In anticancer therapy, the drug-antimetabolite Cytarabine is often used.
Composition, Form and Packing of
The active ingredient of Cytarabine is cytarabine. The excipients are represented by medical low molecular weight polyvinylpyrrolidone.
Manufacturer
The drug is produced in Belarus by RUE "Belmedpreparaty".
Indications for use
Cytarabine injections are prescribed:
- For non-Hodgkin's lymphomas;
- In the complex therapy of myeloblastic and lymphoblastic leukemia;
- With lymphogranulomatosis or chronic myeloid leukemia;
- For the treatment of erythroleukemia and bone marrow dysplasia syndrome.
Contraindications
Cytarabine is strongly contraindicated:
- If there is a particular sensitivity to the drug;
- Pregnant women;
- With mielodepression;
- Breastfeeding women;
- Persons with renal and hepatic insufficiency;
- For bone marrow aplasia;
- Patients with infectious pathologies in acute form.
Mechanism of action
Cytarabine injections are related to antimetabolic, antitumor and immunosuppressive drugs.
The drug, relating to antimetabolites of pyrimidine metabolism, is endowed with anti-leukemia, which is caused by proliferative inhibition of lymphocytic, lymphoblastic and myeloblastic cellular structures.
In malignant tumor cells, a metabolite is formed, which depresses DNA polymerase, which leads to disturbances in the synthesis processes.
Instructions for use Cytarabine
The final dosage of the drug is determined on an individual basis by a specialist. Cytarabine injection is indicated to be injected into the spinal cord, subcutaneously or intravenously.
Before use, the lyophilizate is diluted with injection water or an isotonic sodium chloride solution.
- Intravenous administration is carried out at a daily dosage of 100 mg / m2.Introduce the drug in the drip infusion of a 3-hour duration of twice a day. Between infusions, an interval of at least 10 hours is mandatory. Or enter once and continuously for 24 hours.
- Elderly patients and people with depressed hematopoiesis have been shown to administer reduced daily doses of the drug - 50 or 75 mg / m2.
- Sometimes cytarabine is prescribed in high-dose therapy, then the drug is administered by infusion of 3 g / m2 at a frequency of once every 12 hours. The duration of the infusion is 75 minutes, the duration of the course is 1-6 days.
- When injected into the spinal cord, injections are given every 3 days for 2 weeks. Dosage - 20 mg / m2.In total, it is necessary to conduct 4-7 courses of therapy with a break between courses of 1.5-2 weeks.
- With subcutaneous administration, the daily dosage of injections is 20 mg / m2 twice-thrice a day, the duration of the course is 3-10 days.
Side effects of
Adverse reactions can affect the patient's various health fields and generally manifest themselves in such an action:
- Depression of bone marrow functions , thrombocytopenic or leukopenic complications, less often arrhythmic processes, soreness at the injection site, thrombophlebitis or anemia of the megaloblastic type;
- Bronchospasm , less often interstitial diffuse pneumonitis or pulmonary edema;
- Toxic effects on cerebrospinal structures, cerebellum or nervous system;
- The causeless fatigue of , tingling sensations on the face and in the fingers of the limbs, excessive anxiety and headaches( especially when injected into the bone marrow), conjunctivitis of hemorrhagic type;
- Nephropathy or hyperuricemia , in rare cases there is a delay in urine;
- Nausea-vomiting , stomatitis and abdominal pain, lack of appetite, diarrhea and esophagitis, less often yellowing of the skin and sclera;
- Alopecia and spots on the skin , itching and subcutaneous tissue damage, cytarabine syndrome, including hyperthermia and chest pains, muscle and bone pain, general discomfort or weakness.
Overdose of
Exceeding conventional therapeutic doses can cause bone marrow depression with heavy bleeding and life-threatening infections, as well as neurotoxic effects.
The antidote of the drug is not known, so every injection should be done with the utmost caution.
Intravenous 12-fold infusion of 4.5 g / m2 with a duration of 60 minutes every 12 hours can cause irreversible nervous system changes and death.
Special instructions
In the course of treatment, it is necessary to control the leukocyte level and hematopoietic function in the day( before and after the course of treatment), as well as renal and hepatic functions.
Elderly patients may require a reduction in dosage. It is not recommended to apply the drug to chickenpox( including after contact with the diseased or recently transferred disease), shingles and other infectious lesions.
With caution, the drug is used in people who have recently undergone radiation treatment or cytotoxic therapy in patients with bone marrow infiltration of cancer cells, renal and hepatic impairment, and hematopoietic depression.
For the period of treatment it is necessary to refuse vaccination and avoid contact with people vaccinated against polio, as well as with sick infections of bacterial origin.
It is also recommended that extreme care be taken with sharp objects such as scissors, a knife or a razor to avoid cuts.
It is important to avoid types of professional and sports activities related to injuries or hemorrhages. Pregnancy during treatment is unacceptable.
The drug is actively excreted in the dialysis process, so patients with dialysis Cytarabine is not administered before and during the purification procedure on the dialysis machine. Also, one should not allow contact with the mucous membrane and skin tissues, especially it is recommended to protect from eye contact.
Drug Interaction
When prescribing combined treatment, use extreme caution and take medication at strictly scheduled hours.
The drug is combined with Vincristine and Rubomycin, Cyclophosphamide and Carminomycin, Thioguanine. Pharmaceutically, Citarabin is not compatible with Methotrexate and Heparin, Insulin and Oxacillin, 5-Fluorouracil and Methylprednisolone, Benzylpenicillin.
When combined with myelosupressive antitumor agents or radiation, cytarabine enhances the immunosuppressive and cytotoxic activity of these treatments.
When using the drug as part of polychemotherapy, a reversible decrease in digoxin concentration in the plasma is observed, therefore, such patients are prescribed the use of digitoxin.
When combined with fluorocytosine, the therapeutic effect of the latter is likely to decrease. The use of immunosuppressants such as Chlorambucil and Azathioprine, glucocorticosteroids and Cyclophosphamide increases the risk of infectious complications.
Reviews
Reviews in the network regarding the use of the drug Cytarabine could not be found. Perhaps this is due to the lack of a drug in pharmacies. In addition, patients with malignant tumors are not particularly eager to write about their treatment, which is understandable and understandable.
Like other antitumour agents, cytarabine is accompanied by a considerable number of adverse reactions, therefore it requires necessarily medical control and high qualification of the medical worker who injects.
Price for Cytarabine
Today it is almost impossible to find cytarabine in pharmacies, but its direct analogue and a synonym - Cytarabine-LENS are available for sale.
Analogues of
Medication similar to Cytarabin:
- Vaidasa;
- 5-Fluorouracil-Ebwe;
- Gemzar;
- Alex;
- Gemtaz;
- Gemita;
- Gemcitabine;
- Gemcitabine Medak;
- Fopurin;
- Mercaptopurine;
- Fluorouracil.
Synonyms of medication
Synonyms of cytarabine are:
- Alex;
- Aracitidine;
- Ara-S;
- Cytarabine-Lance;
- Cytosar;
- Cytastadine;
- Cytostadine;
- Cytosine.
Disposal conditions from pharmacies
Requires a prescription.
Storage Conditions and Shelf Life
The preparation is indicated to be stored under conditions not exceeding 5 ° C for a maximum of 2 years.