Dexrazoxane
Pronunciation: (dex-RAZ-oh-zane).
- Generic name
- dexrazoxane
- Brand names
- Dexocard, Cardioxane, Savene, Zinecard, Totect, Dexrazox
- Drug class
- Cardioprotective agent; antidote for anthracycline extravasation
Availability and supply rules vary by country
Trade names by country: Canada
Australia: · Full directory
What dexrazoxane is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how dexrazoxane works
Dexrazoxane is a bisdioxopiperazine derivative that acts as an intracellular iron-chelating agent, inhibiting the formation of iron-mediated free radicals; this reduces anthracycline-induced oxidative damage to cardiac myocytes and, in extravasation, limits tissue injury via similar free-radical-related mechanisms. This mechanism-of-action detail is retained from the clinician-authored database record; the reviewed FDA label was used primarily for dosing/safety facts, not mechanism narrative. (2)
What dexrazoxane is used for
Reducing the incidence and severity of cardiomyopathy associated with doxorubicin
In women with metastatic breast cancer who have received a cumulative doxorubicin dose of 300 mg/m² and will continue doxorubicin therapy. (1)
Treatment of extravasation from IV anthracycline chemotherapy
Accidental leakage of anthracycline chemotherapy into the tissue around the injection site. (1)
Before taking dexrazoxane
Do not take / not appropriate for
- Do not use dexrazoxane with chemotherapy regimens that do not contain an anthracycline. This is the only absolute contraindication in the US prescribing information. (all countries)
- Do not breastfeed during dexrazoxane treatment or for 2 weeks after the final dose, because of the potential for serious adverse reactions in a breastfed child. There are no data on dexrazoxane in human milk. (United States)
- Dexrazoxane can cause fetal harm, so it should not be used during pregnancy unless your treatment team judges the benefit to outweigh the risk. Females of reproductive potential should use effective contraception during treatment and for 6 months after the final dose. (United States)
Tell your clinician about
- Whether you are, could be, or are planning to become pregnant, and whether you are breastfeeding.
- Any existing problems with your blood counts, since dexrazoxane adds to the myelosuppression caused by chemotherapy.
- Any kidney or liver problems.
- All other medicines, supplements, and topical products you use — including topical dimethyl sulfoxide (DMSO), which is not recommended alongside dexrazoxane for extravasation.
How to take dexrazoxane
- Dexrazoxane is given only by intravenous infusion by a healthcare professional in a hospital or clinic setting — patients do not administer it themselves. For cardioprotection: infused over 15 minutes, with doxorubicin given within 30 minutes after the infusion completes. For extravasation: infused over 1 to 2 hours once daily for 3 consecutive days, started within 6 hours of the extravasation event. If severe allergic reactions or intolerable side effects occur, your treatment team will assess whether to continue or stop.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
This medicine is scheduled and administered by your treatment team as part of a clinic or hospital visit. If you are unable to attend a scheduled dose, contact your healthcare provider to reschedule — do not attempt to self-administer or adjust the schedule.
Overdose
Overdose with dexrazoxane can lead to signs of bone marrow failure. There is no known antidote; management is supportive care (including treatment of infections, fluid regulation, and nutritional support) under close clinical supervision. Since this medicine is always administered by a healthcare professional, self-overdose is not applicable in the usual sense. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional. Because dexrazoxane is given alongside chemotherapy, some effects may reflect the combined regimen rather than dexrazoxane alone.
Nausea and vomiting
Incidence: Most common adverse reaction in extravasation use (≥15%)
Fever (pyrexia)
Incidence: Most common adverse reaction in extravasation use (≥15%)
Injection site pain
Incidence: Most common adverse reaction in both extravasation and cardioprotection use
Fatigue, alopecia (hair loss), stomatitis (mouth sores) (DB-sourced, not independently confirmed as dexrazoxane-specific in this pass — may reflect concurrent chemotherapy)
Incidence: Reported in the clinician-authored database; frequency not established
Warning signs requiring prompt medical contact
What to notice: Unusual bruising or bleeding; fever or signs of infection; shortness of breath or chest pain; swelling of the hands, feet, or face; severe pain, redness, or swelling at the injection site
What to do: Contact your healthcare provider promptly if any of these occur. (2)
Serious warnings
Myelosuppression — serious
Symptoms: Myelosuppression: treatment is associated with leukopenia, neutropenia, and thrombocytopenia (reduced white blood cells, neutrophils, and platelets). In extravasation trials, grade 2-4 decreases occurred in white blood cells (73%), neutrophils (61%), and platelets (26%) of patients. Your treatment team will monitor blood counts.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Secondary malignancies such as acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) have been reported in studies of pediatric patients — serious
Symptoms: Secondary malignancies such as acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) have been reported in studies of pediatric patients.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Embryo-fetal toxicity — serious
Symptoms: Embryo-fetal toxicity: dexrazoxane can cause fetal harm when given to a pregnant woman. Females of reproductive potential are advised to use effective contraception during treatment and for 6 months after the final dose.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
No contraindications are listed in the reviewed FDA label — serious
Symptoms: No contraindications are listed in the reviewed FDA label.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Topical dimethyl sulfoxide (DMSO) | Use with topical DMSO is not recommended, because concurrent use may reduce dexrazoxane's benefit (relevant specifically in the extravasation setting, where DMSO is sometimes otherwise used). | (1) |
| Other chemotherapy agents and nephrotoxic/hepatotoxic medications (DB-sourced, not independently verified in this pass) | Not established from the sources reviewed: the clinician-authored database record notes possible interaction with other bone-marrow-affecting chemotherapy agents and nephrotoxic/hepatotoxic medicines, but the reviewed FDA label does not independently confirm this specific list beyond the DMSO warning. Your treatment team manages all concurrent medicines as part of chemotherapy planning. | (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Can cause fetal harm. Females of reproductive potential are advised to use effective contraception during treatment and for 6 months following the final dose. (1)
Breastfeeding
Advised not to breastfeed during treatment and for 2 weeks following the final dose. (1)
Children
Safety and effectiveness in pediatric patients have not been established; secondary malignancies (AML, MDS) have been reported in pediatric studies. (1)
Renal_impairment
Renal: your prescriber will reduce the dose by 50% in patients with creatinine clearance below 40 mL/min. (1)
Hepatic_impairment
Renal: your prescriber will reduce the dose by 50% in patients with creatinine clearance below 40 mL/min. (1)
Monitoring
(1)Storage
Store the powder at room temperature, protected from light and moisture. Reconstituted solutions should be used within the recommended time frame per product instructions. (DB-sourced; not independently re-verified against the reviewed FDA label excerpt in this pass.)
