The drug "Doxorubicin": instructions for use, reviews, photo, dosage form, storage, storage. Doxorubicin-Lance: instructions for use

Cancer is extremely dangerous for human life. It consists of malignant and uncontrolled dividing cells that are capable of penetrating into nearby tissues, as well as metastasizing to other organs.

The development of drugs and methods of treatment of such diseases is the most important task. Unfortunately, until now no one has completely solved it. Although there are still drugs that can slow down the division of tumor cells. One of them includes the medicine "Doxorubicin". Instructions for use and photos of this drug will be discussed in this article. In it you will find information about how to store the mentioned facility, in what form it goes on sale, and so on.

Packaging, composition, form and description

In what form is Doxorubicin sold? Instructions for use indicate the following types of medication:

• Lyophilizate for solution for intravascular and intravesical injections. It is a red-yellow porous mass and contains an active substance such as doxorubicin hydrochloride. Mannitol is used as additional ingredients. The drug goes on sale in vials, enclosed in cardboard boxes.
• Concentrate for making a solution for intravascular and intravesical injections. It is a red and clear liquid that contains doxorubicin hydrochloride and is available in vials and carton packs.

Pharmacology of the drug

What is a medicine like Doxorubicin? Instructions for use (the form of the drug was indicated above) reports that it is an antitumor anthracycline antibiotic that is isolated from the culture of the Streptomyces peucetius fungus. It is able to have antimitotic and antiproliferative effects.

Interacting with DNA, this medicine suppresses RNA polymerase, DNA polymerase and topoisomerase of the second type, and also activates the production of free radicals and affects the cell walls. As a result of this influence, DNA replication and biological synthesis of nucleic acids are slowed down.

One can not but note the fact that the agent we are considering has a direct cytotoxic effect. Cells show special sensitivity to the drug in the G2 phase and S-phase of their life.

Kinetic properties

What kinetic parameters are inherent in the drug "Doxorubicin"? Instruction for use states that after intravenous injection this agent is always distributed multiphase. During the first 5 minutes, the medication is quickly captured by the tissues, and its concentration in the blood intensively decreases. With regard to the second phase, it is a slow release of drug molecules from the tissues.

This drug concentrates in the liver, kidneys, spleen, lungs and myocardium. It also penetrates the placenta and is excreted together with the mother's milk.

The reaction with plasma proteins occurs by 75%. The metabolism of the drug is carried out in the liver, resulting in an active derivative such as doxorubicinol.

In the process of the restoration of enzymes, the synthesis of free radicals can influence the development of cardiotoxic action.

The half-life of doxorubicin and doxorubicinol is similar and is about 20-48 hours.

Approximately 40% of the dose taken is excreted together with bile and only 6-11% of doxorubicin, as well as its derivatives, are detected in urine within 5 days.

Indications for use

At what diseases can the drug "Doxorubicin" be prescribed?

Instructions for use (for bladder cancer this remedy is used very often) states that this medication is well manifested when:

• Cancer of the thyroid gland, Kaposi's sarcoma and Ewing;
• Wilms' tumor, stomach cancer, small cell lung cancer;
• Insulinoma, breast cancer, mesothelioma;
• Cancer of the esophagus, carcinoid, neuroblastoma;
• Osteogenic sarcoma, primary hepatocellular carcinoma, non-Hodgkin's lymphoma ;
• Prostate cancer, oncological diseases of the neck and head region, malignant thymoma;
• Cancer of the cervix, some types of testicular tumor;
• Sarcoma of the uterus, endometrial cancer, Hodgkin's disease;
• Rhabdomyosarcoma, acute leukemia;
• Chronic lymphocytic leukemia, multiple myeloma.

Contraindications

What conditions of the patient forbid to prescribe him the drug "Doxorubicin"? Instructions for use, reviews of oncologists say that this tool is not very effective when:

• Sensitization to doxorubicin or other substances of the preparation, as well as to representatives of anthracenedions and anthracyclines;
• Previous therapy with other representatives of anthracyclines or anthracendones in the limiting doses, as well as with hepatic insufficiency (severe), myocardial infarction, arrhythmias, acute viral infections and heart failure (for intravenous administration);
• Malignant tumors that grow into the walls of the bladder, infectious diseases of the genitourinary tract and cystitis (for intravesical administration).

With special care, this medication should be used by people who received intensive chemotherapy, as well as with risk factors for cardiotoxicity, impaired liver function, bone marrow infiltration with cancer cells and obesity.

In addition, the drug under consideration is cautiously prescribed to children and the elderly, as well as in multi-species and multicomponent antitumor therapy.

The drug "Doxorubicin": instructions for use, dosage

According to the instructions, the drug in question can be administered intraarterially, intravesically and intravenously. It should also be noted that this drug is allowed to be used singly or in combination with other cytostatics in different dosages.

The reconstituted medicinal solution "Doxorubicin" should be used immediately after its manufacture.

Intravenous administration of the drug

With monotherapy, the recommended dosage of Doxorubicin per cycle is 60-75 mg / sq. M every three weeks. As a rule, this medicine is administered once. However, this dose can be administered and for several injections (in the amount of 25-30 mg / m2 per day during the first 3 days of the cycle).

To reduce the toxic effect, a weekly method of administration of 10-20 mg / sq. M once a week.

When combined with other antineoplastic agents, this medication is administered in a cyclic dose in an amount of 30-60 mg / sq. M every 4 weeks.

Repeated courses of treatment are carried out only after elimination of all symptoms of toxicity.

The total dose of this drug should not be more than 550 mg / square. M.

