Dexrazoxaan

Dexrazoxane is a medication used in oncology to reduce certain chemotherapy-related toxicities. It is marketed under several brand names, including Zinecard for cardioprotection and Totect or Savene for the treatment of extravasation injuries from anthracycline chemotherapy. It is administered intravenously and is typically used in specific situations rather than as a general sleepable remedy.

The drug acts primarily as an intracellular iron chelator. By binding iron, it helps limit the formation of free radicals that can contribute to damage of cardiac tissue during anthracycline therapy. Dexrazoxane is considered a prodrug that is converted inside cells to an active chelating form. This mechanism underpins its use to protect the heart from anthracycline-induced cardiotoxicity and its role in managing tissue injury from accidental leakage of anthracyclines into surrounding tissues.

Indications include prevention or reduction of cardiomyopathy in patients receiving anthracyclines such as doxorubicin, especially at higher cumulative doses, and treatment of extravasation injuries caused by these drugs. Dosing and scheduling depend on the indication and patient factors and are determined by the treating clinician. For extravasation, the regimen is administered promptly after injury, often following a multi-day intravenous course; for cardioprotection, dexrazoxane is given in relation to the anthracycline infusion.

Common adverse effects include bone marrow suppression, fever, injection-site reactions, nausea, and fatigue. It can interact with other myelosuppressive therapies and should be used with caution in pregnancy and renal impairment. Dexrazoxane is a specialized agent with targeted indications and is not a substitute for standard cancer chemotherapy regimens.