Treosulfan.txt

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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 278.3

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : No data

%Excreted unchanged in urine &nbsp &nbsp : 22–30

Volume of distribution (L/kg) &nbsp &nbsp &nbsp : 44–88 litres

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp : 1.5–1.94

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Use a reduced dose

10 to 20 &nbsp &nbsp : Use a reduced dose

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Use a reduced dose

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Unknown dialysability. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Dialysed. Dose as in GFR <10 mL/min

HDF/high flux &nbsp : Dialysed. Dose as in GFR <10 mL/min

CAV/VVHD &nbsp &nbsp &nbsp: 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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