Dexrazoxane (Zinecard®, Totect®)
Pronounce: dex-ray-ZOX-ane
Classification: Cytoprotective agent
About Dexrazoxane (Zinecard®, Totect®)
This medication works to protect your heart from the harmful effects of certain types of chemotherapy. This medication is a potent "intracellular chelating agent," meaning that it inactivates certain metal ions in the body such as harmful free radicals. The way dexrazoxane works to protect the heart is not fully understood.
This medication can also be used to lessen damage to tissues if a certain type of chemotherapy medication (anthracycline) leaks out of the vein (extravasation) while it is being administered.
How to Take This Medication
When dexrazoxane injection is used to prevent heart damage caused by doxorubicin, it is given just before each dose of doxorubicin, by intravenous (IV, into a vein) infusion. When used to prevent tissue damage after extravasation, it is given once a day for 3 days, beginning no more than 6 hours after the leakage. When using this medication, you might experience burning at the injection site. If this happens, talk to your provider.
Possible Side Effects
This medication was studied in conjunction with chemotherapy medications, making it difficult to determine if the side effects are truly caused by the dexrazoxane. These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.
Low White Blood Cell Count (Leukopenia or Neutropenia)
White blood cells (WBC) help your body fight infection. While you are having treatment for cancer, your WBC count can drop, putting you at a higher risk of an infection. Tell your provider right away if you have a fever (temperature greater than 100.4°F or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
Tips for preventing infection:
- Hand washing: both yours and your visitors is the best way to prevent the spread of infection.
- Avoid large crowds and people who are sick (those who have a cold, fever, or cough, or live with someone with these symptoms).
- When working outside, wear clothes that protect you, like long pants and gloves.
- Do not handle pet waste.
- Keep all cuts and scratches clean.
- Shower or bathe daily.
- Brush your teeth at least twice a day.
- Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
- Ask your providers before scheduling dental appointments or procedures.
- Ask your providers before you or someone you live with has any vaccines.
Low Red Blood Cell Count (Anemia)
Anemia is when your red blood cell count is lower than normal. Red blood cells carry oxygen to the tissues in your body. When your red cell count is low, you may feel tired or weak. Tell your providers if you have shortness of breath, trouble breathing, or pain in your chest. If your count gets too low, you may receive a blood transfusion.
Low Platelet Count (Thrombocytopenia)
Platelets are blood cells that help your blood clot. Thrombocytopenia is when your platelet count is lower than normal, and you are at a higher risk of bleeding. Tell your providers if you have any bruising or bleeding, including nose bleeds, bleeding gums, or blood in your urine or stool. If your count gets too low, you may receive platelets from a donor.
- Do not use a razor (an electric razor is fine).
- Do not do activities that can cause injury or bleeding.
- Talk to your provider before taking any non-steroidal, anti-inflammatory medications (NSAIDs) like Motrin/Advil (ibuprofen), Aleve (naproxen), Celebrex (celecoxib), and others. These can raise the risk of bleeding.
- Use a soft-bristle toothbrush to brush your teeth. Ask your provider about flossing or using toothpicks.
Liver Toxicity
This medication can cause liver toxicity, or liver problems, which your provider may monitor for with blood tests called liver function tests. Symptoms may be:
- Yellowing of your skin or eyes.
- Dark or brown urine.
- Pain in your abdomen (belly).
Tell your provider if you have any of these symptoms.
Reproductive Concerns
There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. Talk with your provider about what kind of birth control is safest for you and your partner. Talk to your provider before breastfeeding while receiving this medication.