Idarubicin
Mechanism :
Idarubicin, either as a single agent or in combination, has been shown to be a potent antileukemic agent capable of inducing complete remission in previously untreated and in relapsed and refractory acute non-lymphocytic leukemia (ANLL) including resistant patients, and in adult and pediatric relapsed patients with acute lymphoblastic leukemia (ALL).
Indication :
- Acute lymphocytic leukemia (ALL)
- Acute myeloid leukemia (AML)
Contraindications :
Patients with a history of allergic reactions to idarubicin.
Dosing :
Acute myeloid Leukemia (AML):
10-12 mg/m² IV/day for 3 days for 3 weeks.
Adverse Effect :
Severe myelosuppression and cardiac toxicity. Other adverse reactions include reversible alopecia, mucositis, acute nausea and vomiting, diarrhea, esophagitis, fever with chills, skin rash, elevation of liver enzymes and bilirubin, infections.
Interaction :
Contraindicated:
Adenovirus Vaccine, Live; BCG Live Intravesical; Influenza Nasal Vaccine, Live; Measles/Mumps/Rubella Vaccine, Live; Rotavirus Vaccine, Live; Smallpox Vaccine (Live Vaccinia Virus); Typhoid Vaccine, Live; Varicella Vaccine, Live; Yellow Fever Vaccine, Live; Zoster Vaccine, Live.
Avoid/Use Alternative:
Alefacept, Deferiprone, Natalizumab, Palifermin, Radium Ra 223 Dichloride, Sipuleucel-T.
Monitor/Modify Treatment:
Ado-Trastuzumab Emtansine, Aldesleukin, Azathioprine, Bevacizumab, Cidofovir, Clozapine, Daunorubicin, Dexrazoxane, Digoxin, Doxorubicin, Epirubicin, Filgrastim, Flucytosine, Ganciclovir, Hydroxyurea, Idarubicin, Interferon Alfa 2b, Interferon Alfacon-1
Interferon Beta 1a, Mitoxantrone, Mycophenolate Mofetil, Mycophenolic Acid, Oprelvekin, Pegfilgrastim, Peginterferon Alfa 2b, Ponatinib, Primaquine, Pyrimethamine, Sargramostim, Tbo-Filgrastim, Trametinib, Trastuzumab, Valganciclovir, Zidovudine.
Caution Advised:
Anthrax Vaccine, Belatacept, Belimumab, Diphtheria/Tetanus and/or Pertussis Vaccine, Fingolimod, Granisetron, Haemophilus B Conjugate Vaccine, Hepatitis A Vaccine, Hepatitis B Vaccine, Human Papillomavirus Vaccine, Influenza H5N1 Vaccine (Avian Flu), Influenza Vaccine, Japanese Encephalitis Vaccine, Leflunomide, Meningococcal Vaccine, Pneumococcal Vaccine, Poliovirus Vaccine, Rabies Vaccine, Sirolimus, Teriflunomide, Tofacitinib, Typhoid Vi Polysaccharide Vaccine, Ustekinumab.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Use 75% of dose |
| 10-20 | Use 75% of dose with caution |
| <10 | Use 50% of dose with caution |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
Dosage depends on level of serum bilirubin
- Total bilirubin 2.5 to 5 mg/dL: reduce recommended dose by 50%.
- Total bilirubin greater than 5 mg/dL: Use is contraindicated.