Eribulin mesylate injection (HALAVEN)

For CrCl 15-49 mL/min, reduce the starting dose to 1.1 mg/m2 IV over 2-5 minutes on days 1 and 8 of each 21-day cycle. The usual starting dose is 1.4 mg/m2 on that schedule. Assess blood counts and neuropathy before each dose; hematologic and other toxicity rules can require additional withholding or reduction. This selected renal guidance does not establish a regimen below CrCl 15 or on dialysis.

For CrCl 15-49 mL/min, the recommended dose is 1.1 mg/m2 IV over 2-5 minutes on days 1 and 8 of a 21-day cycle, rather than the usual 1.4 mg/m2. The renal impairment section does not provide a regimen below 15 or for dialysis.

Assess complete blood counts and peripheral neuropathy before each dose. Renal dose selection does not replace the separate hematologic and nonhematologic toxicity hold/reduction instructions. The mild-impairment pharmacokinetic observation is not a dialysis recommendation.

eviQ lists eribulin mesilate 1.4 mg/m2 IV on days 1 and 8 every 21 days. Its displayed kidney table recommends reducing each dose by 25% at indexed eGFR 30-50 mL/min/1.73 m2; below 30, it states that severe kidney dysfunction has not been studied. It does not supply a dialysis regimen.

The protocol calls its modification recommendations conservative guidance with limited evidence and requires clinical judgement. This differs from the U.S. label-mirror CrCl bands and fixed 1.1-mg/m2 renal dose. Do not equate indexed eGFR with absolute CrCl or convert a percentage to a rounded prescription without oncology review.