IM, bladder and intracavitary instillations: 60 mg in single or divided doses Intrathecal: maximum 10 mg Other doses depend on indication or local protocol
20 to 50     : IM: Use a reduced dose with caution
10 to 20     : IM: Use a reduced dose with caution
<10           : IM: Use a reduced dose with caution
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                : Unknown dialysability. Dose as in GFR <10 mL/min
HD                     : Dialysed. Dose as in GFR
<10           : mL/ min
HDF/high flux   : Dialysed. Dose as in GFR
<10           : mL/ min
CAV/VVHD      : Dialysed. Dose as in GFR=10– 20 mL/min
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Antipsychotics: avoid concomitant use with clozapine Avoid concomitant use with other myelosuppressive agents
ADMINISTRATION
Reconstition
1.5 mL water for injection
Route
IV, IM, intrathecal (can be administered directly into pleural, pericardial or peritoneal cavities and as a bladder instillation)
Rate of Administration
–
Comments
–
OTHER INFORMATION
Haemorrhagic cystitis has occurred Metabolised in liver to triethylene phosphoramide (TEPA). Only traces of unchanged thiotepa and (TEPA) are excreted in the urine, together with a large proportion of metabolites (60% within 72 hours) .