Dexrazoxane (Zinecard) Administration

[Aeterna, BSN, RN]

Just the other day, I had to administer IV Dexrazoxane due to a patient receiving Doxorubicin by IV push. The instructions specifically read that the span of time between starting the Dexrazoxane and finishing the Doxorubicin should not exceed 30 mins.

The catch? The Dexrazoxane came up in an IV bag containing approximately 420 mL. The Doxorubicin was to be given over 10-15 mins, leaving just 15-20 mins to infuse the 420 mL of Dexrazoxane. That meant the Dexrazoxane had to be infused @ 1680 mL/h! Which is, of course, physically impossible as far as I know. Our pumps only infuse at a max rate of 999 mL/h and we could try hanging it by gravity but, as the patient had a PICC, it would never drip fast enough.

I talked with our nurse educator, who didn't know the answer to this problem either. She said we rarely give this med and the last time she gave it, she gave it as a push. She phoned the pharmacist, who told her that the best we could do was hang it by gravity the best we could. We did...and it infused too slowly, as we suspected. But we tried our best.

Has anyone else had to give this med before? How did you do it?

[Wasnt, BSN]

Hello. Sorry I don’t have answers to your question. I have a question for you. I gave Doxorubicin IV push with NS. I Checked for blood return with every 2-3 ml, unfortunately I forgot to close the NS and got NS mixed with Doxorubicin. Will this affect the effectiveness of Doxorubicin? Thanks! I just started with oncology infusion and I  am a nervous wreck! Affecting my sleep and life!