Idarubicin

Idarubicin hydrochloride is a DNA-interacalating analog of daunorubicin which has an inhibitory effect on nucleic acid synthesis and interacts with the enzyme topoisomerase II. It belongs to anthracylic antineoplastic group. Idarubicin is an anthracycline antineoplastic (anti-cancer) drug primarily used in the treatment of certain types of leukemia. It works by intercalating DNA strands, thereby inhibiting the enzyme topoisomerase II, which is crucial for DNA replication and repair. This leads to the interruption of cancer cell growth and division, eventually causing cell death.

Indications

Idarubicin is used for the treatment of: -Acute myeloid leukemia (AML) in adults. -Acute lymphoblastic leukemia (ALL), usually in combination with other chemotherapy drugs.

Dosage

-Adults (AML Induction Therapy): Idarubicin is administered intravenously. The typical dosage is 12 mg/m² once daily for 3 days in combination with cytarabine. -Adults (ALL Treatment): Dosage varies depending on specific protocols and combinations with other chemotherapeutic agents. Always follow specific treatment protocols and guidelines.

Contra-Indications

-Hypersensitivity to idarubicin or other anthracyclines. -Severe hepatic or renal impairment. -Patients with severe myocardial insufficiency, recent myocardial infarction, or severe arrhythmias. -Patients with persistent myelosuppression or uncontrolled infections.

Special Precautions

-Cardiac Monitoring: Patients should undergo regular cardiac monitoring (e.g., ECG, echocardiogram) due to the risk of cardiotoxicity. -Myelosuppression: Monitor blood counts regularly; idarubicin can cause significant bone marrow suppression leading to neutropenia, anemia, and thrombocytopenia. -Renal and Hepatic Function: Dose adjustments may be required in patients with impaired renal or hepatic function. -Extravasation Risk: Idarubicin is a vesicant; avoid extravasation as it can cause severe local tissue necrosis.

Side Effects

-Common: Nausea, vomiting, alopecia, myelosuppression (anemia, leukopenia, thrombocytopenia), mucositis. -Serious: Cardiotoxicity (arrhythmias, congestive heart failure), severe myelosuppression, secondary malignancies, hypersensitivity reactions.

Drug Interactions

-Other Chemotherapeutic Agents: Enhanced toxicity when used with other cytotoxic drugs. -Cardiotoxic Agents: Increased risk of cardiotoxicity when combined with other drugs that have cardiotoxic potential. -CYP3A4 Inhibitors/Inducers: May affect the metabolism of idarubicin, leading to altered drug efficacy and toxicity.