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Valrubicin (Valstar)
(val- ROO-bih-sin)
Pregnancy Category: C Valstar (Rx)

Classification: Antineoplastic, antibiotic

See Also: See also Antineoplastic Agents.

Action/Kinetics: Related to doxorubicin. Inhibits incorporation of nucleosides into nucleic acids, causes extensive chromosome damage, and arrests cell cycle G 2. Although minimal metabolism occurs when instilled into the bladder, valrubicin metabolites interfere with normal DNA breaking-resealing action of DNA topoisomerase II. It penetrates the bladder wall. Almost completely excreted by voiding the instillate.

Uses: Intravesical therapy of BCG-refractory carcinoma in situ of the urinary bladder.

Contraindications: Hypersensitivity to anthracyclines or Cremophor EL. Concurrent UTIs, small bladder capacity (i.e., unable to hold 75 mL instillation). Use in those with a perforated bladder or when the integrity of the bladder mucosa has been compromised. IM or IV use. Lactation.

Special Concerns: Use with caution in severe irritable bladder symptoms. Safety and efficacy have not been determined in children.

Side Effects: GU: Local bladder symptoms, urinary frequency, dysuria, urinary urgency, bladder spasm, hematuria, bladder pain, urinary incontinence, cystitis, nocturia, local burning symptoms, urethral pain, pelvic pain, UTI, urinary retention, poor urine flow, urethritis. GI: Abdominal pain, N&V, diarrhea, flatulence, taste loss. Metabolic: Hyperglycemia, peripheral edema. CNS: Headache, dizziness. Dermatologic: Rash, pruritus, local skin irritation. Body as a whole: Asthenia, malaise, fever, myalgia. Miscellaneous: Back pain, chest pain, anemia, vasodilation, pneumonia, tenesmus.

How Supplied: Solution for intravesical instillation: 40 mg/mL

?Solution for intravesical use Bladder cancer.
Adults: 800 mg once a week for 6 weeks.

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