Cytoprotective and supportive care agents:
Indications for TOTECT:
To treat extravasation resulting from IV anthracycline chemotherapy.
Give once daily for 3 consecutive days by IV infusion over 1–2 hours. Initiate 1st dose as soon as possible and within 1st 6 hours after extravasation. Days 1 and 2: 1000mg/m2; max 2000mg. Day 3: 500mg/m2; max 1000mg. Renal impairment (CrCl <40mL/min): reduce dose by 50%.
Myelosuppression: monitor CBCs. Renal impairment: monitor for hematological toxicity. Hepatic impairment: not recommended. Elderly. Embryo-fetal toxicity. Pregnancy (avoid); exclude status prior to chemotherapy initiation. Use effective contraception during treatment and for 6 months (females) or 3 months (males) after final dose. Nursing mothers: not recommended (during and for 2 weeks after final dose).
Avoid topical dimethylsulfoxide (DMSO). Caution with concurrent cytotoxic chemotherapy (additive cytotoxicity).
Inj site reactions, nausea, vomiting, pyrexia, infections, leukopenia, neutropenia, thrombocytopenia, elevated liver enzymes; hypersensitivity reactions (if severe, consider permanent discontinuation).