Dakarʙazin

When ATH:
L01AX04

Pharmacological action.
Antitumor, alkylating, cytostatic, immunosuppressive.

Application.

Melanoma, limfogranulematoz, soft tissue sarcomas, tumors of the gastrointestinal tract, colon, CNS, testicular (as a second-row).

Contraindications.

Hypersensitivity.

Restrictions apply.

Assessment of the risk-benefit ratio is needed in the appointment of the following cases: suppression of bone marrow function, enable vetryanaya, herpes zoster and other systemic infections, the liver and kidneys, prior cytotoxic or radiation therapy, the elderly and children's age.

Pregnancy and breast-feeding.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

At the time of treatment should stop breastfeeding.

Side effects.

From the digestive tract: gastrointestinal bleeding, stomatitis, nausea, vomiting, diarrhea, abdominal pain, anorexia, stomatitis, liver, including hepatocellular necrosis and hepatic vein thrombosis.

Cardio-vascular system and blood (hematopoiesis, hemostasis): anemia, leukopenia, thrombocytopenia, bleeding and hemorrhage, phlebitis.

With the genitourinary system: painful or difficult urination, amenorrhea, azoospermia.

For the skin: numbness and facial flushing, alopecia, redness, swelling, soreness, necrosis of the subcutaneous tissue, scarring at the injection site, Education extravasates.

Other: anaphylactic reactions, temperature rise, flu-like symptoms, cough, the development of infections, pain syndrome (backache, by, joints and muscles), increasing the concentration of AST, GOLD, alkaline phosphatase, blood urea nitrogen.

Cooperation.

Weakens the effectiveness of immunization inactivated vaccines; using vaccines, containing live viruses, enhances viral replication and side effects of vaccination. The combined use with other myelotoxicity drugs and radiation therapy increases bone marrow depression (potentiate the neutropenia, thrombocytopenia), с индукторами ферментов печени — метаболизм дакарбазина (necessary correction mode). Reduces the effect of dacarbazine protivopodagricakih drugs (allopurinol et al.). Compatible with other anticancer drugs (bleomycin, cisplatin, ftoruracil, vincristine, and others.).

Overdose.

Symptoms: nausea, vomiting, severe bone marrow depression, fever, bleeding.

Treatment: hospitalization, monitoring vital functions; simptomaticheskaya therapy; if necessary - transfusion of blood components, the appointment of broad-spectrum antibiotics.

Dosing and Administration.

B /, Dose picked individually, is corrected on the basis of clinical effect, the severity of the toxic effect. Adults, melanoma 250 mg / m² body surface during 5 days, повторный курс — через 21–29 дней или 2–4,5 мг/кг/сут в течение 10 days, Refresh course — via 28 days. If chlamydia 150 mg / m² body surface during 5 days in combination with other drugs, Refresh course — via 28 days or 375 mg / m² in 1 day in combination with other drugs, repeated every 15 days.

Precautions.

Use only under medical supervision, with experience of chemotherapy. Prior to and during treatment (at short intervals) necessary to determine hemoglobin or hematocrit, the number of leukocytes (overall, differential), Platelet, IS aktivnosti, GOLD, LDH, creatinine, BUN, bilirubin, Uric acid. Leukopenia and thrombocytopenia develop with 16-20 days after initiation of therapy, the lowest possible amount of white blood cells and platelets observed in the 21-25 day, recovery occurs over the next 3-5 days (when expressed myelodepression treatment should be discontinued until symptoms resolve gematotoksichnosti). In the formation of extravasates at the injection site with a / in the introduction of the appointment immediately stopped and resumed at another vein until a full dose. Тошнота и рвота могут продолжаться в течение 1–12 ч после введения, weaken, usually, within 1-2 days after the start of treatment. Flu-like syndrome occurs through 7 days after injection and lasts 1-3 weeks. In the event of thrombocytopenia advised extreme caution when performing invasive procedures, Regular inspection of places on / in the, skin and mucous membranes (for signs of bleeding), limit frequency troublesome and the rejection of the / m injection, control of blood in the urine, vomit, Kale. The patients must be carefully shave, manicure, brush your teeth, dentists use threads and toothpicks, to conduct dental procedures; should be the prevention of constipation, avoid falls and other injuries, as well as the intake of alcohol and acetylsalicylic acid, increase the risk of gastrointestinal bleeding. Should defer vaccination schedule (carried out not earlier than 3 Months before 1 years after completion of the last cycle of chemotherapy) patient and other family members, residing with him (should abandon immunization oral polio vaccine). Avoid contact with infectious patients, or use non-event for the prevention of (face mask, etc.). It should refrain from the use in pediatric practice, because the safety and efficacy of its use in children is not identified. During treatment should use appropriate contraceptive measures. In case of contact with skin or mucous membranes must be thorough washing with water (mucosa) or soap and water (skin). Dissolution, dilution and administration of the preparation is carried out by trained medical staff with the protection (gloves, masks, clothing and other.).

Cautions.

The solution for parenteral administration is prepared, adding 9,9 ml (во флакон со 100 mg), 19,7 ml (in vial 200 mg) or 49,5 ml (in vial 500 mg) sterile water for injection (concentration is 10 мг дакарбазина в 1 ml). Для в/в инфузии раствор дополнительно разбавляют до 250 ml 5% or dextrose 0,9% sodium chloride solution. Приготовленные растворы стабильны до 72 no (with stronger dilution 24 no) at a temperature 4 °C или до 8 hours at room temperature.

Cooperation