Streptozocin


Concise Prescribing Info
Indications/Uses
Metastatic islet cell carcinoma of the pancreas
Dosage/Direction for Use
Adult : IV 2 dosage regimens: Daily regimen: 500 mg/m2 for 5 consecutive days every 6 wk. Wkly regimen: Initial: Single dose of 1000 mg/m2 at wkly intervals for the first two wk, may escalate doses in subsequent cycles. Max single dose: 1500 mg/m2.
Dosage Details
Intravenous
Metastatic islet cell carcinoma of the pancreas
Adult: Consult individual protocols; administer as rapid IV inj or short/prolonged IV infusion. May be given according to 2 different dosage regimens. Daily regimen: 500 mg/m2 for 5 consecutive days every 6 wk; till max benefit or treatment-limiting toxicity occurs. Dose escalation is not recommended. Wkly regimen: Initial: Single dose of 1000 mg/m2 at wkly intervals for the first two wk. Subsequent doses may be escalated if patients have not achieved therapeutic response and have not experienced significant toxicity in previous course of treatment. Max single dose: 1500 mg/m2.
Renal Impairment
Dosage reduction may be required.
Reconstitution
Reconstitute powder with 9.5 mL of 5% dextrose or 0.9% sodium chloride inj to a concentration of 100 mg/mL. May be further diluted using the above vehicles if more dilute infusion solutions are desired. The use of glove is recommended when handling the powder and the solution.
Incompatibility
Compatibility: Stable in of 5% dextrose, 0.9% sodium chloride inj.
Special Precautions
Caution in patients with pre-existing renal disease. Renal toxicity is dose-related and cumulative and may be severe or fatal. Monitor serial urinalysis, BUN, plasma creatinine, serum electrolytes and creatinine clearance prior to, at least wkly during and for four weeks after Streptozocin administration. Reduce the dose or discontinue therapy if significant renal toxicity occurs. Avoid concomitant use of potential nephrotoxic agents. Myelosuppression and liver dysfunction have been reported in some patients; monitor for signs of haematologic and hepatic toxicity. Streptozocin is an antineoplastic agent of high emetic risk. Streptozocin may affect glucose tolerance; insulin shock with severe hypoglycaemia has occurred rarely. May cause confusion, lethargy, and depression; caution when driving and/or operating machinery. Extravasation leading to severe tissue lesions and necrosis may occur. Use precaution for handling and disposal of chemotherapy agents. Streptozocin is mutagenic; and has been observed to be tumorigenic and carcinogenic in some rodents. Use and efficacy in children has not been established. Caution in elderly. Nursing should be discontinued when receiving Streptozocin. Not recommended in pregnancy.
Adverse Reactions
Nausea, vomiting, diarrhoea, increased BUN, hypophosphatemia, proteinuria, renal tubular acidosis, renal dysfunction, elevated liver enzyme (SGOT and LDH) levels, hypoalbuminemia, glucose tolerance abnormalities, hypoglycaemia, diabetes insipidus, inj site reactions, lethargy, confusion, depression, myelosuppression, leukopenia, thrombocytopenia, and secondary malignancy.
IV/Parenteral: D
Overdosage
Specific antidote for Streptozocin is unknown.
Drug Interactions
Concurrent use of Streptozocin with other myelosuppressive nitrosourea antineoplastic agent (e.g. carmustine) may synergistically increase haematologic toxicity of both drugs. May prolong elimination half-life of doxorubicin, dosage of doxorubicin may need to be reduced in patients receiving concurrent Streptozocin. Concurrent use with other agents that decrease haematopoiesis may increase the risk of haematologic toxicity. May result in cumulative nephrotoxicity (severe or fatal) if used with other nephrotoxic drugs. Phenytoin may reduce cytotoxic effects of Streptozocin on pancreatic beta cells as suggested by limited data.
Action
Description: Streptozocin is an antineoplastic antibiotic produced by Streptomyces achromogenes, which is chemically similar to other nitrosourea antineoplastic agents. It has been shown to inhibit DNA synthesis in both bacterial and mammalian cells but the exact mechanism of its antineoplastic action has not been fully established. It is generally considered to be an alkylating agent which causes interstrand cross linking of DNA.
Pharmacokinetics:
Distribution: Rapidly cleared from the blood; concentrates in liver, intestine, pancreas, and kidney (following IV admin in animal studies). It does not cross the blood-brain barrier but its metabolites are readily distributed into CSF.
Metabolism: Extensively metabolised, maybe in the liver and kidney.
Excretion: Terminal half-life: About 35-40 min. Excreted mainly in urine (about 60-70% as metabolites, 10% as unchanged drug); faeces (<1%). Streptozocin and/or its metabolite may also be eliminated via expired air.
Storage
Unopened vials: Store under refrigeration at 2-8°C. Protect from light; preferably stored in carton. Reconstituted solution should be used within 12 hr; the vials are not intended for multiple-dose withdrawal.
Disclaimer: This information is independently developed by MIMS based on Streptozocin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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