Utilización de dexrazoxano como antidoto para el tratamiento de la extravasación de antraciclinas en población pediátrica

Abstract

Anthracycline extravasation is characterized for producing intense and lasting tissular pain, including tissue necrosis. Dexrazoxane is the only approved treatment by the European Medicines Agency (EMA) for anthracycline extravasation. Currently there exist two commercial presentations in Spain with this same active principle, but with a significant price difference. Cardioxane® is for the prevention of anthracycline-induced cardiotoxicity, and Savene® for the treatment of its extravasation. In a case of extravasation with doxorubicin in a pediatric patient, we evaluated the possibility of using Cardioxane® as the extravasation antidote. We concluded that Cardioxane® could not be used for anthracycline extravasation. Savene® should be used instead because of a higher pH, once reconstituted and diluted, which allows for its peripheral administration. Cardioxane® has an acid pH, which requires it to be administered by central pathway. It is also required to be under general anesthesia, thus making it incompatible with an emergency administration