Epirubicin

When ATH:
L01DB03

Characteristic.

Synthetic antibiotics anthracyclines.

Pharmacological action.
Antitumor.

Application.

Leukemia, nehodzhkinskaya lymphoma, limfogranulematoz, mnozhestvennaya myeloma, ovarian cancer, Breast, stomach, liver, pancreas, sigmoid colon and rectum, Bladder (surface), Head and Neck, bronchogenic lung cancer, soft tissue sarcoma, osteosarcoma.

Contraindications.

Hypersensitivity, therapy cumulative doses of anthracycline antibiotics history, severe myelosuppression, heart failure (incl. history), pregnancy, lactation.

Restrictions apply.

Childbearing age (The appointment patients of childbearing age should use reliable contraceptive measures), childhood (Safety and efficacy have not been established).

Pregnancy and breast-feeding.

Contraindicated in pregnancy.

Category actions result in FDA - D. (There is evidence of the risk of adverse effects of drugs on the human fetus, obtained in research or practice, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk, if the drug is needed in life-threatening situations or severe disease, when safer agents should not be used or are ineffective.)

At the time of treatment should stop breastfeeding.

Side effects.

Cardio-vascular system and blood (hematopoiesis, hemostasis): heart failure (may develop a few weeks after the end of treatment), toxic myocarditis, arrhythmia, arterial hypertension, bone marrow hypoplasia, leukopenia (It is transient, reaching a maximal level within 10-14 days after treatment; normalization of white blood cell count comes to 21 th day), thrombocytopenia, anemia.

From the digestive tract: gastrointestinal disorders ( nausea, vomiting, diarrhea), anorexia, mucositis (stomatitis in the form of painful erosions, especially on the sides and on the tongue sublingual mucosa) - can develop 5-10 days after the start of treatment.

For the skin: 60–90% of cases - alopecia (usually reversible), accompanied by a male termination of beard growth.

Allergic reactions: Rarely - fever, chills, hives, anaphylaxis.

Other: asthenia, conjunctivitis, mukozit, hyperthermia, hardening of the veins (with possible necrosis of surrounding tissues when extravasation), reddish coloration of urine (1-2 days after treatment).

Cooperation.

Pharmaceutically compatible with heparin solution (possible precipitation).

Overdose.

Symptoms: enhancement of side effects.

Dosing and Administration.

B /, 3-5 min, dissolved in sterile water for injection or physiological saline. With monotherapy, administered at a dose of 60–90 mg/m² 1 once every 3 Sun. When bone marrow suppression, metastasis to bone marrow, Dose functional disorders are reduced to 60–75 mg/m². Total dose per cycle can be divided and administered for 2-3 consecutive days.

In combination therapy with other antitumor agents, reduce the dose.

Intravesical (through the catheter) with papillary cell cancer of the bladder- 50 mg (in 25-50 ml of physiological solution) 1 once a week, Course - 8 Sun. In the case of local toxic symptoms, the dose is reduced to 30 mg, cancer on-site the dose can be increased to 80 mg depending on individual tolerance of drugs. For the prevention of relapses after transient resection of the surface tumors of the bladder - 50 Mg intracurrency 1 once a week for 4 Sun, then once a month for 11 month in the same dose.

After intra -skipped administration, the drug should be held in the bladder for 1 no, Thereafter, the patient should urinate.

Precautions.

Prior to initiating therapy and regularly during treatment should be carefully cardiac monitoring and control of various laboratory parameters. A systematic control of cellular blood, heart and liver functions, content in plasma urate. Reduced voltage QRS on ECG is the first sign of myocardial damage. The total term paper should not exceed 1000 mg / m², Recommended concentration - 2 mg/ml 0,9% sodium chloride solution or water for injection. Avoid contact with skin and mucous membranes.

Cautions.

The use of epirubicin should be under the supervision of qualified doctors, with experience in anti-tumor therapy, compliance with established precautions (using goggles, disposable gloves and masks) and the destruction of materials, used for, and residues of unused product.

You can not mix in the same syringe with other anti-cancer agents.

In case of accidental contact with the drug on the skin should be thoroughly wash them with plenty of soap and water, when it gets into the eye - a physiological solution.

If the solution is spilled preparation, processing necessary to dilute sodium hypochlorite (using well liquid absorbent material), then water.

Cooperation