Cardioprotectant / anthracycline extravasation antidote
Dexrazoxane
Brand names: Cardioxane, Savene
Adult dose
Dose: Cardioprotection: 10:1 ratio with doxorubicin/epirubicin IV; Extravasation: 1000mg/m² IV within 6h, repeat at 24h, then 500mg/m² at 48h
Route: IV
Frequency: Per indication
Clinical pearls
- UKONS extravasation guideline: anthracycline extravasation — Savene IV protocol within 6 hours
- Cardioprotection during anthracycline chemotherapy in adults with metastatic breast cancer (cumulative dose >300mg/m² doxorubicin / 540mg/m² epirubicin)
- ESMO supportive care guideline
Contraindications
- Pregnancy/breastfeeding
- Children (cardioprotection — relative)
- Hypersensitivity
Side effects
- Myelosuppression (additive)
- Increased risk of secondary malignancy
- Pain at injection site
- Hepatotoxicity
- Reversible LFT changes
Interactions
- Topical DMSO (do not use within 6h of dexrazoxane in extravasation)
Monitoring
- FBC
- LFTs
- LVEF
- Local site
Reference: BNF; UKONS extravasation; ESMO supportive care; SmPC; https://bnf.nice.org.uk/drugs/dexrazoxane/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.