Hospital Pharmacy - May 2017 - 344

344

B.
C.
D.

E.

F.

G.
H.

I.
J.

Hospital Pharmacy 52(5)
hemorrhage (all grades) 1% to 2%,1 (grade 3 or 4) 2%1;
rectal bleeding (grade 1 or 2) 1%3; unspecified bleeding
(all grades) 1% to 8%2,5; (grade 3 or 4) 6%2; hypertension (all grades) 1% to 28%1-5; (grade 3 or 4) 1% to
11%1-3; thromboembolic events (all grades) 1% to 9%,13, 5
(grade 3 or 4) 1% to 6%.1-3
Constitutional: Fatigue (all grades) 4% to 62%,1-3,5
(grade 3 or 4) 4% to 16%.1-3,5
Dermatologic: Alopecia (grade 1 or 2) 2%,1 skin hyperpigmentation (grade 1 or 2) 2% to 43%.1
Gastrointestinal: Anorexia (all grades) 3% to 34%,1-3
(grade 3 or 4) 3% to 13%1; diarrhea (all grades) 1% to
62%,1-5 (grade 3 or 4) 1% to 16%2-4; dysgeusia (grade 1
or 2) 6% to 28%1; gastrointestinal perforation (all grades)
1% to 2%,1,3-5 (grade 3 or 4) 1%3,4; nausea (all grades)
1% to 59%,1-4 (grade 3 or 4) 1% to 2%1,3,4; stomatitis/
mucositis (all grades) 2% to 49%,1-4 (grade 3 or 4) 2% to
3%1,3,4; vomiting (all grades) 3% to 32%,1-4 (grade 3 or 4)
3% to 7%2,3; weight loss (all grades) 4% to 12%.3
Hematologic: Anemia (all grades) 2% to 80%,1-4
(grade 3 or 4) 2% to 6%1,2; febrile neutropenia (all
grades) 1% to 2%,1,3 (grade 3 or 4) 2%1; leukopenia
(all grades) 4% to 42%,1,2 (grade 3 or 4) 3% to 4%1,2;
neutropenia (all grades) 4% to 56%,1-4 (grade 3 or 4)
4% to 22%1-4; thrombocytopenia (all grades) 1% to
58%,1-4 (grade 3 or 4) 1% to 6%.1-4
Hepatic: Alanine aminotransferase (ALT) elevation (all grades) 2% to 31%,1,2 (grade 3 or 4) 2% to
19%1; aspartate aminotransferase (AST) elevation (all
grades) 2% to 40%,1,2 (grade 3 or 4) 2% to 22%1; alkaline phosphatase elevation (all grades) 2% to 42%,1
(grade 3 or 4) 2%1; hyperbilirubinemia (all grades) 2%
to 21%,1,2 (grade 3 or 4) 2%.1
Hypersensitivity: Hypersensitivity/allergy (grade 1
or 2) 2% to 6%1-2; injection site reaction (grade 1 or 2)
1% to 8%.2,3
Neurologic: Abdominal pain (all grades) 1% to 12%,3
(grade 3 or 4) 3%3; hand-foot syndrome (all grades)
2% to 58%,1-5 (grade 3 or 4) 2% to 8%1-4; neurotoxicity (grade 1 or 2) 9% to 25%3; paraesthesia (grade 1 or
2) 3% to 19%3; peripheral neuropathy (grade 1 or 2)
38% to 45%1; sensory neuropathy (all grades) 8% to
83%,2,5 (grade 3 or 4) 14%2; unspecified neuropathy
(all grades) 4% to 45%,3,4 (grade 3 or 4) 4% to 18%.3,4
Renal: Increased serum creatinine (all grades) 2% to
21%,1 (grade 3 or 4) 2%1; proteinuria (all grades) 1%
to 36%,1-5 (grade 3 or 4) 1% to 6%.2-4
Treatment-Related Death: Gastrointestinal perforation 1%,3 cardiac event 2%.4

Pretreatment Laboratory Studies
Needed
A. Baseline
1. AST/ALT

2.
3.
4.

