Initial treatment: Generally by IV inj, daily 3-6 mg/kg body wt (120-240 mg/m2) or massive-intermittent therapy: 10-15 mg/kg body wt (400-600 mg/m2) w/ therapy-free intervals of 2 or 5 days or 20-40 mg/kg body wt (800-1600 mg/m2), w/ therapy-free intervals of 10-20 days. Maintenance: 50-200 mg/day orally.
Patients of reproductive age should use contraceptives throughout therapy & for not <6 mth afterwards. DM; elderly & debilitated patients; renal & hepatic failure.
GI upsets; alopecia; reticulo-endothelial system depression; hematuria; reversible amenorrhea & azoospermia; myocardial damage w/ very high doses; pigmentation, macrocytosis, water retention; induction of hyperglycemia or hypoglycemia; risk of secondary malignancies.
Drug Interactions
May potentiate hypoglycemic effect of sulfonylureas. Allopurinol (increased incidence of bone marrow depression). Suxamethonium (prolongation of apnoea).
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