Streptozocin

What is Streptozocin

Streptozocin is an alkylating agent of the nitrosurea family, which includes carmustine and lomustine. It is a natural product from Streptomyces achromogenes.

Streptozocin is used in the management of pancreatic islet cell carcinoma, carcinoid tumor, colorectal cancer, and pancreatic adenocarcinoma.

It seems to have specific activity only in pancreatic cancers and some gastrointestinal tumors. The generic name is sometimes spelled streptozotocin. Streptozocin was aproved by the FDA in 1982.

Brand Name

Zanosar

Indications

  • carcinoid
  • colorectal cancer
  • pancreatic cancer

Side Effects

  1. anemia
  2. anuria
  3. azotemia
  4. bone marrow suppression
  5. diabetes insipidus
  6. diarrhea
  7. edema
  8. elevated hepatic enzymes
  9. erythema
  10. glycosuria
  11. hepatotoxicity
  12. hypoalbuminemia
  13. hypoglycemia
  14. hypophosphatemia
  15. injection site reaction
  16. insulin shock
  17. leukopenia
  18. nausea
  19. nephrotoxicity
  20. neutropenia
  21. proteinuria
  22. renal tubular acidosis (RTA)
  23. skin irritation
  24. thrombocytopenia
  25. tissue necrosis
  26. vomiting

Monitoring Parameters

  • blood glucose
  • CBC with differential
  • LFTs
  • platelet count
  • serum creatinine/BUN
  • serum electrolytes
  • serum phosphate
  • urinalysis

Contraindications

  • accidental exposure
  • bone marrow suppression
  • breast-feeding
  • chemotherapy-induced nausea/vomiting
  • dental disease
  • dental work
  • diabetes mellitus
  • diarrhea
  • driving or operating machinery
  • extravasation
  • hepatic disease
  • hepatotoxicity
  • herpes infection
  • hypophosphatemia
  • infection
  • intramuscular administration
  • intramuscular injections
  • nephrotoxicity
  • neutropenia
  • new primary malignancy
  • ocular exposure
  • pregnancy
  • proteinuria
  • renal disease
  • renal failure
  • renal impairment
  • requires a specialized care setting
  • requires an experienced clinician
  • subcutaneous administration
  • thrombocytopenia
  • tumorigenicity
  • vaccination
  • varicella
  • viral infection

Interactions

  • Aldesleukin, IL-2
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Amikacin
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminoglycosides
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Atenolol; Chlorthalidone
  • Azilsartan; Chlorthalidone
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bumetanide
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril; Hydrochlorothiazide, HCTZ
  • Celecoxib
  • Chlorothiazide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Cisplatin
  • Clozapine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Doxorubicin
  • Doxorubicin Liposomal
  • Echinacea
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Esomeprazole; Naproxen
  • Ethacrynic Acid
  • Etodolac
  • Famotidine; Ibuprofen
  • Febuxostat
  • Fenoprofen
  • Flucytosine
  • Flurbiprofen
  • Foscarnet
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Furosemide
  • Gentamicin
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Ibuprofen
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Immune Globulin IV, IVIG, IGIV
  • Indomethacin
  • Kanamycin
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Live Vaccines
  • Loop diuretics
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Methyclothiazide
  • Metolazone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oxaprozin
  • Palifermin
  • Paromomycin
  • Pegfilgrastim
  • Penicillamine
  • Phenytoin
  • Piroxicam
  • Plazomicin
  • Potassium-sparing diuretics
  • Rofecoxib
  • Spironolactone
  • Streptomycin
  • Sulindac
  • Telavancin
  • Thiazide diuretics
  • Tobramycin
  • Tolmetin
  • Torsemide
  • Triamterene
  • Tuberculin Purified Protein Derivative, PPD
  • Valdecoxib
  • Vancomycin
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