Total bilirubin
Serum creatinine
Complete blood count (CBC) with differential

B. Prior to Each Treatment
1. CBC with differential
C. Recommended Pretreatment Values: The minimally acceptable pretreatment CBC values required
to begin a cycle with full-dose therapy in the protocols reviewed were:
1. Absolute neutrophil count (ANC), greater than
or equal to 1500 cells/mcL.1-3,5,10
2. White blood cell (WBC) count, greater than or
equal to 3,000 cell/mcL.2
3. Hemoglobin, greater than or equal to 9 g/dL.1-3,5
4. Platelet count, greater than or equal to 100 000
cells/mcL.2,3,5,10
5. Renal function
a. Serum creatinine, within normal institutional
limits2,4 or less than or equal to 1.5 times the
upper normal limit (ULN)1,3 or less than or 2
mg/dL.5
b. Creatinine clearance, greater than or equal
to 50 mL/min or greater than or equal to 30
mL/min.2,3,5
c. Proteinuria, less than grade 11 or less than 2+
for protein11 or urine protein creatinine ratio
less than or equal to 1.5
6. Hepatic function
a. Total bilirubin, less than or equal to 2 mg/dL1
or less than or equal to 1.5 times the UNL.2,3,5,10
b. ALT/AST, less than or equal to 2.5 times the
upper limit of normal1-3,5,10 or less than or
equal to 5 times the UNL if liver metastases
were present.1,3,5
c. Alkaline phosphatase, less than or equal to
2.5 times the UNL5,10 or less than or equal
to 5 times the UNL if liver metastases were
present or less than or equal to 10 times the
UNL if bone metastases were present.5
In clinical practice, a pretreatment ANC of 1000 cells/
mcL and platelets of 75 000 cells/mcL are usually considered
acceptable.

Dosage Modifications
A. Renal Function
1. Capecitabine: Creatinine clearance
a. 30 to 50 mL/min, reduce dose by 25%.3,5,35,36
b. Less than 30 mL/min, do not give drug.35
2. Oxaliplatin: Creatinine clearance
a. Greater than 20 mL/min, give 100% dose.37
b. Greater than or equal to 30 mL/min, give
100% dose.38



