Chemocare.com
Care During Chemotherapy and Beyond

Dexrazoxane

(deks-ray-ZOKS-ane)

Trade name: Zinecard®

Dexrazoxane is the generic name for the trade name drug Zinecard. In some cases, health care professionals may use the trade name Zinecard when referring to the generic drug name dexrazoxane.

Drug type: Dexrazoxane is a drug used to reduce the undesired side effects of doxorubicin, a chemotherapy medication. This medication is classified as a "chemoprotectant agent." It can also be classified as an "extravasation antidote." (For more detail, see "How Dexrazoxane Works" below)

What Dexrazoxane Is Used For:

  • Dexrazoxane is used to reduce the incidence and severity of heart problems associated with the chemotherapy agent doxorubicin in women being treated for metastatic breast cancer.
    • It is only used for women who have received a high cumulative dose of doxorubicin and who would benefit from continued therapy.
    • It is not recommended for women who are just starting doxorubicin.
    • It has not been approved by the Food and Drug administration to be used in other disease states or to help reduce heart problems associated with other chemotherapy medications, however it is being studied in these populations.
  • Dexrazoxane can be used to treat tissue damage caused by some drugs if they leak from the vein while they are being given.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Dexrazoxane Is Given:

  • This medication is administered into a vein as a rapid drip infusion given over 15 minutes.
  • It is given just prior to doxorubicin. Doxorubicin should not be given before dexrazoxane.
  • The amount of dexrazoxane that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.
  • If using to treat tissue damage, dexrazoxane will be administered into a vein as an infusion over 1-2 hours. You will also receive at least two more doses of the medication administered on the two consecutive days.

Side Effects

Important things to remember about the side effects of dexrazoxane:

  • Most people will not experience all of the dexrazoxane side effects listed.
  • The side effects seen with dexrazoxane are often attributable to the other chemotherapy medications given in combination with dexrazoxane.
  • Dexrazoxane side effects are often predictable in terms of their onset, duration, and severity.
  • Dexrazoxane side effects will improve after therapy is complete.
  • Dexrazoxane side effects may be quite manageable. There are many options to minimize or prevent the side effects of dexrazoxane.

The following side effects are common (occurring in greater than 30%) for patients taking dexrazoxane:

Used for prevention of undesired side effects of doxorubicin

Used to treat tissue damage caused by anthracyclines

These are less common side effects (occurring in 10-29%) for patients receiving dexrazoxane:

Used for prevention of undesired side effects from doxorubicin

Used to treat tissue damage caused by athracyclines

Treatment with dexrazoxane doesn't completely eliminate the risk of doxorubicin related heart damage. A serious, but uncommon side effect of doxorubicin is a decrease in the heart's pumping capability. Your doctor will check your heart function (with an ECHO test) before you may take dexrazoxane and doxorubicin as well as monitor your heart closely during your treatment.

Another rare, yet serious risk that is associated with dexrazoxane therapy is the risk of developing a blood cancer such as leukemia. Talk to your doctor about this risk.

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° (38° C) or higher, chills (possible signs of infection)
  • Shortness of breath, wheezing, difficulty breathing, closing up of throat, swelling or facial features, hives (possible allergic reaction)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea (4-6 episodes in a 24 hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)
  • Mouth sores (painful redness, swelling or ulcers)

Always inform your health care provider if you experience any unusual symptoms.

Precautions

  • Before starting dexrazoxane treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin or products containing aspirin unless your doctor permits this.
  • Do not receive any kind of vaccination without your doctor's approval while taking dexrazoxane.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus). This drug must not be given to a pregnant woman of a woman who intends to become pregnant. If a woman becomes pregnant while taking dexrazoxane, the medication must be stopped immediately and the woman given appropriate counseling.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking dexrazoxane. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant after therapy.
  • Do not breast feed while taking dexrazoxane.

Self-Care Tips

  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Dexrazoxane

A baseline heart evaluation is recommended before starting treatment and continuous monitoring of your heart will occur during dexrazoxane therapy. You will be checked regularly by your health care professional while you are taking dexrazoxane, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidney and liver) will also be ordered by your doctor.

How Dexrazoxane Works

Chemoprotective agents are drugs that are used with certain types of chemotherapy to protect the body from or minimize the side effects of the chemotherapy. These medications do not eliminate side effects completely, but help protect the body from some of the potentially serious side effects. These drugs also have side effects of their own so they are used only with specific types of chemotherapy or when the benefit clearly is greater than the risk.

How dexrazoxane works is not fully understood. Dexrazoxane is given prior to receiving doxorubicin. Doxorubicin forms free radicals which can be harmful to your heart if you are exposed to high enough doses of doxorubicin, Dexrazoxane, a chemoprotectant, is thought to bind to the free radicals formed by doxorubicin limiting their harmful effects and protecting your heart.

When dexrazoxane is used to treat tissue damage caused by some chemotherapy drugs if they leak from the vein while they are being given, it is referred to as an extravasation antidote. This means that the drug will bind to the chemotherapy drug that leaked from the vein preventing it from causing any damage to the surrounding tissue.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Reference: Dexrazoxane. Lexi-Comp Online® [13 April 2017]. Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc.; 13 April 2017.

Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org