Alkeran (ALKERAN) 2mg, 25 PL.
Offer type: salePublished: 31.01.2013
| Seller: |  nikolaevich vladimir |
| Phones: |  093-413-67-63 Show phone |
Alkeran (ALKERAN) 2mg, 25 PL. at a good price. with a good term. Delivery to any city. Phone 093-413-67-63
Pharmacological action
Antitumor alkylating drug action. Is a bifunctional compound. The alkylation process is the covalent linkage formed from two bis-2-chloraniline groups of carbon intermediates 7-nitrogen of guanine in DNA and cross-linking of two DNA helices, which leads to disruption of replication of cells.
Readings
- localized form of malignant melanoma of the extremities and localized form of soft tissue sarcoma of the extremities (for holding regional arterial perfusion);
- multiple myeloma (in/in the introduction, both as monotherapy and in combination with other cytotoxic drugs, when conducting high-dose therapy for oral administration);
progressive ovarian cancer (in/in the introduction, both as monotherapy and in combination with other cytotoxic drugs and ingestion);
- launched neuroblastoma in children (in/in the introduction when conducting high-dose therapy under the protection of autologous bone marrow was used as monotherapy and in combination with radiation therapy and/or other cytotoxic drugs, to consolidate the effect of standard therapy);
- polycythemia Vera (for ingestion).
The dosage
Alkeran should apply only to physicians with experience in the treatment of malignant tumors by cytotoxic drugs.
During the therapy should be regularly monitored picture of peripheral blood and, if necessary, adjust the dose of the drug.
In multiple myeloma Alkeran assigned/in the intermittent mode, both in monotherapy and in combination with other cytotoxic means, in the dose range of 8 to 30 mg/m2 of body surface, with intervals from 2 to 6 weeks. In some regimens additionally include prednisone. Monotherapy Algernon average dose of 0.4 mg/kg of body weight (16 mg/m2). Repeated injections are conducted at appropriate intervals (e.g. once every 4 weeks), provided that recovery for this period of peripheral blood. When used in mode high-dose therapy the drug is administered once in a dose of from 100 to 200 mg/m2 of body surface (approximately from 2.5 to 5.0 mg/kg body weight). After application of the drug in doses exceeding 140 mg/m2 required transplantation of autologous bone marrow. In connection with development concerns myelosupression after administration of high doses of Alkeran treatment should only be carried out by experienced specialists in specialized centers. The average dose of Alkeran for oral administration is 0.15 mg/kg/day in several stages over 4 days. The interval between courses is 6 weeks. Continuation of treatment beyond 1 year in patients responding to therapy probably does not lead to improved outcomes.
In renal failure the dose should be reduced by 50%.
With adenocarcinoma of the ovary Alkeran use in/as monotherapy at a dose of 1 mg/kg (approximately 40 mg/m2) with an interval of 4 weeks. When used in combination cytotoxic therapy, the recommended doses range from 100 to 400 μg/kg of body weight (12 to 16 mg/m2 body surface) with an interval of 4-6 weeks. Inside the drug is prescribed based 150 µg/kg of body weight (6 mg/m2 body surface) per day for 5 days every 6 weeks.
In malignant melanoma Alkeran applied in the form of hyperthermic regional perfusion as an adjuvant therapy for early stage disease, as well as palliative treatment in the later stages, but only in a localized form. The dose is determined by the adopted methodology and schema therapy.
When soft tissue sarcoma Alkeran applied in the form of hyperthermic regional perfusion in a localized form of soft tissue sarcoma, usually in combination with surgical treatment, at all stages of the disease. Alkeran is also assigned in combination with actinomycin D. the Dose of the drug is determined by the adopted methodology and schema therapy.
When running the neuroblastoma children Alkeran use in/in doses from 100 to 240 mg/m2 body surface (sometimes the dose is administered in 3 divided doses for three consecutive days), both in monotherapy and in combination with radiation or cytotoxic chemotherapy under the protection of autologous bone marrow.
If true polycythemia for the induction of remission, the average dose is inside of 6-10 mg/day for 5-7 days, then 3-4 mg to achieve the effect. The dose of the drug when maintenance therapy is 2-6 mg per week.
