IV inj After satisfactory remission has occurred, maintenance w/ tab is recommended. Initially 3-6 mg/kg daily, or massive-intermittent therapy w/ 10-15 mg/kg, w/ therapy-free interval of 2-5 days, or massive-intermittent therapy w/ 20-40 mg/kg, w/ therapy-free interval of 21-28 days.
Contraindications
Severely impaired bone marrow function (particular in patients pre-treated w/ cytotoxic agents &/or radiotherapy); inflammation of bladder (cystitis), urinary outflow obstructions, active infections. Pregnancy & lactation.
Special Precautions
Patients of reproductive age should use contraceptives throughout therapy & for not <6 mth afterwards. DM. Renal & hepatic failure. Elderly & debilitated patients.
Adverse Reactions
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.
May potentiate hypoglycemic effects of sulfonylureas. Allopurinol (increased incidence of bone marrow depression). Suxamethonium (prolongation of apnoea).
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