Fotemustine
When ATH:
L01AD05
Characteristic
Nitrosoureas. Soluble in 95% ethanol and methanol, slightly soluble in water.
Pharmacological action
Antitumor, cytostatic, alkylating, immunosuppressive.
Application
Disseminirovannaya zlokachestvennaya melanoma (especially brain metastases), Primary malignant brain tumor.
Contraindications
Hypersensitivity (incl. to others. nitrosoureas), bone marrow hypoplasia (число тромбоцитов менее 100·109/l, гранулоцитов — менее 2·109/l), pregnancy, lactation, childhood (safety and effectiveness in children have not identified).
Restrictions apply
Assessment of the risk-benefit ratio is needed in the appointment of the following cases: suppression of bone marrow function, prior cytotoxic or radiation therapy.
Pregnancy and breast-feeding
Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.
Side effects
Nausea and vomiting through 2 hours after injection (47%), thrombocytopenia and leykopeniya (40–46%) with a maximum severity after 4-6 weeks after the first injection, disturbance of consciousness, sense of taste, paresthesia, abdominal pain, diarrhea, moderate and reversible increase in urea (0,8%), transaminases, alkaline phosphatase and bilirubin in plasma (30%), hyperthermia (3,3%), phlebitis at the injection site (3%), itching (0,7%).
Cooperation
Strengthens the respiratory toxicity of dacarbazine. Other myelotoxicity drugs and radiation therapy may potentiate the inhibition of hematopoiesis.
Overdose
Symptoms: nausea, vomiting, severe bone marrow depression, bleeding.
Treatment: simptomaticheskaya therapy; if necessary - transfusion of blood components, the appointment of broad-spectrum antibiotics; monitoring vital functions.
Dosing and Administration
B / by 100 mg / m2, 2Infusion at intervals of -3 7 days for the induction of remission, then a break for 4-5 weeks and continue to support the exchange rate: 1 once every 3 Sun. When chemotherapy at the same dose in the 1st and 8th day (third injection is not carried out). Treatment starts, если число тромбоцитов не менее 100·109/л и гранулоцитов — не менее 2·109/l. При уменьшении этих показателей до 80·109/л и 1,5·109/l, respectively, dose reduce on 25%, а при уменьшении числа гранулоцитов до 1·109/l is on 50% (more pronounced in the case of bone marrow suppression postpone the introduction of the next dose).
Precautions
Use only under medical supervision, with experience chemotherapy. Prior to and during treatment (at short intervals) you must determine the level of hemoglobin, or hematocrit, bilirubin, BUN, creatinine, the number of leukocytes (overall, differential), Platelet. The next course is not recommended before 4-6 weeks after the previous course. Do not apply before, than 3 weeks after the dacarbazine (the risk of respiratory distress syndrome). 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 qualified medical personnel with the protection (gloves, masks, clothing and other.).
Cautions
The solution for the on / in the cook, adding to the contents of the vial supplied solvent (When this turns out 4 ml, contains 200 mg fotemustina). After calculation of the required dose of the solution is further diluted 5% glucose solution. Cooked solution should be used within 1 hours after preparation.
