Totect

Resources

Guidelines support the use of TOTECT® (dexrazoxane) for injection

The MASCC Textbook of Cancer Supportive Care and Survivorship1
  • It is recommended that this treatment [TOTECT and Savene*] is available in every institution in which anthracyclines are administered.
  • Healthcare providers need to be well informed of current extravasation management recommendations and guidelines in order to most effectively treat patients receiving vesicant chemotherapy.
*The non-US equivalent of TOTECT
Infusion Nurses Society2
  • Daily intravenous (IV) infusion of dexrazoxane [TOTECT] over 3 days is the recommended antidote for anthracycline extravasation.
Oncology Nursing Society – Chemotherapy and Biotherapy Guidelines3
  • Vesicant Extravasation Management Guidelines – Dexrazoxane [TOTECT] is listed as the antidote for anthracyclines.
References:
1. Schulmeister L. Extravasation. In: Olver I (ed) The MASCC Textbook of Cancer Supportive Care and Survivorship, Springer, Berlin; 2011: 351-359. 2. Infusion Nurses Society 2016 Standards Infilitrations and Extravasations. 3. Schulmeister L. Safe Management of Chemotherapy: Infusion-Related Complications. Clin Journal of Oncol Nurs 2014;18(3):283-287.

INDICATION: TOTECT® (dexrazoxane) is indicated for the treatment of extravasation resulting from intravenous anthracycline chemotherapy.

IMPORTANT DOSAGE AND ADMINISTRATION INSTRUCTIONS
Vial contents must be mixed and diluted with 50 mL of 0.167 M sodium lactate injection solution before use. The TOTECT dose should be reduced by 50% in patients with creatinine clearance
values < 40 mL/min.

IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS

None.

WARNINGS AND PRECAUTIONS
Myelosuppression: TOTECT is associated with leukopenia, neutropenia, and thrombocytopenia. Perform hematological monitoring.
Use in Pregnancy: Fetal harm can occur when administered to a pregnant woman. Apprise women of potential harm to the fetus.

ADVERSE REACTIONS
In the clinical studies, TOTECT was administered to patients also receiving chemotherapeutic agents for cancer, and the adverse reaction profile reflects the combination of TOTECT, underlying disease, and already administered chemotherapy. The most common adverse reactions (≥16%) are nausea, fever, injection site pain and vomiting.

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