Amsacrine

CLINICAL USE

Antineoplastic agent: Acute leukaemias

DOSE IN NORMAL RENAL FUNCTION

Induction of remission: 90–120 mg/m 2 daily for 5–8 days, repeated at 2–4 week intervals according to response

Maintenance: 150 mg/m 2 as a single dose or divided over 3 consecutive days every 3–4 weeks

Or according to local policy

PHARMACOKINETICS

Molecular weight : 393.5

%Protein binding : 96–98

%Excreted unchanged in urine : 2–10

Volume of distribution (L/kg) : 1.67

half-life – normal/ESRD (hrs) : 5–8/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : 60–75 mg/m2 daily

10 to 20 : 60–75 mg/m2 daily

<10 : 60–75 mg/m2 daily

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD : Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux : Unlikely to be 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

–

Route

Rate of Administration

60–90 minutes

Comments

Dilute in 500 mL of glucose 5% Use glass syringes Incompatible with sodium chloride

OTHER INFORMATION

Increased risk of side effects in renal impairment

Amsacrine is extensively metabolised in the liver. The principal metabolites, via microsomal oxidation, are much more cytotoxic than the parent drug. Excretion is via the bile; >50% excreted in faeces within 2 hours; 35% in urine

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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