2.1 Recommended Dosage

Administer IDAMYCIN PFS 12 mg/m2 intravenously over 10 to 15 minutes on days 1, 2, and 3 of induction in combination with cytarabine. The cytarabine may be given as 100 mg/m2 by continuous intravenous infusion daily for 7 days or as cytarabine 25 mg/m2 intravenous bolus followed by cytarabine 200 mg/m2 continuous intravenous infusion daily for 5 days.

If a response is not achieved with the first induction cycle, a second induction cycle may be administered. Other dosage regimens may be used for a second induction cycle.

Individualize the dose and dosing schedule of IDAMYCIN PFS based on the specific regimen administered, disease state, response to treatment, and patient risk factors.

2.2 Dosage Modifications for Adverse Reactions

Cardiomyopathy

Discontinue IDAMYCIN PFS in patients who develop signs or symptoms of cardiomyopathy [see Warnings and Precautions (5.1)].

Myelosuppression

If patients develop severe myelosuppression, reduce the dose of IDAMYCIN PFS by 25% or as clinically indicated in subsequent cycles [see Warnings and Precautions (5.4)].

Mucositis

If patients develop severe mucositis with IDAMYCIN PFS, reduce the dose by 25% in subsequent cycles. If a second cycle is planned, delay administration in patients who develop severe mucositis until this adverse reaction has resolved [see Adverse Reactions (6.1)].

2.3 Recommended IDAMYCIN PFS Dosage in Patients with Renal Impairment

In patients with renal impairment, reduce the dose of IDAMYCIN PFS as described in Table 1 [see Use in Specific Populations (8.6)].

Table 1: Recommended IDAMYCIN PFS Dosage for Patients with Renal Impairment

2.4 Recommended IDAMYCIN PFS Dosage in Patients with Hepatic Impairment

In patients with hepatic impairment, reduce the dose of IDAMYCIN PFS as described in Table 2 [see Use in Specific Populations (8.7)].

Table 2: Recommended IDAMYCIN PFS Dosage for Patients with Hepatic Impairment

2.5 Preparation

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IDAMYCIN PFS is a hazardous drug. Follow applicable special handling and disposal procedures.1

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Do not mix IDAMYCIN PFS or administer as an infusion with other drugs or heparin.

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Avoid prolonged contact with any solution of an alkaline pH, as this will result in degradation of IDAMYCIN PFS.

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Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

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Withdraw the volume of IDAMYCIN PFS needed based on the required dose.

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Do not further dilute prior to administration (see section 2.6 Administration).

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Discard unused portion.

2.6 Administration

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IDAMYCIN PFS is for intravenous infusion only.

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Prior to administration, flush the intravenous catheter used for IDAMYCIN PFS administration to ensure patency and to minimize the risk of extravasation.

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Administer IDAMYCIN PFS over 10 to 15 minutes into the tubing of a freely running intravenous infusion of 0.9% Sodium Chloride Injection or 5% Dextrose Injection.

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Closely monitor the infusion site for extravasation or drug infiltration during administration. Manage cases of extravasation as per institutional guidelines.

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Immediately discontinue the infusion if extravasation occurs [see Warnings and Precautions (5.3)].