Pentostatin

CLINICAL USE

Antineoplastic agent used in hairy cell leukaemia

DOSE IN NORMAL RENAL FUNCTION

4 mg/m2 every other week

PHARMACOKINETICS

Molecular weight :268.3

%Protein binding :4

%Excreted unchanged in urine : 50–96

Volume of distribution (L/kg) :36.1 litres

half-life – normal/ESRD (hrs) :2.6–10/18

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

50–60 50% of dose. See ‘Other Information’10–50 See ‘Other Information’

<10 : See ‘Other Information’

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 :Likely dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR=10–50 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antipsychotics: avoid concomitant use with clozapine (increased risk of agranulocytosis)Cytotoxics: increased risk of toxicity with high-dose cyclophosphamide – avoid concomitant use; increased pulmonary toxicity with fludarabine (unacceptably high incidence of fatalities)

ADMINISTRATION

Reconstition

5 mL water for injections

Route

IV bolus or infusion

Rate of Administration

20–30 minutes

Comments

Add to 25–50 mL glucose 5% or sodium chloride 0.9% (final concentration 180–330 mcg/mL)

OTHER INFORMATION

Only a small amount is metabolised. It is primarily excreted unchanged by the kidneys (30–90% excreted by kidneys within 24 hours)Patients with CKD are at a greater risk of toxicity with pentostatin

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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