From Standard of Care
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Dosage modified according to formulas for glomerular filtration rates.
Can produce a wide spectrum of hypersensitivity reactions including erythroderma, tachycardia, chest tightness and wheezing, facial swelling, shortness of breath, hypotension and hypertension.
Causes hypersensitivity reactions usually after multiple courses of treatment and with a increased total dose.
More then 5 cycles of chemotherapy and/or more than 2500-7200 mg the drug administration significantly increases the incidence of hypersensitivity reactions.
Hypersensitivity reactions usually occur within the first 5-10 minutes of intravenous infusion.
Hypersensitivity reactions occur in 1% of patients receiving fewer than 5 courses of treatment, and up to 27% of patients receiving more than 7 treatments (Zanotti KM et al).
Skin tests for sensitivity is suggestive for patients after the sixth course of treatment.
Patients should be pretreated with corticosteroids and H1 and H2 antihistamines.