Etoposide - a drug belonging to the group of anti-tumor drugs.
The drugs etoposide
Etoposide belongs to a semi-synthetic derivative of podophylotoxins. It shows an antitumor effect on the body.
At the heart of the drug etoposide - the mechanism of inhibition of topoisomerase II. The therapeutic effect of Etoposide reception due to the ability of the drug to inhibit mitosis by blocking the cells in the interphase between S and G2 (fazospetsifichnoe cytotoxic effects). In healthy cells the drug has an effect only when used in high doses.
There Etoposide ability to influence the DNA molecule, disturbing the process of replication. Also, the drug inhibits cell proliferation and suppresses nucleotide transport. This mechanism prevents the recovery of DNA and its synthesis.
In the pharmaceutical network are three forms of the drug etoposide:
- Concentrated agent etoposide for solution designed for infusions;
- Concentrated liquid solution for oral administration.
Instruction notes etoposide efficacy in the treatment of the following diseases:
- germ cell tumors of the ovary and testis;
- cancer of the adrenal cortex;
- lung cancer;
- bladder cancer;
- non-Hodgkin's lymphoma;
- myelogenous leukemia and acute monoblastic forms;
- Hodgkin's disease;
- Ewing's sarcoma;
- Kaposi's sarcoma;
- stomach cancer;
Among the contraindications to the drug many medical reviews etoposide note the following:
- hypersensitivity to any component of Etoposide;
- kidney or liver failure;
- suppression of bone marrow hematopoiesis in severe (cases when leukopenia was 2 thousand. / l or below, neutropenia - 1, 5 thousand. / l or below, and thrombocytopenia - below 75 thousand. / l);
- fungal infections, bacterial and viral nature in an acute form (including chickenpox and herpes);
- during pregnancy and breastfeeding.
The drug etoposide should be used with caution in the following patient groups:
- undergoing chemotherapy or radiation therapy;
- suffering from chicken pox;
- patients with infectious lesions of the mucous membranes;
- patients with heart rhythm disturbances;
- patients with impaired renal function;
- patients with diseases of the nervous system;
- patients with chronic alcohol dependence;
- children whose age is less than 2 years (it should be understood that the safety and efficiency when using the children are not installed).
Instructions for Use Etoposide
According to the instructions of Etoposide formulation is generally administered intravenous drip.
The dosage regimen should be prescribed individually, focusing on the stage of the disease, medical indications, chemotherapy scheme used and the state of the hematopoietic system.
Before application of the drug can be dissolved in 250 ml of 0 9% solution of NaCl, calculating the rate of administration so that the total time of the dropper is from 30 minutes to one hour. Etoposide can also be mixed with dextrose solution so that a final concentration of 0, 2-0, 4 mg / l. It is forbidden to touch the drug with a buffered aqueous solution, the pH value (pH) is above 8.
Dosages Etoposide may include the following:
- 100 mg / sq. m times a day 1 to day 5 of treatment. The cycle is repeated every 3 weeks, a month;
- at 100-125 mg / sq. m in the 1st, 3rd, 5th rd day. The course is repeated on the expiration of 3 weeks;
- 50 mg / sq. m inside daily for 21 days. The course should be repeated every 4 weeks. There is also another scheme dosage: 100-200 mg / sq. m must be taken within 5 days, after which a break for 3 weeks.
It is important to bear in mind that the treatment is repeated only after normalizes peripheral blood.
Side effects Etoposide
In some cases, adverse reactions may occur during treatment with etoposide. These include:
- phlebitis (with on / in the introduction of the drug), local irritating effect (up to necrosis) in contact with agents under the cover of the skin;
- toxic manifestations of reducing the number of granulocytes and leukocytes. When this is the lowest number of granulocytes typically observed 7-14 days of therapy, the minimum number of platelets can be observed on day 9-16 after the start of Etoposide. Indicators of blood often recovered 20 days after the beginning of use (with the proviso that, a standard dose);
- vomiting, nausea, abdominal pain, diarrhea, esophagitis, stomatitis, anorexia, dysphagia, increase in liver transaminases, hyperbilirubinemia;
- lowering blood pressure, non-transitory (observed with the rapid infusion of medications w / w);
- allergic reactions in the form of bronchospasm, tachycardia, shortness of breath, chills. Eliminate such reactions can be achieved by the use of antihistamines;
- alopecia, wearing reversible (in some cases (about 66%) is not ruled out a complete loss of hair), skin pigmentation, radiation dermatitis, pruritus;
- somnolence, peripheral neuropathy, fatigue, pulmonary fibrosis, interstitial dermatitis, the residual taste in the mouth, Stevens-Johnson syndrome, optic neuritis, Lyell's syndrome, muscle cramps, hyperuricemia, metabolic acidosis.
Numerous experiments and reviews etoposide, based on data obtained by experiment, note the incompatibility of drug with activities that require high concentration and speed of reaction.
Etoposide is capable of mutagenic effects.
It is recommended to monitor patterns of peripheral blood during treatment with etoposide.
Storage conditions Etoposide
Etoposide should be stored in a place where the sun's rays do not penetrate, and the temperature is between 15-25 ° C. The drug should be protected from access by children. Shelf life when stored is 3 years.