Drugs used for cytotoxic-induced side-effects listed elsewhere in the formulary:

• Folic acid, see 9.1.2 Drugs used in megaloblastic anaemias

If a cytotoxic drug given intravenously leaks into the surrounding tissue, urgent action must be taken. The injection or infusion must be stopped immediately, the patient should be informed, and the doctor notified. Treatment should follow hospital guidelines for the management of cytotoxic drug extravasation. Treatment will vary according to whether a cytotoxic drug causes local tissue necrosis.

The following are used to manage some systemic side effects to cytotoxic drugs:

Calcium folinate (folinic acid)

• Tablets 15mg
• Solution for injection ampoules 15mg/2ml
• Solution for injection vials 50mg/5ml, 100mg/10ml, 200mg/20ml, 300mg/30ml, 350mg/35ml

Disodium folinate (folinic acid)

• Solution for injection vials 100mg/2ml, 400mg/8ml

Dexrazoxane hydrochloride

• Savene powder for concentrate and solvent for solution for infusion vials 500mg

Glucarpidase

• Powder for solution for injection vials 1,000 units (unlicensed preparation)

Notes

1. NHS England (NHSE) will commission Glucarpidase for the urgent treatment of methotrexate-induced renal dysfunction (see NHSE Clinical Commissioning Policy for more details)

Mesna

• Tablets 400mg, 600mg
• Solution for injection ampoules 400mg/4ml, 1g/10ml