Etopozid

Etopozid – the drug entering into group of antineoplastic medicines.

Pharmacological action of Etopozid

Etopozid treats semi-synthetic derivatives of podophyllotoxin. Has antineoplastic effect on an organism.

At the heart of effect of drug Etopozid – the topoisomerase II inhibition mechanism. The therapeutic effect of Etopozid's reception is caused by ability of medicine to oppress a mitosis by means of blocking of cells in the period of S and G2 interphase (fazospetsifichny tsitoksichesky influence). Drug exerts impact only at use in high doses on healthy cells.

Etopozid's ability to influence molecule DNA is noted, breaking process of its replication. Also drug slows down proliferation of cells and suppresses nucleotide transport. The similar mechanism interferes with recovery of DNA and its synthesis.

Release form

In pharmaceutical networks three forms of drug Etopozid are available:

• capsules;
• the concentrated means Etopozid for preparation of the solution intended for infusions;
• the concentrated means for preparation of solution for intake.

Indications to Etopozid's use

The instruction to Etopozid notes efficiency of drug at treatment of the following diseases:

• germinogenny tumors of ovaries and small egg;
• cancer of bark of adrenal glands;
• lung cancer;
• bladder cancer;
• nekhodzhkinsky lymphoma;
• miyeloblastny and monoblast leukosis in acute forms;
• lymphogranulomatosis;
• Ewing's sarcoma;
• Kaposha's sarcoma;
• horionepitelioma;
• carcinoma of the stomach;
• neuroblastoma.

Contraindications

Among contraindications to drug numerous medical reviews of Etopozida note the following:

• hypersensitivity to any of Etopozid's components;
• renal or liver failure;
• oppression of a marrowy hemopoiesis in a severe form (cases when the leukopenia makes 2 thousand / мкл or below, a neutropenia – 1,5 thousand / мкл or below, and thrombocytopenia – is lower than 75 thousand / мкл);
• infections of the fungal, bacterial and virus nature in an acute form (including chicken pox and herpes);
• arrhythmia;
• period of pregnancy and feeding by a breast.

Drug Etopozid should be used with care to the following groups of patients:

• transferred chemotherapy or radiation therapy;
• suffering from chicken pox;
• patients with infectious damages of mucous membranes;
• patients with disturbances of a cordial rhythm;
• patients with disturbances of functioning of kidneys;
• patients with diseases of a nervous system;
• patients with chronic alcohol addiction;
• children, whose age less than 2 years (it must be kept in mind that safety and efficiency at use by children are not established).

Application instruction of Etopozid

According to the instruction to Etopozid the drug is administered, as a rule, intravenously, kapelno.

It is necessary to appoint the mode of dosing individually, being guided by a disease stage, medical indications, schemes of the applied chemotherapy and a condition of the hemopoietic system.

Before use drug it is necessary to dissolve 0,9% of NaCl solution in 250 ml, calculating rate of administering so that the general time of a dropper made of 30 minutes till one o'clock. Also Etopozid it is possible to mix with dextrose solution so that final concentration made 0,2-0,4 mg/l. The contact of drug with buffered aqueous solutions which hydrogen indicator (pH) is higher than 8 is forbidden.

Etopozid's dosages can be the following:

• on 100 mg/sq.m of times a day from 1 to 5 day of treatment. The cycle is repeated by each 3 weeks-months;
• on 100-125 mg/sq.m in the 1st, 3rd, 5-y day. To repeat a course on the expiration of 3 weeks;
• on 50 mg/sq.m daily inside for 21 days. It is necessary to repeat a course each 4 weeks. There is also other scheme of a dosage: on 100-200 mg/sq.m it is necessary to accept within 5 days then to take a break for 3 weeks.

It is important to mean that the course of treatment is repeated only after indicators of peripheral blood are normalized.

Side effects of Etopozid

Emergence of side reactions against the background of Etopozid's use is in certain cases possible. Treat those:

• phlebitis (at in administration of drug), local irritative action (up to a necrosis) at hit of means under skin covers;
• toxic manifestations in the form of decrease in quantity of granulocytes and leukocytes. At the same time the lowest number of granulocytes is, as a rule, observed for 7-14 day of performing therapy, the minimum number of thrombocytes can be observed for 9-16 day later began Etopozid's uses. Indicators of blood are most often recovered in 20 days after the beginning of use (provided that the standard dose is entered);
• anemia;
• vomiting, nausea, abdominal pain, diarrhea, esophagitis, stomatitis, loss of appetite, dysphagy, increase in activity of hepatic transaminases, hyperbilirubinemia;
• the decrease in the ABP which is temporary (it is observed at bystry injection of medicine in/in);
• allergic manifestations in the form of a bronchospasm, tachycardia, an asthma, a fever. It is possible to eliminate similar reactions by use of antihistaminic drugs;
• the alopecia having reversible character (in certain cases (about 66%) is not excluded total loss of hair), a xanthopathy, beam dermatitis, an itch;
• drowsiness, peripheral neuropathy, increased fatigue, pneumosclerosis, intersticial dermatitis, residual smack in an oral cavity, Stephens-Johnson's syndrome, an optic neuritis, a Lyell's disease, muscular spasms, a hyperuricemia, a metabolic acidosis.

Special instructions

The numerous experiments and reviews of Etopozida based on the data obtained by practical consideration note incompatibility of drug with types of activity, the demanding high degree of concentration and speed of response.

Etopozid is capable to have mutagen effect.

Control of a picture of peripheral blood is recommended during treatment by drug Etopozid.

Etopozid storage conditions

Etopozid is recommended to store in the place where sunshine do not get, and temperature is in limits of 15-25 °C. Drug should be preserved against access for children. The period of validity at observance of storage conditions equals to 3 years.