Dacarbazine is an effective antitumor agent that is widely used in oncology. The drug causes the death of cancer cells by breaking DNA strands.
Form release, formulation and packaging
The preparation is available in the form of a lyophilizate( white or yellowish powder) to prepare a solution for parenteral administration. Powder is packaged in 100 and 200 mg in bottles of dark glass, which are sealed with chlorobutyl plugs.
For reliable sealing of the preparation on top is an aluminum cap with polypropylene lid white( 100 mg) and green( 200 ml).
Vials are packed in cardboard packs of 1 or 10 pieces together with an annotation.
Manufacturer of Dakarbazin
The drug is manufactured by the pharmaceutical company Medak GmbH, Germany.
Indications for use
Dacarbazine is prescribed for the therapy of the following malignancies:
- Melanoma, lymphogranulomatosis, sarcomas( with the exception of hemorrhagic sarcomatosis);
- Osteogenic sarcoma, lymphosarcoma, embryonic rhabdomyosarcoma, peritoneal and pleural mesothelioma - as an integrated systemic therapy;
- Epithelial carcinoma, neuroblastoma, glioma, pheochromocytoma.
Contraindications
The drug can not be used in such cases:
- Presence of hypersensitivity to the drug;
- Development of myelosuppression;
- Child's age;
- Severe liver and kidney pathology;
- Pregnancy and lactation period;
- Disturbance of the functional activity of the nervous system;
- Infectious processes that are caused by viruses, fungi or pathogenic bacteria. This is due to the ability of Dakarbazine to lead to an uncontrolled spread of infection;
- Radiation therapy.
Pharmacological action
Dacarbazine is an effective antitumor, cytostatic agent.
The drug is capable of leading to a violation of the synthesis of DNA and RNA cells by formation of complexes with carbonium ions. This leads to the termination of the mitotic cell cycle.
Cytostatic results in the release of diazomethane, which is able to bind firmly to molecules that contain SH-groups. The drug is able to act as a purine analogue, therefore it possesses the properties of antimetabolite.
Prolonged use of dacarbazine can lead to the appearance of secondary malignant neoplasms due to a strong carcinogenic effect.
So during the use of the drug in rats, individuals developed proliferative endocardial damage( sarcomas, fibrosarcomas).During the introduction of the cytostatic, the mice developed malignant spleen tumors in the animals, irreversible changes in the sex glands, which provoke the development of amenorrhea and azoospermia.
Numerous tests have shown a high mutagenicity of the drug, and with increasing dosage, Dacarbazine has a teratogenic effect.
Instructions for use: dosage
Cytotoxic is used for intravenous, and in some cases for intra-arterial administration. The dose is established only individually.
If necessary, Dakarbazine can be combined with other chemotherapy, but the doctor must take into account the degree of possible intoxication and clinical picture of the disease.
The infusion solution can be stored in the refrigerator for 72 hours or for no more than 8 hours at room temperature. The duration of the course of treatment is 7 days, then take a break for 3 weeks. However, the number and duration of such treatment cycles can only be determined by an oncologist.
Side effects of
Dacarbazine is capable of leading to the development of such symptoms:
- Myelosuppression. State of manifestation of the development of anemia, leukopenia, thrombocytopenia, granulocytopenia. Decreased myelopoiesis is a dose-dependent side effect. The development of leukocytopenia is noted on day 14 after the administration of the cytostatic, on the 18th day the appearance of thrombocytopenia is possible. Normally, all blood counts are restored after 4 weeks;
- On the part of the digestive organs, nausea and vomiting often occur, a decrease in appetite, and stomatitis develops. In some cases, patients also note diarrhea, an increase in the activity of liver enzymes. The most dangerous complication is necrosis of hepatocytes, which is associated with the occlusion of veins inside the liver( such a syndrome may appear during the second course of therapy, it can lead to death of the patient).With the development of pathology in the patient noted: fever, abdominal pain, the liver increases in size, the shock state may develop;
- On the part of the urinary system: , in some cases, there is an increased content of creatinine and urea in the urine;
- From the side of the central nervous system: headaches, sleep disturbance, confusion, visual impairment, convulsions, asthenia, paresthesia;
- In some cases, the infertility of is developing due to amenorrhea, azoospermia.
