Brand and Other Names:Idamycin
- Classes: Antineoplastics, Antibiotic
Dosing & Uses
Dosage Forms & Strengths
Acute Myeloid Leukemia
Consolidation: 10-12 mg/m²/day IV for 2 days
- CrCl < 50 mL/min: 75% of dose
- Peritoneal dialysis: 75% of dose
- Hemodialysis: 75% of dose
- Renal replacement therapy: 75% of dose
- CrCl 10-50 mL/min: 75% of dose
- CrCl <10 mL/min: 50% of dose
- Hemodialysis: Supplemental dose not necessary
- Peritoneal dialysis: Supplemental dose not necessary
Bilirubin 2.6-5 mg/dL: 50% of dose
Bilirubin >5 mg/dL: Avoid use
CBC, LFTs, cardiac & renal function
Mucositis Development: Discontinue if severe mucositis after 1st course, after resolution continue w/ 25% dose reduction
Dosage Forms & Strengths
Acute Myeloid Leukemia
10-12 mg/m² IV qDay for 3 days q3weeks
Acute Lymphoblastic Leukemia (Orphan)
Treatment of acute lymphoblastic leukemia in pediatric patients.
Orphan indication sponsor
- Pharmacia & Upjohn; 7000 Portage Road, Unit 0633-298-113; Kalamazoo, MI 49001-0199
Serious - Use Alternative
Significant - Monitor Closely
Elevated bilirubin and transaminases (20-30%)
Myelosuppression: > 10%
Peripheral neuropathy (8%)
Frequency Not Defined
Inflammatory disease of mucous membrane
Red discoloration of urine
Black Box Warnings
The drug should be administered under the supervision of a cancer chemotherapy physician experienced in acute leukemia treatment in a facility with appropriate equipment to monitor patients compromised by drug toxicity. Severe hemorrhagic conditions or overwhelming infection resulting from the therapy should also be able to be treated at the facility.
Only administer intravenously into a freely flowing IV infusion. Do not administer intramuscularly or subcutaneously. Severe local tissue damage can occur with extravasation.
Myocardial toxicity leading to CHF may occur. Toxicity is more common with prior anthracycline use or preexisting cardiac disease.
Myelosuppression can be severe at therapeutic doses
Reduce dose in renal or hepatic impairment
Serum bilirubin >5 mg/dL [>85.5 umol/L]
Risk of myocardiac toxicity leading to potentially fatal CHF
Prior radiation treatment to mediastinal-pericardial area & prior anthracyclines increases cardiotoxic risk
Cumulative doses >150 mg/m² associated with decreased ejection fraction
Possibility of injection site reactions
Pregnancy & Lactation
Pregnancy Category: D
Lactation: not known if excreted in breast milk; do not nurse
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Anthracycline; intercalates between DNA base pairs, inhibits topoisomerase II, which in turn inhibits DNA and RNA synthesis
Half-Life: 14-35 hr (PO); 12-27 hr (IV)
Protein Bound: 94-97%
Vd: 64 L/kg
Peak plasma time: 1-5 hr
Clearance: 122.8 L/hr
Excretion: Urine (5-13%)
Y-site: acyclovir, allopurinol, ampicillin/sulbactam, cefazolin, cefepime, ceftazidime, clindamycin, dexamethasone Na-phosphate, etoposide, fluorouracil, furosemide, gentamicin, heparin, hydrocortisone Na-succinate, lorazepam, meperidine, methotrexate, piperacillin/tazobactam, Na-bicarb, teniposide, vancomycin, vincristine
Solution: with most common diluents
Y-site (partial list): cimetidine, diphenhydramine, etoposide PO4, granisetron, MgSO4, metoclopramide, KCl
Vials: reconstitute with NS to a concentration of 1 mg/mL
- IV push: dose/syringe (concentration is 1 mg/mL); maximum syringe size for IVP is 30 mL syringe & syringe should be <75% full
- IVPB: dose/100 mL D5W or NS
Administer by intermittent infusion over 10-15 min
Administer into a free flowing IV solution of NS or D5W
Local erythematous streaking along the vein may indicate rapid administration
Topical cooling may be achieved using ice packs or cooling pad with circulating ice water
Cooling of site for 25 hr as tolerated by pt.
Elevate & rest extremity 24-48 hr, then resume normal activity as tolerated
Cold inhibits vesicant's cytotoxicity
Heat can be harmful & is contraindicated
If pain, erythema, &/or swelling persist beyond 48 hr, refer pt immediately to plastic surgeon for consultation & possible debridement
See also Totect
Store intact vials of lyophilized powder at room temp
Protect from light
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Select a box to add or remove a plan.
Select a class to view formulary status for similar drugs