Alkeran is often used in standard doses in the elderly, however, specific information on the use of the drug in patients in this age group no. Experience in the use of Alkeran in high doses in elderly patients is limited. Therefore, before applying Alkeran modes high-dose therapy in elderly patients should verify the adequacy of the overall condition and function of internal organs.
When impaired renal clearance of Alkeran reduced. In those cases, when the solution of Alkeran for injection is used in standard doses (8-40 mg/m2 body surface), in patients with moderate or severe renal insufficiency is recommended to reduce initial dose by 50 per cent and then to pick up the dose, depending on the degree of inhibition of bone marrow function.
In those cases, when the solution of Alkeran used in the modes of high-dose therapy (100-240 mg/m2 body surface), the need to reduce the dose depends on the degree of renal dysfunction, whether infusion of autologous stem cells from bone marrow, and therapeutic purposes. In moderate and severe renal insufficiency (EDTA clearance 30-50 ml/min) the dose is reduced by 50%. You also need a sufficient quantity of liquid and to carry out forced diuresis. Patients with more severe degrees of renal dysfunction (EDTA clearance less than 30 ml/min) to appoint Alkeran in high doses is not recommended.
Tablet Alkeran swallowed whole and cannot be split up.
Rules for preparation of solution for injection
The solution was prepared at room temperature by mixing the dried powder with the solvent, which is attached to the vial Algernon.
In a bottle with liofilizirovannam powder, add 10 ml of solvent (simultaneously) and vigorously shaken until complete dissolution. The resulting solution contains 5 mg of anhydrous melphalan in 1 ml and has a pH of about 6.5.
Injection has limited stability and should be prepared immediately before use; it cannot be stored in the refrigerator, because this forms a precipitate. Unused solution should be destroyed.
The rules of the injection solution for injection
The solution for injection is used for on/in the introduction, except when shown holding regional arterial perfusion.
The solution is placed in/in slowly through a special closing the access infusion system with rapid infusion of another solution.
If this introduction in the infusion system is impossible, the solution of Alkeran throw in any capacity for infusion using only 0.9% sodium chloride for injection. Cannot be mixed with infusion solutions containing dextrose.
The stability of the solution Alkeran for injection decreases with further dilution in the infusion solution, as well as with increasing ambient temperature. At room temperature (approximately 25°C) total time from the moment of preparation of the solution Alkeran for injection to complete its infusion should not exceed 1.5 hours
If prepared or diluted solution of Alkeran will appear blurred or crystallization, it should be destroyed.
Care must be taken to avoid the potential introduction of Alkeran not in the vein and into the surrounding tissue. In case of difficult access to peripheral veins should consider the introduction of the drug into the Central vein. The introduction of the drug through a Central vein is recommended in cases when Alkeran is administered in high doses, regardless of whether is or not autologous bone marrow transplantation.
When using the drug for regional arterial perfusion used technique depends on the chosen regimen.
Side effects
On the part of the circulatory system: the most commonly - leukopenia, thrombocytopenia.
From the digestive system: the use of Alkeran in standard doses rarely stomatitis. When using high-dose therapy (under the protection of autologous bone marrow), diarrhea, vomiting and stomatitis are doselimiting factors for toxicity.
Allergic reactions: after the first dose, and subsequent treatment rarely urticaria, edema, rash, and anaphylactic shock (mainly when the/in the introduction of Alkeran); in rare cases, cardiac arrest was associated with these reactions. Rarely maculo-papular rash, itching.
Other: in some cases of pulmonary fibrosis fatal, hemolytic anemia, alopecia (uncharacteristic with the drug in standard doses). Approximately 2/3 of patients with hematological malignancies treated with Alkeran in high doses injected into a Central vein, described subjective transient sensation of heat and/or tingling.
Contraindications
- hypersensitivity to the drug.
Pregnancy and lactation
The drug is not recommended in the first trimester of pregnancy. When used in II and III trimesters should be related to the expected benefit to the mother and the potential risk to the fetus. If necessary, the appointment of the drug during lactation should decide on the cessation of breastfeeding.
