Trade Names:Valstar- Injection, solution, concentrate 40 mg/mL
Inhibits the incorporation of nucleosides into nucleic acids, causing extensive chromosomal damage and arresting cell cycle in G2.
After intravesical administration, penetrates into the bladder wall. Unless the bladder is perforated, only nanogram amounts of the drug are absorbed systemically.
After retention, the drug is almost completely excreted by voiding the instillate.
Intravesical treatment of Bacillus Calmette-Guérin–refractory carcinoma in situ (CIS) of the urinary bladder in patients for whom immediate cystectomy would be associated with unacceptable morbidity or mortality.
UTI; patients with small bladder capacity (ie, unable to tolerate a 75 mL instillation); hypersensitivity to anthracyclines or polyoxyl castor oil.
Intravesically 800 mg once a wk for 6 wk.
Store in refrigerator at 36° to 46°F. Vials diluted in sodium chloride 0.9% injection are stable for 12 h at temperatures up to 77°F.
None well documented.
None well documented.
Asthenia, headache, malaise (4%); dizziness (3%).
Nausea (5%); diarrhea (3%); vomiting (2%); flatulence (1%).
Any local bladder symptom (88%); urinary frequency (61%); urinary urgency (57%); dysuria (56%); bladder spasm (31%); hematuria (29%); bladder pain (28%); urinary incontinence (22%); cystitis, UTI (15%); nocturia (7%); urinary retention (4%); urethral pain (3%); gross hematuria, pelvic pain (1%).
Local procedural-related burning symptoms (5%).
Hyperglycemia, peripheral edema (1%).
Back pain (3%); myalgia (1%).
Abdominal pain (5%); chest pain (3%); fever (2%).
In patients undergoing transurethral resection of the bladder, determine the status of the bladder before instillation of valrubicin. In case of bladder perforation, delay administration until bladder integrity has been restored.
Category C .
Safety and efficacy not established.
No specific precautions for use of valrubicin in elderly patients who are otherwise in good health.
Delaying cystectomy could lead to fatal metastatic bladder carcinoma.
Complete response only occurs in about 20% of patients with Bacillus Calmette-Guérin–refractory CIS.
Use with caution in patients with irritable bladder symptoms.
Do not administer to patients with a perforated bladder or to those in whom the integrity of the bladder mucosa is compromised.
Irritable bladder symptoms.
Copyright © 2009 Wolters Kluwer Health.