Treosulfan
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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