• Cytoprotective and supportive care agents

Totect Generic Name & Formulations

General Description

Dexrazoxane 500mg; per vial; lyophilized pwd for IV infusion after reconstitution and dilution; preservative-free.

Pharmacological Class

Cytoprotective agent.

How Supplied

Single-dose vial—1


Totect Indications


To treat extravasation resulting from IV anthracycline chemotherapy. To reduce incidence and severity of cardiomyopathy associated with doxorubicin administration in women with metastatic breast cancer who have received a cumulative doxorubicin dose of 300mg/m2 and will continue to receive doxorubicin therapy to maintain tumor control.

Totect Dosage and Administration


Extravasation: give once daily for 3 consecutive days by IV infusion over 1–2hrs. Initiate 1st dose as soon as possible and within 1st 6hrs after extravasation. Days 1 and 2: 1000mg/m2; max 2000mg. Day 3: 500mg/m2; max 1000mg. Cardiomyopathy: give by IV infusion over 15mins. Initiate prior to and until discontinuation of doxorubicin. Dose ratio: 10:1 (eg, Totect 500mg/m2 to doxorubicin 50mg/m2). May administer doxorubicin within 30mins after completing Totect infusion. Renal impairment (CrCl <40mL/min): reduce dose by 50%. Hepatic impairment (extravasation): not recommended; (cardiomyopathy): reduce Totect dose proportionately to doxorubicin (maintaining 10:1 ratio).


Not established.

Totect Contraindications

Not Applicable

Totect Boxed Warnings

Not Applicable

Totect Warnings/Precautions


Myelosuppression. Obtain CBCs prior to each course of therapy (for cardiomyopathy). Monitor cardiac function prior to and during therapy (eg, LVEF). Renal impairment: monitor for hematological toxicity. Hepatic impairment (see Adult dose). Elderly. Embryo-fetal toxicity. Use effective contraception during treatment and for 6 months (females of reproductive potential) or 3 months (males w. female partners) after the last dose. Pregnancy: exclude status prior to chemotherapy initiation. Nursing mothers: not recommended (during and for 2 weeks after the last dose).

Totect Pharmacokinetics

See Literature

Totect Interactions


Avoid with chemotherapy initiation; may interfere with antitumor activity of the chemo regimen. Increased risk of secondary malignancies concomitant with chemotherapy. Extravasation: concomitant topical dimethylsulfoxide (DMSO); not recommended.

Totect Adverse Reactions

Adverse Reactions

Inj site pain/discomfort, nausea, vomiting, pyrexia, post-op infection; leukopenia, neutropenia, thrombocytopenia, lab abnormalities, cardiac toxicity, hypersensitivity reactions (if severe, consider permanent discontinuation).

Totect Clinical Trials

See Literature

Totect Note

Not Applicable

Totect Patient Counseling

See Literature