Initial treatment Daily IV inj of 3-6 mg/kg (120-240 mg/m2) or 10-15 mg/kg (400-600 mg/m2) w/ therapy-free intervals of 2-5 days; or 20-40 mg/kg body wt w/ therapy-free intervals of 10-20 days. Maintenance 50-200 mg/day orally.
Administration
Should be taken on an empty stomach: Best taken on an empty stomach. May be taken w/ meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole.
Contraindications
Severe bone marrow suppression, severe impairment of renal function, lower urinary outflow obstruction, acute infection. Pregnancy.
Special Precautions
Patients of reproductive age should use contraceptives throughout therapy & for not <6 mth afterwards. DM. Renal & hepatic failure. Elderly & debilitated patients.
Adverse Reactions
GI upsets; alopecia; reticulo-endothelial system depression; hematuria; reversible amenorrhea & azoospermia; myocardial damage w/ very high doses; pigmentation, macrocytosis, water retention; induction of hyperglycemia or hypoglycemia; risk of secondary malignancies.
May potentiate hypoglycemic effect of sulfonylureas. Allopurinol (increased incidence of bone marrow depression). Suxamethonium (prolongation of apnoea).
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