Table of Contents for the Digital Edition of Hospital Pharmacy - May 2017

Editorial, For Sale: FDA Priority Review Vouchers
Current FDA-Related Drug Information; Approvals, Submission, and Important Labeling Changes for US Marketed Pharmaceuticals
Summaries of Safety Labeling Changes Approved by the FDA: Boxed Warnings
ISMP Adverse Drug Reactions: Levofloxacin-Induced Neuroexcitation and Hallucinations Statin-Induced Muscle Rupture Mefloquine-Induced Rhabdomyolysis Methimazole-Induced
Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy
Capecitabine, Oxaliplatin, and Bevacizumab (BCapOx) Regimen for Metastatic Colorectal Cancer
Clinical Pharmacy Discharge Counseling Service and the Impact on Readmission Rates in High-Risk Patients
Mannitol Prescribing Practices With Cisplatin Before and After an Educational Newsletter Intervention
Pharmacists’ Knowledge of the Cost of Laboratory Testing
Adverse Drug Reaction Reporting Practices Among United Arab Emirates Pharmacists and Prescribers
Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital
Formulary Drug Reviews
Hospital Pharmacy - May 2017 - 317
Hospital Pharmacy - May 2017 - 318
Hospital Pharmacy - May 2017 - 319
Hospital Pharmacy - May 2017 - 320
Hospital Pharmacy - May 2017 - 321
Hospital Pharmacy - May 2017 - 322
Hospital Pharmacy - May 2017 - 323
Hospital Pharmacy - May 2017 - Editorial, For Sale: FDA Priority Review Vouchers
Hospital Pharmacy - May 2017 - 325
Hospital Pharmacy - May 2017 - Current FDA-Related Drug Information; Approvals, Submission, and Important Labeling Changes for US Marketed Pharmaceuticals
Hospital Pharmacy - May 2017 - Summaries of Safety Labeling Changes Approved by the FDA: Boxed Warnings
Hospital Pharmacy - May 2017 - 328
Hospital Pharmacy - May 2017 - 329
Hospital Pharmacy - May 2017 - ISMP Adverse Drug Reactions: Levofloxacin-Induced Neuroexcitation and Hallucinations Statin-Induced Muscle Rupture Mefloquine-Induced Rhabdomyolysis Methimazole-Induced
Hospital Pharmacy - May 2017 - 331
Hospital Pharmacy - May 2017 - 332
Hospital Pharmacy - May 2017 - 333
Hospital Pharmacy - May 2017 - Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy
Hospital Pharmacy - May 2017 - 335
Hospital Pharmacy - May 2017 - 336
Hospital Pharmacy - May 2017 - 337
Hospital Pharmacy - May 2017 - 338
Hospital Pharmacy - May 2017 - 339
Hospital Pharmacy - May 2017 - 340
Hospital Pharmacy - May 2017 - Capecitabine, Oxaliplatin, and Bevacizumab (BCapOx) Regimen for Metastatic Colorectal Cancer
Hospital Pharmacy - May 2017 - 342
Hospital Pharmacy - May 2017 - 343
Hospital Pharmacy - May 2017 - 344
Hospital Pharmacy - May 2017 - 345
Hospital Pharmacy - May 2017 - 346
Hospital Pharmacy - May 2017 - 347
Hospital Pharmacy - May 2017 - Clinical Pharmacy Discharge Counseling Service and the Impact on Readmission Rates in High-Risk Patients
Hospital Pharmacy - May 2017 - 349
Hospital Pharmacy - May 2017 - 350
Hospital Pharmacy - May 2017 - 351
Hospital Pharmacy - May 2017 - 352
Hospital Pharmacy - May 2017 - Mannitol Prescribing Practices With Cisplatin Before and After an Educational Newsletter Intervention
Hospital Pharmacy - May 2017 - 354
Hospital Pharmacy - May 2017 - 355
Hospital Pharmacy - May 2017 - 356
Hospital Pharmacy - May 2017 - Pharmacists’ Knowledge of the Cost of Laboratory Testing
Hospital Pharmacy - May 2017 - 358
Hospital Pharmacy - May 2017 - 359
Hospital Pharmacy - May 2017 - 360
Hospital Pharmacy - May 2017 - Adverse Drug Reaction Reporting Practices Among United Arab Emirates Pharmacists and Prescribers
Hospital Pharmacy - May 2017 - 362
Hospital Pharmacy - May 2017 - 363
Hospital Pharmacy - May 2017 - 364
Hospital Pharmacy - May 2017 - 365
Hospital Pharmacy - May 2017 - 366
Hospital Pharmacy - May 2017 - Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital
Hospital Pharmacy - May 2017 - 368
Hospital Pharmacy - May 2017 - 369
Hospital Pharmacy - May 2017 - 370
Hospital Pharmacy - May 2017 - 371
Hospital Pharmacy - May 2017 - 372
Hospital Pharmacy - May 2017 - 373
Hospital Pharmacy - May 2017 - Formulary Drug Reviews
Hospital Pharmacy - May 2017 - 375
Hospital Pharmacy - May 2017 - 376
Hospital Pharmacy - May 2017 - 377
Hospital Pharmacy - May 2017 - 378
Hospital Pharmacy - May 2017 - 379
Hospital Pharmacy - May 2017 - 380
Hospital Pharmacy - May 2017 - 381
Hospital Pharmacy - May 2017 - 382
Hospital Pharmacy - May 2017 - 383
Hospital Pharmacy - May 2017 - 384
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2019
http://www.nxtbook.com/nxtbooks/sage/fai_201909
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_july2019
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2019
http://www.nxtbook.com/nxtbooks/sage/canadianpharmacistsjournal_05062019
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2019
http://www.nxtbook.com/nxtbooks/sage/sri_supplement_201903
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2019
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2018
http://www.nxtbook.com/nxtbooks/sage/tec_20180810
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2018
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2018
http://www.nxtbook.com/nxtbooks/sage/fai_201807
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2018
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2018
http://www.nxtbook.com/nxtbooks/sage/sri_supplement_201803
http://www.nxtbook.com/nxtbooks/sage/slas_discovery_201712
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2018
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2017
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_november2017
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2017
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_september2017
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2017
http://www.nxtbook.com/nxtbooks/sage/fai_supplement_201709
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2017
http://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_may2017
http://www.nxtbook.com/nxtbooks/sage/fai_201706
http://www.nxtbook.com/nxtbooks/sage/fai_201607
http://www.nxtbookMEDIA.com