Dangerous Drug: Thiotepa (Triethylenethiophosphoramide, TESPA, TSPA)(thye oh tep’ ah)
Thioplex
PREGNANCY CATEGORY D
Drug Classes
Alkylating drug
Antineoplastic
Therapeutic Actions
Cytotoxic: Disrupts the bonds of DNA, causing cell death; cell cycle nonspecific.
Indications
Treatment of adenocarcinoma of the breast, ovary
Superficial papillary carcinoma of the urinary bladder
Controlling intracavitary effusions secondary to diffuse or localized neoplastic disease of various serosal cavities
Treatment of lymphoma, including Hodgkin lymphoma (no longer a drug of choice)
Contraindications and Cautions
Contraindicated with allergy to thiotepa, hematopoietic depression, pregnancy, lactation.
Use cautiously with impaired hepatic or renal function, concomitant therapy with other alkylating agents or irradiation.
Available Forms
Powder for injection—15 mg
Dosages
Adults
IV
0.3–0.4 mg/kg by rapid IV infusion at 1- to 4-wk intervals.
Intratumor
Drug is diluted in sterile water to a concentration of 10 mg/mL, then 0.6–0.8 mg/kg is injected directly into the tumor after a local anesthetic is injected through the same needle. Maintenance doses of 0.6–0.8 mg/kg every 1–4 wk depending on patient’s condition.
Intracavitary
0.6–0.8 mg/kg every 1–4 wk through the same tube that is used to remove fluid from the cavity.
Intravesical
Dehydrate patient with papillary carcinoma of the bladder for 8–12 hr prior to treatment. Then instill 30–60 mg in 60 mL of 0.9% sodium chloride injection into the bladder by catheter. Retain for 2 hr. If patient is unable to retain 60 mL, give the dose in 30 mL. Repeat once a week for 4 wk. Maintenance doses with 30–60 mg intravesically once monthly for up to 1 yr may be required.
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