CLINICAL USE

Alkylating agent for ovarian cancer

DOSE IN NORMAL RENAL FUNCTION

IV: 3–8 g/m 2 every 1–3 weeks; doses >3 g/ m2 should be given as an infusion Doses up to 1.5 g/m 2 have been given IP Oral: 1 g daily in 4 divided doses for 2–4 weeks or 1.5 g daily in 3 divided doses for 1 week Or according to local protocol

PHARMACOKINETICS

  • Molecular weight                           : 278.3
  • %Protein binding                           : No data
  • %Excreted unchanged in urine     : 22–30
  • Volume of distribution (L/kg)       : 44–88 litres
  • half-life – normal/ESRD (hrs)      : 1.5–1.94

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Use a reduced dose
  • 10 to 20     : Use a reduced dose
  • <10           : Use a reduced dose

    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      : Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • None known

    ADMINISTRATION

    Reconstition

    20 or 100 mL water for injection for 1 g and 5 g vials respectively

    Route

    Oral, IV, IP

    Rate of Administration

    3 g/m 2 over 5–10 minutes (8 g/m2 over 30 minutes)

    Comments

    Powder reconstitutes easier if water heated to 25–30°C

    OTHER INFORMATION

    Treosulfan is a prodrug of a bifunctional alkylating agent; high and relatively constant bioavailability. Mean urinary excretion of the parent compound is ~15% over 24 hrs Haemorrhagic cystitis has occurred after intravesical or intravenous administration .

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