Universal reference book for medicines
Product name: DAUNORUBICIN-LANS (DAUNORUBICIN-LANS)

Active substance: daunorubicin

Type: Antitumor antibiotic

Manufacturer: ЛЭНС-ФАРМ (Russia)
Description of the active substance:
This information is a reference and it is not enough that the drug was prescribed by a doctor.
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PHARMACHOLOGIC EFFECT
An antitumour agent from the anthracycline antibiotic group is produced by Streptomyces coeruleorubidis.
Cytotoxic effect is due to the ability to inhibit the synthesis of DNA, RNA and proteins. The mechanism of action is based on the intercalation of anthracycline between adjacent base pairs of the double helix DNA, which prevents its "unfolding" for subsequent replication.
PHARMACOKINETICS
After iv introduction quickly distributed in the body, especially in the kidneys, spleen, liver, heart.
Does not penetrate the BBB. Metabolised in the liver with the formation of an active metabolite daunorubicinol.
T 1/2 in the initial phase is 45 minutes;
in the final phase - for daunorubicin 18.5 h, for daunorubicinol 26.7 h, for other metabolites 55 h. It is excreted by the kidneys and with bile.
INDICATIONS
Acute leukemia, lymphogranulomatosis, uterine chorioepithelioma, neuroblastoma, Ewing tumor, Wilms tumor, non-Hodgkin's lymphomas.

DOSING MODE
Established individually, depending on the indications and stage of the disease, the state of the hematopoiesis system, the scheme of antitumor therapy.

SIDE EFFECT
On the part of the hematopoiesis system: anemia, leukopenia, thrombocytopenia.

On the part of the digestive system: nausea, vomiting, diarrhea, stomatitis.

From the cardiovascular system: heart failure, arrhythmias;
rarely - myocarditis, pericarditis.
From the side of the reproductive system: amenorrhea, azoospermia.

Other: alopecia, allergic reactions, headache.

Local reactions: pain at the injection site, necrosis of the tissue (in violation of the technique of administration).

CONTRAINDICATIONS
Leucopenia (number of leukocytes below 4000 / μl), thrombocytopenia (platelet count below 120,000 / μl), chronic heart failure in decompensation stage, marked violations of the liver and / or kidney function, gastric and duodenal peptic ulcer in the acute phase, pregnancy, increased sensitivity to daunorubicin.

PREGNANCY AND LACTATION
Daunorubicin is contraindicated in pregnancy.
If necessary, use during lactation should stop breastfeeding.
Women of childbearing age should use reliable contraceptive methods during daunorubicin therapy.

In experimental studies , teratogenic, embryotoxic effect of daunorubicin was established.

APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in severe impairment of kidney function.
Use with caution in patients with impaired renal function.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in severe violations of liver function.
Use with caution in patients with impaired hepatic function.
APPLICATION FOR CHILDREN
The frequency of cardiotoxic side effects in children increases if the total dose of daunorubicin exceeds 300 mg / m 2 .
Violations of myocardial contractility, the symptoms of chronic heart failure and other cardiotoxic effects of daunorubicin in children may occur several months and even years after the end of treatment, therefore, the control of the functional state of the cardiovascular system should be carried out for a long time.
SPECIAL INSTRUCTIONS
They are used with caution in patients with impaired renal and / or liver function, heart disease (including history), gout or nephrolithiasis (including history), as well as in patients who received or are currently receiving time combined chemotherapy with other antitumor drugs that have a myelotoxic effect, or a course of radiation therapy.

Do not recommend the use of daunorubicin in patients with chickenpox (including recently ill or after contact with the sick), with herpes zoster or other acute infectious diseases.

Before and during the treatment, control of the peripheral blood picture, functional state of the kidneys, liver, chest X-ray, ECG, echocardiography, determination of the cardiac shock volume is necessary.

The frequency of cardiotoxic side effects increases if the total dose of daunorubicin exceeds 400 mg / m 2 in adults and 300 mg / m 2 in children.
Violations of myocardial contractility, symptoms of chronic heart failure and other cardiotoxic effects of daunorubicin may occur several months and even years after the end of treatment (especially in children), therefore, the control of the functional state of the cardiovascular system should be carried out for a long time.
Do not recommend the vaccination of the patient or his family.

Do not recommend the use of daunorubicin in patients who previously received complete cumulative doses of doxorubicin.
If the received dose rate of doxorubicin is below the cumulative dose, then the total dose of daunorubicin and doxorubicin should not exceed 550 mg / m 2 .
In the first few days of using daunorubicin, it is possible to stain the urine red.

DRUG INTERACTION
With simultaneous use with drugs that have a myelotoxic effect, it is possible to intensify toxic effects.

When used with cyclophosphamide or doxorubicin, the risk of cardiotoxicity increases.

When combined with methotrexate (or with other drugs with a hepatotoxic effect), the likelihood of hepatotoxicity increases.

The use of daunorubicin with uricosuric drugs increases the risk of developing nephropathy.

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