Valrubicin

What is Valrubicin

Valrubicin is a semisynthetic analog of doxorubicin indicated for intravesical therapy of BCG-resistant carcinoma in situ (CIS) of the bladder in patients for whom immediate cystectomy would be associated with unacceptable morbidity or mortality.

It has been shown to induce complete response in only about 1 in 5 patients with BCG-refractory CIS; delaying cystectomy to receive valrubicin may lead to development of metastatic bladder cancer, although the risk of such a delay is difficult to detect.

Valrubicin is contraindicated in patients with a perforated bladder or active urinary tract infection, as systemic exposure is significantly increased when the integrity of the bladder wall is compromised; administration should be delayed for at least 2 weeks after transurethral resection and/or fulguration.

It is also contraindicated in patients with a small bladder capacity unable to tolerate a 75 mL instillation, as spontaneous discharge of the instillate may occur

Brand Name

Valstar

Indications

  • bladder cancer

For the treatment of BCG-refractory bladder cancer in situ (CIS) in patients for whom immediate cystectomy would be associated with unacceptable morbidity or mortality

Side Effects

  1. abdominal pain
  2. anemia
  3. asthenia
  4. back pain
  5. bladder spasm
  6. chest pain (unspecified)
  7. cystitis
  8. diarrhea
  9. dizziness
  10. dysuria
  11. fever
  12. flatulence
  13. headache
  14. hematuria
  15. hyperglycemia
  16. increased urinary frequency
  17. infection
  18. leukopenia
  19. malaise
  20. myalgia
  21. nausea
  22. neutropenia
  23. nocturia
  24. pelvic pain
  25. peripheral edema
  26. peripheral vasodilation
  27. pruritus
  28. rash
  29. skin irritation
  30. tenesmus
  31. urethral pain
  32. urinary incontinence
  33. urinary retention
  34. urinary urgency
  35. urine discoloration
  36. vomiting

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • anthracycline hypersensitivity
  • bladder cancer
  • bladder perforation
  • breast-feeding
  • contraception requirements
  • infertility
  • irritable bladder
  • male-mediated teratogenicity
  • polyoxyethylated castor oil hypersensitivity
  • pregnancy
  • reproductive risk
  • urinary tract infection (UTI)

Interactions

There are no drug interactions associated with Valrubicin products.

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