Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
Antitumor agent. It is a semisynthetic derivative of podophyllotoxin. The mechanism of action is associated with the inhibition of topoisomerase II. Oppresses mitosis, blocks cells in the SG 2 -terphase of the cell cycle, in higher doses acts in the G 2 -phase. Cytotoxic action against normal healthy cells is observed only when etoposide is used in high doses.
PHARMACOKINETICS
When ingestion etoposide is absorbed from the digestive tract. Bioavailability is on average 50%. Distribution in the cerebrospinal fluid is low and variable; the concentration in normal lung tissue is higher than in the presence of metastases in the lungs; a close level of concentrations in the tissues of primary tumors and in normal tissues of the myometrium is determined.
A direct correlation between the etoposide binding rate and the albumin level in the blood plasma of healthy people and patients with cancer has been noted.Metabolised in the liver.
The final T 1/2 on average is 7 hours. It is excreted by the kidneys - 44-60%, with feces - up to 16%, with bile - 6% or less.
INDICATIONS
Germinogenic tumors (testicular tumors, choriocarcinoma), ovarian cancer, small cell and non-small cell lung cancer, lymphogranulomatosis, non-Hodgkin's lymphomas, stomach cancer (for monotherapy and combined therapy), Ewing's sarcoma, Kaposi's sarcoma, neuroblastoma, breast cancer (with metastases in liver, pleura), acute non-lymphoblastic leukemia, mesothelioma.
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: leukopenia, anemia; less often - thrombocytopenia.
On the part of the digestive system: nausea, vomiting; rarely - anorexia, mucositis, diarrhea; when used in high doses - toxic reactions from the liver.
From the side of the central nervous system and peripheral nervous system: drowsiness, increased fatigue; defeat of the peripheral nervous system.
From the side of metabolism: hyperuricemia; when using high doses - metabolic acidosis.
From the cardiovascular system: tachycardia, arterial hypotension.
From the side of the reproductive system: azoospermia, amenorrhea.
Allergic reactions: chills, fever, bronchospasm.
Dermatological reactions: alopecia.
CONTRAINDICATIONS
Pronounced mielodepression, marked violations of the liver and kidneys, pregnancy, children under 2 years old, hypersensitivity to podophylline or its derivatives.
PREGNANCY AND LACTATION
Etoposide is contraindicated in pregnancy. If necessary, use during lactation should stop breastfeeding.
During treatment and within 3 months after its end, patients of childbearing age need to apply effective methods of contraception.
In experimental studies , it has been established that etoposide exerts a teratogenic and embryotoxic effect.
APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in severe impairment of kidney function.
With moderate and mild renal impairment, the dose is reduced in accordance with the values ​​of CC.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in severe violations of liver function.
Use with caution in patients with impaired liver function.
APPLICATION FOR CHILDREN
Contraindicated in children under 2 years.
Use with caution in children older than 2 years.
SPECIAL INSTRUCTIONS
With caution apply in patients with previous radiation or chemotherapy, with chickenpox, herpes zoster, with infectious lesions of the mucous membranes, with heart rhythm disturbances, with an increased risk of myocardial infarction, liver dysfunction, nervous system diseases (epilepsy), chronic alcoholism, in children older than 2 years.
If the renal function is impaired, the dose is reduced in accordance with the values ​​of the CC.
Before and against the background of ongoing therapy should monitor the picture of peripheral blood.
Do not recommend the vaccination of patients and their families.
In experimental studies, it has been established that etoposide has a mutagenic effect.
Impact on the ability to drive vehicles and manage mechanisms
During treatment should refrain from occupations that require increased attention and rapid psychomotor reactions.
DRUG INTERACTION
With simultaneous use with other drugs that cause myelodepression, additive inhibition of bone marrow function is possible.
When used simultaneously with cisplatin, the clearance of etoposide may decrease and its toxicity increase.
Cyclosporine in high doses can reduce the clearance of etoposide and increase the duration of its action, with the possible increase in leukopenia.
