STREPTOZOCIN SHOULD BE ADMINISTERED INTRAVENOUSLY BY RAPID INJECTION OR SHORT/PROLONGED INFUSION.
TWO DIFFERENT DOSAGE SCHEDULES HAVE BEEN EMPLOYED SUCCESSFULLY WITH STREPTOZOCIN.
DAILY SCHEDULE - THE RECOMMENDED DOSE FOR DAILY INTRAVENOUS ADMINISTRATION IS 500 MG/M2 OF BODY SURFACE AREA FOR FIVE CONSECUTIVE DAYS EVERY SIX WEEKS UNTIL MAXIMUM BENEFIT OR UNTIL TREATMENT-LIMITING TOXICITY IS OBSERVED. DOSE ESCALATION ON THIS SCHEDULE IS NOT RECOMMENDED.
WEEKLY SCHEDULE - THE RECOMMENDED INITIAL DOSE FOR WEEKLY INTRAVENOUS ADMINISTRATION IS 1000 MG/M2 OF BODY SURFACE AREA AT WEEKLY INTERVALS FOR THE FIRST TWO COURSES (WEEKS). IN SUBSEQUENT COURSES, DRUG DOSES MAY BE ESCALATED IN PATIENTS WHO HAVE NOT ACHIEVED A THERAPEUTIC RESPONSE AND WHO HAVE NOT EXPERIENCED SIGNIFICANT TOXICITY WITH THE PREVIOUS COURSE OF TREATMENT. HOWEVER, A SINGLE DOSE OF 1500 MG/M2 BODY SURFACE AREA SHOULD NOT BE EXCEEDED AS A GREATER DOSE MAY CAUSE AZOTEMIA. WHEN ADMINISTERED ON THIS SCHEDULE, THE MEDIAN TIME TO ONSET OF RESPONSE IS ABOUT 17 DAYS AND THE MEDIAN TIME TO MAXIMUM RESPONSE IS ABOUT 35 DAYS. THE MEDIAN TOTAL DOSE TO ONSET OF RESPONSE IS ABOUT 2000 MG/M2 BODY SURFACE AREA AND THE MEDIAN TOTAL DOSE TO MAXIMUM RESPONSE IS ABOUT 4000 MG/M2 BODY SURFACE AREA.
HE IDEAL DURATION OF MAINTENANCE THERAPY WITH ZANOSAR HAS NOT YET BEEN CLEARLY ESTABLISHED FOR EITHER OF THE ABOVE SCHEDULES.
RECONSTITUTE WITH 9.5 ML OF DEXTROSE INJECTION USP, OR 0.9% SODIUM CHLORIDE INJECTION USP. WHERE MORE DILUTE INFUSION SOLUTIONS ARE DESIRABLE, FURTHER DILUTION IN THE ABOVE VEHICLES IS RECOMMENDED. THE TOTAL STORAGE TIME FOR STREPTOZOCIN AFTER IT HAS BEEN PLACED IN SOLUTION SHOULD NOT EXCEED 12 HOURS