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ZINECARD® (dexrazoxane) Adverse Reactions

6 ADVERSE REACTIONS

6.1 Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, the adverse reaction rates observed cannot be directly compared to rates in other trials and may not reflect the rates observed in clinical practice.

The adverse reaction profile described in this section was identified from randomized, placebo-controlled, double-blind studies in patients with metastatic breast cancer who received the combination of the FAC chemotherapy regimen with or without ZINECARD. The dose of doxorubicin was 50 mg/m2 in each of these trials. Treatment was administered every three weeks until disease progression or cardiac toxicity.

Patients in clinical trials who received FAC with ZINECARD experienced more severe leukopenia, granulocytopenia, and thrombocytopenia than patients receiving FAC without ZINECARD [see Warnings and Precautions (5.1)].

Table 1 below lists the incidence of adverse reactions for patients receiving FAC with either ZINECARD or placebo in the breast cancer studies. Adverse experiences occurring during courses 1 through 6 are displayed for patients receiving ZINECARD or placebo with FAC beginning with their first course of therapy (columns 1 and 3, respectively). Adverse experiences occurring at course 7 and beyond for patients who received placebo with FAC during the first six courses and who then received either ZINECARD or placebo with FAC are also displayed (columns 2 and 4, respectively).

The adverse reactions listed below in Table 1 demonstrate that the frequency of adverse reaction "Pain on Injection" has been greater for ZINECARD arm, as compared to placebo.

Table 1
Adverse ReactionPercentage (%) of Breast Cancer Patients With Adverse Reaction
FAC + ZINECARDFAC + Placebo
Courses 1–6
N = 413
Courses ≥ 7
N = 102
Courses 1–6
N = 458
Courses ≥ 7
N = 99
Alopecia941009798
Nausea77518460
Vomiting59427249
Fatigue/Malaise61485855
Anorexia42274738
Stomatitis34264128
Fever34222918
Infection23191821
Diarrhea2114247
Pain on Injection121330
Sepsis1712149
Neurotoxicity1710135
Streaking/Erythema5442
Phlebitis6335
Esophagitis6374
Dysphagia80105
Hemorrhage2321
Extravasation1312
Urticaria2220
Recall Skin Reaction1120

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