Thiotepa

Although thiotepa is chemically less reactive than the nitrogen mustards, it is thought to act by similar mechanisms. Its oral absorption is erratic. After intravenous injection, the plasma half-life is less than 2 hours. Urinary excretion accounts for 60 to 80% of eliminated drug.

Thiotepa has antitumor activity against ovarian and breast cancers and lymphomas. However, it has been largely supplanted by cyclophosphamide and other nitrogen mustards for treatment of these diseases. It is used by direct instillation into the bladder for multifo-cal local bladder carcinoma.

Nausea and myelosuppression are the major toxici-ties of thiotepa. It is not a local vesicant and has been safely injected intramuscularly and even intrathecally.

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