Drug Examples of

Usual Doses
Toxicity Interactions, Issues
Direct DNA-Interacting Agents
Alkylators
Cyclophosphamide 4002000 mg/m
2

IV
100 mg/m
2
PO qd
Marrow (relatie
platelet spari!g"
Cystitis
Commo! al#ylator
a
Cardiac (high dose"
$ier meta%olism req&ired to
actiate to phosphoramide
m&stard ' acrolei!
Mes!a protects agai!st (high)
dose( %ladder damage
Mechlorethami!e * mg/m
2
IV day 1
a!d day +

Marrow
Vesica!t
,a&sea
-opical &se i! c&ta!eo&s
lymphoma
Chloram%&cil 1. mg/m
2
qd PO

Marrow
Commo! al#ylator
a

Melphala! + mg/m
2
qd / 01
PO

Marrow (delayed
!adir"
2I (high dose"
3ecreased re!al 4&!ctio!
delays cleara!ce
Carm&sti!e (5C,6" 200 mg/m
2
IV
100 mg/m
2
PO
Marrow (delayed
!adir"
2I1 lier (high
dose"
7e!al

$om&sti!e (CC,6" 100.00 mg/m
2

PO

Marrow (delayed
!adir"

I4os4amide 182 g/m
2
per day
qd / 0 ' mes!a

Myelos&ppressie
5ladder
,e&rologic
Meta%olic acidosis
,e&ropathy
Isomeric a!alog&e o4
cyclophosphamide
More lipid sol&%le
2reater actiity s testic&lar
!eoplasms a!d sarcomas
M&st &se mes!a
Drug Examples of
Usual Doses
Toxicity Interactions, Issues
Procar%a9i!e 100 mg/m
2
per
day qd /14

Marrow
,a&sea
,e&rologic
Commo! al#ylator
a
$ier a!d tiss&e meta%olism
req&ired
3is&l4ira!)li#e e44ect with
etha!ol
:cts as M:OI
;5P a4ter tyrosi!ase)rich
4oods
3acar%a9i!e (3-IC" .<0 mg/m
2
IV day
1 a!d day 10

Marrow
,a&sea
=l&li#e
Meta%olic actiatio!
-emo9olomide 100200 mg/m
2

qd / 0 q2+d or <0
mg/m
2
qd / *<
wee#s

,a&sea/omiti!g
;eadache/4atig&e
Co!stipatio!
I!4req&e!t myelos&ppressio!
:ltretami!e (4ormerly
he/amethylmelami!e"
2*0 mg/m
2
per
day qd /1421 as
4 diided oral
doses

,a&sea
,e&rologic (mood
swi!g"
,e&ropathy
Marrow (less"
$ier actiatio!
5ar%it&rates
e!ha!ce/cimetidi!e dimi!ishes
Cisplati! 20 mg/m
2
qd /0
IV 1 q.4 wee#s
or 100200
mg/m
2
per dose
IV q.4 wee#s

,a&sea
,e&ropathy
:&ditory
Marrow platelets >
?5Cs
7e!al Mg
2'
1 Ca
2'
Mai!tai! high &ri!e 4low@
osmotic di&resis1 mo!itor
i!ta#e/o&tp&t A
'
1 Mg
2'
Bmetoge!icCprophyla/is
!eeded
=&ll dose i4 CrCl > *0 m$/mi!
a!d tolerate 4l&id p&sh
Car%oplati! .*0 mg/m
2
IV
q.4 wee#s as
adD&sted 4or CrCl

Marrow platelets >
?5Cs
7ed&ce dose accordi!g to
CrClE to :6C o4 0< mg/m$
per mi! F:6C G dose/(CrCl '
20"H
Drug Examples of
Usual Doses
Toxicity Interactions, Issues
,a&sea
7e!al (high dose"
O/aliplati! 1.0 mg/m
2
q.
wee#s oer 2 h or
+0 mg/m
2
q2
wee#s

,a&sea
:!emia
:c&te reersi%le
!e&roto/icity@ chro!ic se!sory
!e&roto/ c&m&latie with
dose@ reersi%le
lary!gophary!geal spasm