Etoposide
Instructions for use:
- 1. Pharmacological action
- 2. Release form
- 3. Indications for use
- 4. Contraindications
- 5. Instructions for use
- 6. Side effects
- 7. Special instructions
- 8. Storage conditions
Etoposide is a drug belonging to the group of anticancer drugs.
Pharmacological action of Etoposide
Etoposide belongs to the semisynthetic derivatives of podophilotoxin. It has an antitumor effect on the body.
The action of the drug Etoposide is based on the mechanism of inhibition of topoisomerase II. The therapeutic effect of taking Etoposide is due to the ability of the drug to inhibit mitosis by blocking cells during the interphase S and G2 (phase-specific cytoxic effect). The drug affects healthy cells only when used in high doses.
The ability of Etoposide to influence the DNA molecule, disrupting the process of its replication, is noted. Also, the drug inhibits cell proliferation and inhibits nucleotide transport. This mechanism interferes with DNA repair and synthesis.
Release form
There are three forms of Etoposide available in pharmaceutical chains:
- capsules;
- concentrated agent Etoposide for the preparation of a solution intended for infusion;
- concentrated product for preparation of oral solution.
Indications for the use of Etoposide
The instruction for Etoposide notes the effectiveness of the drug in the treatment of the following diseases:
- germ cell tumors of the ovaries and testicles;
- adrenal cortex cancer;
- lung cancer;
- bladder cancer;
- non-Hodgkin's lymphoma;
- myeloblastic and monoblastic leukemia in acute forms;
- lymphogranulomatosis;
- Ewing's sarcoma;
- Kaposi's sarcoma;
- chorionepithelioma;
- stomach cancer;
- neuroblastoma.
Contraindications
Among the contraindications to the drug, numerous medical reviews about Etoposide note the following:
- hypersensitivity to any of the components of etoposide;
- renal or hepatic impairment;
- inhibition of bone marrow hematopoiesis in severe form (cases when leukopenia is 2 thousand / μl or less, neutropenia is 1.5 thousand / μl or less, and thrombocytopenia is below 75 thousand / μl);
- infections of a fungal, bacterial and viral nature in acute form (including chickenpox and herpes);
- arrhythmia;
- During pregnancy and breastfeeding.
The drug Etoposide should be used with caution in the following groups of patients:
- have had chemotherapy or radiation therapy;
- suffering from chickenpox;
- patients with infectious lesions of the mucous membranes;
- patients with cardiac arrhythmias;
- 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 borne in mind that safety and efficacy when used by children have not been established).
Instructions for the use of Etoposide
According to the instructions for Etoposide, the drug is usually administered intravenously, drip.
The dosage regimen should be assigned individually, focusing on the stage of the disease, medical indications, chemotherapy regimens and the state of the hematopoietic system.
Before starting use, the drug should be dissolved in 250 ml of 0.9% NaCl solution, calculating the rate of administration in such a way that the total drip time is from 30 minutes to one hour. Also, Etoposide can be mixed with a dextrose solution so that the final concentration is 0.2-0.4 mg / L. It is forbidden to contact the drug with buffered aqueous solutions, the pH value of which is higher than 8.
Dosages of Etoposide may be as follows:
- 100 mg / sq. m once a day from 1 to 5 days of treatment. The cycle is repeated every 3 weeks-month;
- 100-125 mg / sq. m on the 1st, 3rd, 5th day. Repeat the course after 3 weeks;
- 50 mg / sq. m daily inside for 21 days. The course should be repeated every 4 weeks. There is also another dosage regimen: 100-200 mg / sq. m must be taken within 5 days, then take a break for 3 weeks.
It is important to keep in mind that the course of treatment is repeated only after the peripheral blood parameters are normalized.
Side effects of Etoposide
In some cases, adverse reactions may occur while using Etoposide. These include:
- phlebitis (with intravenous administration of the drug), local irritating effect (up to necrosis) when the product gets under the skin;
- toxic manifestations in the form of a decrease in the number of granulocytes and leukocytes. At the same time, the lowest number of granulocytes, as a rule, is observed on the 7-14th day of therapy, the minimum number of platelets can be observed on the 9-16th day after the start of the use of Etoposide. Blood counts are most often restored 20 days after the start of use (provided that a standard dose is administered);
- anemia;
- vomiting, nausea, abdominal pain, diarrhea, esophagitis, stomatitis, decreased appetite, dysphagia, increased activity of hepatic transaminases, hyperbilirubinemia;
- decrease in blood pressure, which is temporary (observed with a rapid infusion of the drug in / in);
- allergic manifestations in the form of bronchospasm, tachycardia, shortness of breath, chills. You can eliminate such reactions by using antihistamines;
- alopecia, which is reversible (in some cases (about 66%), complete hair loss is not excluded), skin pigmentation, radiation dermatitis, itching;
- drowsiness, peripheral neuropathy, fatigue, pulmonary fibrosis, interstitial dermatitis, aftertaste in the mouth, Stevens-Johnson syndrome, optic neuritis, Lyell's syndrome, muscle cramps, hyperuricemia, metabolic acidosis.
special instructions
Numerous experiments and reviews about Etoposide, based on empirically obtained data, note the incompatibility of the drug with activities that require a high degree of concentration and reaction rate.
Etoposide is capable of mutagenic effects.
It is recommended to control the picture of peripheral blood during treatment with Etoposide.
Storage conditions for Etoposide
It is recommended to store etoposide in a place where the sun's rays do not penetrate, and the temperature is between 15-25 ° C. The drug should be kept out of the reach of children. The shelf life, subject to storage conditions, is 3 years.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
