Idarubicin

DEA Class; Rx

Common Brand Names; Idamycin

Hypersensitivity

Serum bilirubin >5 mg/dL [>85.5 umol/L]

• Infection (95%)
• Nausea (30-60%)
• Vomiting (30-60%)
• Alopecia (25-30%)
• Hemorrhage (63%)
• Stomatitis (11%)
• Fever (26%)
• Elevated bilirubin and transaminases (20-30%)
• Myelosuppression: > 10%
• Seizure (4%)
• CHF (2%)
• Peripheral neuropathy (8%)

Vesicant-avoid extravasation

Risk of myocardial toxicity leading to potentially fatal CHF; pre-existing heart disease and previous therapy with anthracyclines at high cumulative doses or other potentially cardiotoxic agents are co-factors for increased risk of cardiac toxicity; benefit to risk ratio of idarubicin therapy in such patients should be weighed before starting treatment

Monitor cardiac function during treatment in order to minimize risk of cardiac toxicity of the type described for other anthracycline compounds

Prior radiation treatment to mediastinal-pericardial area & prior anthracyclines increases cardiotoxic risk

Cumulative doses >150 mg/m² associated with decreased ejection fraction

Possibility of injection site reactions

Use caution in hepatic/renal impairment; dose reduction may be necessary

Not for administration to patients with pre-existing bone marrow suppression induced by previous drug therapy or radiotherapy unless the benefit warrants the risk

Due to the increased risk of cardiotoxicity, avoid concomitant use until cardiotoxic agent has been discontinued for at least 5 half-lives; specifically avoid therapy for up to 7 months after stopping trastuzumab

Avoid pregnancy

There is no conclusive information about therapy adversely affecting human fertility or causing teratogenesis; there has been one report of a fetal fatality after maternal exposure to drug during second trimester

Not known whether drug is excreted in human milk; because many drugs are excreted in human milk and because of potential for serious adverse reactions in nursing infants from drug; mothers should discontinue nursing prior to taking drug and do not breastfeed during treatment and for 14 days after last dose