CLINICAL USE

Antineoplastic agent:Glioblastoma multiforme Malignant glioma

DOSE IN NORMAL RENAL FUNCTION

75 mg/m 2 daily for 42 days with radiotherapyAdjuvant phase/monotherapy: 150– 200 mg/m2 once daily for 5 daysOr according to local policy

PHARMACOKINETICS

  • Molecular weight                           :194.2
  • %Protein binding                           :
  • 10 to 20     :
  • %Excreted unchanged in urine     : 5–10
  • Volume of distribution (L/kg)       :0.3–0.5 (IV) (15–18 L/m2 oral)
  • half-life – normal/ESRD (hrs)      :1.8/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function. Use with caution

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min
  • HD                     :Unknown dialysability. 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 normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Antipsychotics: avoid concomitant use with clozapine, increased risk of agranulocytosis

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    Do not administer with food

    OTHER INFORMATION

    Nadir for white cell count usually occurs 21–28 days after a dose, with recovery within 1–2 weeksRapidly and completely absorbed with 100% bioavailability and has extensive tissue distributionMajor route of elimination is renal: approximately 5–10% is excreted unchanged and the remainder excreted as metabolites.

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