AML in adults for remission induction in untreated patients or in relapsed or refractory patients. 1st-line treatment of AML in childn in combination w/ cytarabine for remission induction. 2nd-line treatment of relapsed acute lymphoblastic leukemia (ALL) in adults & childn.
IVAdultAML 12 mg/m2 daily for 3 days in combination w/ cytarabine or 8 mg/m2 daily for 5 days w/ or w/o combination. ALL 12 mg/m2 daily for 3 days as single agent. ChildnAML 10-12 mg/m2 daily for 3 days in combination w/ cytarabine. ALL 10 mg/m2 daily for 3 days as single agent. Patient who develop severe mucositis Delay administration of 2nd course until recovery & dose reduction of 25% is recommended.
View Zavedos overdosage for action to be taken in the event of an overdose.
Contraindications
Hypersensitivity to idarubicin HCl, other anthracyclines or anthracenediones. Uncontrolled infections. Severe cardiomyopathy. Recent MI. Severe arrhythmias. Persistent myelosuppression. Previous treatment w/ max cumulative doses of idarubicin HCl &/or other anthracyclines & anthracenediones. Severe hepatic & renal impairment. Discontinue breast-feeding during therapy.
Discontinue use should signs or symptoms of extravasation occur. Not for intrathecal use. Secondary leukemia w/ or w/o a preleukemic phase. Cardiotoxicity that may be manifested by early (ie, acute) or late (ie, delayed) events. Mucositis early after administration which, if severe, may progress over a few days to mucosal ulcerations. Potential phlebosclerosis from inj into a small vessel or previous inj into the same vein. Tumor lysis syndrome. Thrombophlebitis & thromboembolic phenomena including pulmonary embolism. May cause red coloration of urine for 1-2 days after administration. Assess hematological profiles prior to & during each cycle of therapy including differential WBC counts. Avoid vaccination w/ live vaccine during treatment. Response to concomitant killed or inactivated vaccines may be diminished. Not to be taken by patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Evaluate liver & kidney function w/ conventional clinical lab tests (using serum bilirubin & creatinine as indicators) prior to & during treatment. Males should use effective contraception during & for at least 3.5 mth after treatment. Possibility of irreversible infertility on men. Women of childbearing potential should adopt adequate contraception during therapy. Pregnancy. Infants & childn.
May induce additive myelosuppressive effects in combination chemotherapy regimens including other agents w/ similar action. Monitor cardiac function throughout treatment in combination chemotherapy w/ other potentially cardiotoxic drugs & cardioactive compd eg, Ca channel blockers. Potential additive myelosuppressant effect w/ RT when given concomitantly or w/in 2-3 wks prior to treatment. Risk of possibly fatal systemic disease w/ live attenuated vaccines eg, yellow fever. Increased frequency of INR w/ oral anticoagulants. Increased AUC w/ cyclosporin A.
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