For induction therapy in adult patients with AML the following dose schedule is recommended: Idarubicin 12 mg/m2 daily for 3 days by slow (10 to 15 min) intravenous injection in combination with cytarabine. The cytarabine may be given as 100 mg/m2 daily by continuous infusion for 7 days or as cytarabine 25 mg/m2 intravenous bolus followed by cytarabine 200 mg/m2 daily for 5 days continuous infusion. In patients with unequivocal evidence of leukemia after the first induction course, a second course may be administered. Administration of the second course should be delayed in patients who experience severe mucositis, until recovery from this toxicity has occurred, and a dose reduction of 25% is recommended. In patients with hepatic and/or renal impairment, a dose reduction of IDAMYCIN PFS should be considered. Idarubicin should not be administered if the bilirubin level exceeds 5 mg%

Treatment of HL-60 cells with 1 uM Idarubicin for 2 h could not induce internucleosomal DNA fragmentation, however, a ladder of DNA fragment, characteristic of apoptosis, was observed after incubation for 4 h. After 10-h, extensive DNA degradation was observed. When HL-60 cells were incubated with different doses of Idarubicin for 8 h, the degree of DNA fragmentation increased at the higher concentration.