Streptozocin
Alkylating agents
Alkylating agentsHigh alert
An error with this medicine can cause serious harm: double checks and protocols are used.Pregnancy: avoid
Avoid in pregnancy. Streptozocin may harm the fetus; pregnancy and breastfeeding are avoided during treatment.
A glucose-linked nitrosourea that is taken up by insulin-making cells; used for pancreatic islet cell cancer. Watch the kidneys and blood sugar.
Also called: streptozotocin
Quick facts
- Group
- Alkylating agents
- Target
- DNA (guanine), methylated by the nitrosourea
- Used for
- Metastatic or progressive cancer
- Key effects
- Severe nausea and vomiting · Diarrhoea · Tiredness
- Monitor
- Kidney function and urine tests before · Blood glucose
- ATC
- L01AD04
No doses: the clinician sets them by the current guideline.
Mechanism of action
Streptozocin is a methylnitrosourea attached to glucose. Its sugar part gives it a high affinity for the islet cells of the pancreas, which explains its use in islet cell tumours (and why it causes diabetes in laboratory animals). Inside the cell it alkylates (methylates) DNA, breaking strands and stopping cell division.
- Its glucose part concentrates it in pancreatic islet cells
- The nitrosourea methylates DNA
- Islet tumour cells stop dividing and die
Indications
- Metastatic or progressive cancer of the pancreatic islet cells (a pancreatic neuroendocrine tumour). Pancreatic neuroendocrine tumours (VIPoma, glucagonoma, somatostatinoma, non-functioning) →
Adverse effects
Common
- Severe nausea and vomiting
- Diarrhoea
- Tiredness, depression
- Pain or redness at the injection site
Contraindications
- Hypersensitivity to streptozocin; existing kidney disease weighs strongly against use
Key interactions
- Other drugs that harm the kidney
- Add to kidney damage; the medication list is reviewed.
- Other myelosuppressive chemotherapy
- Adds to low blood counts.
What is monitored
- Kidney function and urine tests before, during and after treatment
- Blood glucose
- Complete blood count
- Liver tests
Administration and safety
- Hazardous cytotoxic given into a vein only by staff experienced with chemotherapy.
- Can irritate the vein: the site is watched for pain, redness or swelling.
- Fluid intake is encouraged as ordered, to protect the kidneys.
- Antiemetics are given because vomiting is often severe.
Pregnancy and breastfeeding
Avoid in pregnancy. Streptozocin may harm the fetus; pregnancy and breastfeeding are avoided during treatment.
Nursing care
- Measure urine output and weight; teach to report less urine or swelling.
- Check blood glucose; teach the signs of hypoglycaemia (sweating, tremor, sudden hunger, confusion).
- Teach to report fever, bleeding or bruising.
- Drowsiness or confusion can occur: no driving until the effect is known.
Pharmacokinetics
- Absorption
- Given into a vein by trained staff, as daily courses or weekly.
Test yourself
Think of the answer, then tap the question to see it.
Why does streptozocin act selectively on pancreatic islet cells?
Its glucose part gives it a high affinity for islet cells, which take it up selectively.
What is the dose-limiting organ toxicity of streptozocin?
Kidney damage.
Why can a patient on streptozocin sweat, shake and feel confused?
Low blood sugar from sudden insulin release by damaged beta cells.
Connections
← Back to the class: Alkylating agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Streptozocin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2013); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.