Intraarterial administration of the agent

How is intraarterial administration of the drug "Doxorubicin"? The instruction says that to provide local effect to people with hepatocellular cancer this medication should be injected into the general artery of the liver at a dosage of 35-150 mg / sq. M. In this case, the intervals between the cycles should be equal from 3 weeks to 3 months.

Introduction of the drug into the bladder

How is the medicine "Doxorubicin-Teva" administered to the bladder? Instruction for use informs that the dosage of this agent for intravesical administration should be 35-50 mg per one installation.

Treatment procedures should be performed at intervals of 7-28 days, depending on the purpose (prevention or treatment).

The concentration of the drug solution should be 1 mg / 1 ml of physical solution or water.

Instillations are carried out for 2 hours. In the end, the patient should empty the bladder.

Adverse events

The drug "Doxorubicin", the instruction of which was described above, can cause the following side reactions:

• Vomiting, abdominal pain, nausea, colitis, stomatitis, diarrhea, esophagitis, hyperpigmentation of the oral mucosa, anorexia, increased bilirubin concentration in the blood, gastrointestinal bleeding, increased hepatic transaminases;
• Reversible dose-dependent leukopenia, thrombocytopenia, anemia, leukopenia, neutropenia;
• Sinus tachycardia, atrioventricular blockade, tachyarrhythmias, congestive heart failure, bradycardia, thrombophlebitis, bundle branch blockade, ECG abnormalities, ventricular extrasystole, pulmonary embolism, phlebitis, thromboembolic complications;
• Amenorrhea, oligospermia, hyperuricemia, red staining of urine, azoospermia;
• Conjunctivitis, keratitis, lachrymation;
• Peripheral neurotoxicity, epileptic seizures, coma;
• Edema, reversible alopecia, photosensitivity, skin hyperpigmentation, rash, itching, severe pain, urticaria, erythema, moist epidermitis;
• Dermatitis, skin rash, bronchospasm, skin hyperemia, anaphylaxis;
• Local phlebitis, severe inflammation, phlebosclerosis, thrombophlebitis, local soreness, tissue necrosis;
• Polyuria, nocturia, dysuria, necrosis of the membranes of the bladder, hematuria, discomfort, painful urination;
• Erythematous striation at the injection site;
• Asthenia, malaise, fever, chills, development of lymphocytic or myelocytic leukemia (acute), hyperuricemia, hot flashes, nephropathy;
• Ulcer of duodenum / stomach, sclerosis of bile ducts.

Overdose Symptoms

What signs of overdose occur when using a large amount of Doxorubicin? Instruction for use says that an overdose of the drug under consideration can lead to toxic symptoms that are manifested by the digestive organs, as well as severe myelosuppression. In addition, high doses of this medication can easily cause acute heart disease.

Antidote to the drug "Doxorubicin" does not exist. In case of an overdose, the patient is prescribed symptomatic therapy. He is also hospitalized and treated with antibacterial drugs.

Drug Interactions

Is it possible to combine "Doxorubicin" with other drugs? Instructions for use indicate that when using this agent in combination with other cytotoxic drugs, their additive toxicity is very often manifested.

When the drug is combined with other cytotoxic drugs that have cardiotoxicity (for example, with "fluorouracil" or "cyclophosphamide"), careful monitoring of the heart during the entire course of therapy is necessary.

"Streptozocin" increases the half-life of "Doxorubicin".

During the therapy with Doxorubicin, the patient may show signs of exacerbation of hemorrhagic cystitis after treatment with Cyclophosphamide, and hepatotoxicity after the treatment with "Mercaptopurine" will intensify.

The use of "Paclitaxel" before the direct administration of "Doxorubicin" can provoke an increase in the concentration in the blood of the latter.

With what drugs is it forbidden to use the medicine "Doxorubicin"? Instructions for use (for animals not assigned), says that the drug should not be mixed with other drugs. For example, it is pharmaceutically incompatible with "Heparin", "Dexamethasone", sodium succinate, "Hydrocortisone", "Cephalotin", "Aminophylline", "Fluorouracil" and other antitumor drugs.

When combined with live viral vaccines, virus replication is possible, as well as increased adverse reactions and a decrease in antibody synthesis in the patient's body in response to the use of the vaccine.

Special recommendations for use of the medicine

What should I know before using Doxorubicin Lance? The instructions for use indicate that during the treatment with antitumour agents it is necessary to carry out regular monitoring of liver function, picture of peripheral blood, ECG and ultrasound of the heart.

Terms of sale, storage method and expiry date

Where should I store Doxorubicin-Lance? Instruction for use informs you that this product must be kept in a dry and dark place where the air temperature does not exceed five degrees.

The drug is dispensed in pharmacies only on prescription. Its shelf life is two years.

Price and analogy

The cost of the drug in question is 120-150 rubles per 5 ml. If necessary, it can be replaced by such means as Doxorubicin-Teva, Doxorubicin Lahema, Oncodox 50, Oncodox 10, Doxorubicin-Ebove, Doxorubicin-Ronz and others.

Consumer reviews of the drug

Now you know how to use the medicine "Doxorubicin". Instructions for use, storage of this medication were presented above.

Quite a large number of consumer reviews associated with severe adverse reactions that occur against the background of the drug. To such effects include the defeat of internal organs, long-lasting poor health, hair loss and the formation of sores at the injection sites.

As for positive reports, they are extremely rare. And this is not surprising, since the effectiveness of the antitumor drug should be evaluated only by an experienced specialist, based on a large number of different factors: the type of monotherapy or combination therapy, the type of cancer, the patient's condition, late results, and others.