Professional information
Clinician-facing context only. This section does not replace current product labeling.
US
Indication: Cardioprotection (with doxorubicin)
Dose summary: 10:1 ratio to doxorubicin dose, infused IV over 15 minutes; doxorubicin given within 30 minutes after the infusion completes.
Renal context: Your prescriber will reduce the dose by 50% in patients with creatinine clearance below 40 mL/min. (1)
US
Indication: Extravasation from IV anthracycline chemotherapy
Dose summary: 1000 mg/m² (max 2000 mg/day) on days 1 and 2, 500 mg/m² (max 1000 mg/day) on day 3; IV infusion over 1-2 hours once daily for 3 consecutive days, started within 6 hours of the extravasation event.
Renal context: Your prescriber will reduce the dose by 50% in patients with creatinine clearance below 40 mL/min. (1)
Frequently asked questions
What is dexrazoxane used for?
Dexrazoxane is used to reduce the risk of heart damage from doxorubicin chemotherapy in eligible patients, and separately to treat extravasation (leakage) from IV anthracycline chemotherapy.
How does dexrazoxane work?
It binds iron inside cells and reduces the formation of harmful free radicals, which helps limit heart and tissue damage related to anthracycline chemotherapy.
What are the most common side effects?
In extravasation use, the most common effects (in at least 15% of patients) are nausea, fever, injection site pain, vomiting, and postoperative infection. In cardioprotection use, injection site pain is the most commonly reported effect.
Can dexrazoxane be used in children?
Safety and effectiveness in pediatric patients have not been established. Secondary malignancies (leukemia and myelodysplastic syndrome) have been reported in pediatric studies.
Is dexrazoxane a chemotherapy drug?
No. Dexrazoxane is a supportive medication used to help protect the heart and tissues during chemotherapy — it is not itself a cancer treatment.
Can dexrazoxane be given during pregnancy or breastfeeding?
Dexrazoxane can cause fetal harm. Effective contraception is advised during treatment and for 6 months after the final dose, and breastfeeding is advised against during treatment and for 2 weeks after the final dose.
What should I do if I experience severe side effects?
Seek immediate medical attention for symptoms such as severe allergic reactions, chest pain, difficulty breathing, or signs of infection — your treatment team will advise on next steps.
What happens with a dexrazoxane overdose?
Overdose can lead to signs of bone marrow failure; there is no known antidote. Management is supportive care under close clinical supervision. Because this medicine is always given by a healthcare professional, self-directed overdose is not applicable in the usual sense.
Can I drink alcohol during dexrazoxane treatment?
Ask your treatment team for guidance specific to your overall chemotherapy plan.
What is the mechanism of action of dexrazoxane?
Dexrazoxane is a bisdioxopiperazine derivative that acts as an intracellular iron-chelating agent, inhibiting the formation of iron-mediated free radicals; this reduces anthracycline-induced oxidative damage to cardiac myocytes and, in extravasation, limits tissue injury via similar free-radical-related mechanisms. This mechanism-of-action detail is retained from the clinician-authored database record; the reviewed FDA label was used primarily for dosing/safety facts, not mechanism narrative. (2)
What is the generic name of Dexrazoxane?
The generic name is dexrazoxane. It is sold under brand names including Dexocard, Cardioxane, Savene, Zinecard, Totect, Dexrazox.
What class of drug is dexrazoxane?
Dexrazoxane is classed as: Cardioprotective agent; antidote for anthracycline extravasation.
References
- Totect (dexrazoxane) — prescribing informationU.S. Food and Drug Administration · United States · accessed 2026-08-06 · source 1
- MedGuideGlobal clinician-authored medicine record (Supabase medicines table)MedGuideGlobal · United States · accessed 2026-08-06 · source 2
- DEXRAZOXANE (DEXRAZOXANE FOR INJECTION) INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION [ALMAJECT, INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Dexrazoxane — FDA approval record (Drugs@FDA ANDA076068)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- dexrazoxane — RxNorm normalized drug concept (RXCUI 1294534)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient dexrazoxane names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
Canada
- ZINECARD