As with all cytotoxic drugs in the treatment of Algernon patients of childbearing age should use reliable methods of contraception.
Possible teratogenic d
Pharmacological action
Antitumor alkylating drug action. Is a bifunctional compound. The alkylation process is the covalent linkage formed from two bis-2-chloraniline groups of carbon intermediates 7-nitrogen of guanine in DNA and cross-linking of two DNA helices, which leads to disruption of replication of cells.
Readings
- localized form of malignant melanoma of the extremities and localized form of soft tissue sarcoma of the extremities (for holding regional arterial perfusion);
- multiple myeloma (in/in the introduction, both as monotherapy and in combination with other cytotoxic drugs, when conducting high-dose therapy for oral administration);
progressive ovarian cancer (in/in the introduction, both as monotherapy and in combination with other cytotoxic drugs and ingestion);
- launched neuroblastoma in children (in/in the introduction when conducting high-dose therapy under the protection of autologous bone marrow was used as monotherapy and in combination with radiation therapy and/or other cytotoxic drugs, to consolidate the effect of standard therapy);
- polycythemia Vera (for ingestion).
The dosage
Alkeran should apply only to physicians with experience in the treatment of malignant tumors by cytotoxic drugs.
During the therapy should be regularly monitored picture of peripheral blood and, if necessary, adjust the dose of the drug.
In multiple myeloma Alkeran assigned/in the intermittent mode, both in monotherapy and in combination with other cytotoxic means, in the dose range of 8 to 30 mg/m2 of body surface, with intervals from 2 to 6 weeks. In some regimens additionally include prednisone. Monotherapy Algernon average dose of 0.4 mg/kg of body weight (16 mg/m2). Repeated injections are conducted at appropriate intervals (e.g. once every 4 weeks), provided that recovery for this period of peripheral blood. When used in mode high-dose therapy the drug is administered once in a dose of from 100 to 200 mg/m2 of body surface (approximately from 2.5 to 5.0 mg/kg body weight). After application of the drug in doses exceeding 140 mg/m2 required transplantation of autologous bone marrow. In connection with development concerns myelosupression after administration of high doses of Alkeran treatment should only be carried out by experienced specialists in specialized centers. The average dose of Alkeran for oral administration is 0.15 mg/kg/day in several stages over 4 days. The interval between courses is 6 weeks. Continuation of treatment beyond 1 year in patients responding to therapy probably does not lead to improved outcomes.
In renal failure the dose should be reduced by 50%.
With adenocarcinoma of the ovary Alkeran use in/as monotherapy at a dose of 1 mg/kg (approximately 40 mg/m2) with an interval of 4 weeks. When used in combination cytotoxic therapy, the recommended doses range from 100 to 400 μg/kg of body weight (12 to 16 mg/m2 body surface) with an interval of 4-6 weeks. Inside the drug is prescribed based 150 µg/kg of body weight (6 mg/m2 body surface) per day for 5 days every 6 weeks.
In malignant melanoma Alkeran applied in the form of hyperthermic regional perfusion as an adjuvant therapy for early stage disease, as well as palliative treatment in the later stages, but only in a localized form. The dose is determined by the adopted methodology and schema therapy.
When soft tissue sarcoma Alkeran applied in the form of hyperthermic regional perfusion in a localized form of soft tissue sarcoma, usually in combination with surgical treatment, at all stages of the disease. Alkeran is also assigned in combination with actinomycin D. the Dose of the drug is determined by the adopted methodology and schema therapy.
When running the neuroblastoma children Alkeran use in/in doses from 100 to 240 mg/m2 body surface (sometimes the dose is administered in 3 divided doses for three consecutive days), both in monotherapy and in combination with radiation or cytotoxic chemotherapy under the protection of autologous bone marrow.
If true polycythemia for the induction of remission, the average dose is inside of 6-10 mg/day for 5-7 days, then 3-4 mg to achieve the effect. The dose of the drug when maintenance therapy is 2-6 mg per week.
