Tozene Special Precautions

Bone marrow depression: Give with extreme caution to patients with bone marrow depression. Patients may be more prone to bone marrow depression if they have a hematologic disease, are being treated with radiation or marrow suppressant drugs, or have a history of treatment with such drugs or radiation. Bone marrow toxicity can be irreversible and may lead to death in immunosuppressed patients. Frequently monitor hepatic function and hematopoietic system during therapy.
Renal function impairment: Give with extreme caution; drug accumulation may occur. Monitor blood levels to determine the adequacy of renal excretion in such patients. Adjust dosage to prevent progressive accumulation of the drug and to maintain the blood levels at less than 100 mcg/mL.
Monitoring: Before therapy is initiated, determine electrolytes and hematological and renal status of the patient. Because renal impairment can cause accumulation of the drug, monitor blood concentrations and renal function during therapy. Monitor hematologic status (white blood cell count and platelet count) and liver function (alkaline phosphatase, ALT and AST) at frequent intervals during treatment.