elevation of liver enzymes, bilirubin
- Treatment for unusual side effects are available through the study chair identified on the front page of the protocol and/or pharmacy
- Monitor bowel function and administer laxatives when necessary
- INTRATHECAL ADMINISTRATION IS FATAL