Alkeran is often used in standard doses in the elderly, however, specific information on the use of the drug in patients in this age group no. Experience in the use of Alkeran in high doses in elderly patients is limited. Therefore, before applying Alkeran modes high-dose therapy in elderly patients should verify the adequacy of the overall condition and function of internal organs.
When impaired renal clearance of Alkeran reduced. In those cases, when the solution of Alkeran for injection is used in standard doses (8-40 mg/m2 body surface), in patients with moderate or severe renal insufficiency is recommended to reduce initial dose by 50 per cent and then to pick up the dose, depending on the degree of inhibition of bone marrow function.
In those cases, when the solution of Alkeran used in the modes of high-dose therapy (100-240 mg/m2 body surface), the need to reduce the dose depends on the degree of renal dysfunction, whether infusion of autologous stem cells from bone marrow, and therapeutic purposes. In moderate and severe renal insufficiency (EDTA clearance 30-50 ml/min) the dose is reduced by 50%. You also need a sufficient quantity of liquid and to carry out forced diuresis. Patients with more severe degrees of renal dysfunction (EDTA clearance less than 30 ml/min) to appoint Alkeran in high doses is not recommended.
Tablet Alkeran swallowed whole and cannot be split up.
Rules for preparation of solution for injection
The solution was prepared at room temperature by mixing the dried powder with the solvent, which is attached to the vial Algernon.
In a bottle with liofilizirovannam powder, add 10 ml of solvent (simultaneously) and vigorously shaken until complete dissolution. The resulting solution contains 5 mg of anhydrous melphalan in 1 ml and has a pH of about 6.5.
Injection has limited stability and should be prepared immediately before use; it cannot be stored in the refrigerator, because this forms a precipitate. Unused solution should be destroyed.
The rules of the injection solution for injection
The solution for injection is used for on/in the introduction, except when shown holding regional arterial perfusion.
The solution is placed in/in slowly through a special closing the access infusion system with rapid infusion of another solution.
If this introduction in the infusion system is impossible, the solution of Alkeran throw in any capacity for infusion using only 0.9% sodium chloride for injection. Cannot be mixed with infusion solutions containing dextrose.
The stability of the solution Alkeran for injection decreases with further dilution in the infusion solution, as well as with increasing ambient temperature. At room temperature (approximately 25°C) total time from the moment of preparation of the solution Alkeran for injection to complete its infusion should not exceed 1.5 hours
If prepared or diluted solution of Alkeran will appear blurred or crystallization, it should be destroyed.
Care must be taken to avoid the potential introduction of Alkeran not in the vein and into the surrounding tissue. In case of difficult access to peripheral veins should consider the introduction of the drug into the Central vein. The introduction of the drug through a Central vein is recommended in cases when Alkeran is administered in high doses, regardless of whether is or not autologous bone marrow transplantation.
When using the drug for regional arterial perfusion used technique depends on the chosen regimen.
Side effects
On the part of the circulatory system: the most commonly - leukopenia, thrombocytopenia.
From the digestive system: the use of Alkeran in standard doses rarely stomatitis. When using high-dose therapy (under the protection of autologous bone marrow), diarrhea, vomiting and stomatitis are doselimiting factors for toxicity.
Allergic reactions: after the first dose, and subsequent treatment rarely urticaria, edema, rash, and anaphylactic shock (mainly when the/in the introduction of Alkeran); in rare cases, cardiac arrest was associated with these reactions. Rarely maculo-papular rash, itching.
Other: in some cases of pulmonary fibrosis fatal, hemolytic anemia, alopecia (uncharacteristic with the drug in standard doses). Approximately 2/3 of patients with hematological malignancies treated with Alkeran in high doses injected into a Central vein, described subjective transient sensation of heat and/or tingling.
Contraindications
- hypersensitivity to the drug.
Pregnancy and lactation
The drug is not recommended in the first trimester of pregnancy. When used in II and III trimesters should be related to the expected benefit to the mother and the potential risk to the fetus. If necessary, the appointment of the drug during lactation should decide on the cessation of breastfeeding.
As with all cytotoxic drugs in the treatment of Algernon patients of childbearing age should use reliable methods of contraception.
Possible teratogenic d