Some patients develop an allergic reaction( rash, reddening of the facial skin, anaphylaxis), alopecia, photosensitization of the skin.
In the injection site, soreness and swelling may occur. If the drug has got under the skin, then a sharp pain syndrome, tissue necrosis develops.
Overdose of
When patients are dosed, myelosuppression and side effects from the digestive organs are increased. In case of overdose, symptomatic therapy is used due to the absence of a specific antidote.
Special instructions
Cytostatics should be used under the constant supervision of an oncologist who has practical experience in chemotherapy.
Before and during therapy, it is necessary to monitor the picture of peripheral blood: the number of leukocytes, platelets, the level of hematocrit.
When expressed myelodepression, it is necessary to abandon the use of Dacarbazine to normalize the condition. Also should be monitored such biochemical indicators: the activity of AST, LDH, ALT, the level of creatinine, urea, uric acid, bilirubin.
If extravasate is formed at the injection site, it is necessary to stop the infusion immediately, resuming it in a new vein. Nausea and vomiting usually last for 12 hours after parenteral administration. However, after a few days these side effects are weakened.
The development of thrombocytopenia requires extreme caution during the invasive manipulation to exclude the development of bleeding. Also, blood, vomit and feces should be regularly monitored for blood.
During chemotherapy, the patient and his family members need to give up vaccination within 1 year of the last course. The patient should exclude any contact with people who have an infection.
Patients should use reliable contraceptives during dakarbazine.
Dissolution and dilution of the cytostatic should be performed only by physicians, using gloves, masks, special clothing. In case of accidental contact with the skin, wash with water and soap.
Drug Interactions
Drugs( Rifampicin, Phenytoin, barbiturates) that induce microsomal liver enzymes can enhance the metabolism of the cytostatic when used together.
With the combined therapy of Dacarbazine and Methoxypsoralen, the antitumor drug causes an increase in the photosensitizing effect. The cytostatic solution is chemically incompatible with hydrocortisone, heparin, sodium hydrogen carbonate, cysteine.
Dacarbazine can be used simultaneously with other antitumor drugs: Vincristine, Cisplatinum, Bleomycin.
Patient Reviews
Anatoly, 32 years old, from Saratov:
My mom prescribed a course of Dakarbazine with a single dose of 1500. The solution was administered concurrently with antiemetic and anti-edematous drug. The drug was well tolerated, but the platelet count fell to 60 units. Mom had bruises, increased bleeding. After the course of therapy, long-term side effects had to be treated.
Marina Ivanovna, 47, Moscow:
Have prescribed Dakarbazin infusion for 5 days. From the first day, most side effects from the digestive organs appeared: pain, vomiting, stomatitis, diarrhea. Even Cerucal's reception did not help.
Anfisa, 23, St. Petersburg:
My father was diagnosed with "lymphogranulomatosis", the oncologist prescribed a course of Dakarbazin. Dad suffered 7 droppers very hard: constant vomiting, headaches, changes in the picture of blood, bruises all over the body, seizures, alopecia. However, the course of therapy helped to slow the development of cancer.
Price in Moscow for Dakarbazin
The cost of cytostatics on average is 27,000 rubles for 10 bottles.
Dakarbazine Medak( 200 mg) can be bought at pharmacies of the capital for 2200 rubles for 10 bottles, 100 mg of lyophilizate cost 140 rubles per 1 bottle.
Analogues of the preparation
The following analogues stand out:
- Nimustine;
- Moustoforan;
- Nitrosomethyl urea;
- Lomustine.
Synonyms for
Synonyms for Dacarbazine are:
- Dakarbazin-LENS;
- Decarbazim;
- Dacarbazine Lahema;
- Children.
Conditions for dispensing from pharmacies
Cytotoxic is dispensed only by prescription.
Storage conditions and shelf life
The lyophilizate should be stored at a temperature of no more than 25 ° C, in a place where direct sunlight can not penetrate.
The prepared solution is stored in the refrigerator for 72 hours or for 8 hours at room temperature. The drug should be used within 2 years.