IV Individualized dosage. 3-6 mg/kg (120-240 mg/m2) as IV inj twice wkly. Massive intermittent therapy 10-15 mg/kg (400-600 mg/m2) w/ therapy free intervals of 7-10 days; or 20-40 mg/kg (800-1,600 mg/m2) in divided doses over a period of 2-5 days w/ therapy free intervals of 10-20 days.
Myelosuppression; monitor hematologic profile especially neutrophils & platelets regularly. Monitor urinary sediment regularly for RBC which may proceed to hemorrhagic cystitis. Take large quantities of fluid during or immediately after administration to prevent toxicity of urinary bladder. Exclude all conditions of hampered urinary flow in the efferent urinary passages & correct disturbance of electrolyte balance prior to initiation of therapy. Maintain oral & dental hygiene to prevent infections. Take contraceptive measures on both sexes throughout the treatment & for at least 6 mth after its termination. May affect ability to drive or use machines. Impaired renal & hepatic function. Severe renal impairment.
Myelosuppression especially leukopenia (prolonged use of high doses), thrombocytopenia & anaemia develop occasionally; nausea & vomiting commonly, anorexia & less frequently, abdominal discomfort or pain & diarrhoea; alopecia, pigmentation of the skin & changes in nails; hemorrhagic cystitis, haematuria; interferes w/ oogenesis & spermatogenesis, may cause sterility in both sexes; significant suppression of immune responses; rare instances of anaphylactic reactions.
May potentiate the reduction in blood sugar level w/ antidiabetic drugs. Increased bone marrow depression w/ allopurinol. Marked persistent inhibition of cholinesterase activity & potentiates the effect of succinyl choline Cl.
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