One of the newest drugs used in oncotherapy, is Spriceil. The drug is quite a multi-directional effect. Especially recommended drug for chronic myelogenous leukemia.
Composition, form and packaging of
The active ingredient of the drug is dasatinib. Auxiliary components:
- Giprolose;
- Lactose monohydrate;
- Sodium croscarmellose;
- Microcrystalline cellulose;
- Magnesium stearate;
- White opadray.
The drug is available in tablet form. Tablets, depending on the amount of active substance, have different shapes.
- 20 mg - white, biconcave, round tablets marked with BMS and 527 on different sides of the pill;
- 50 mg - white, biconcave, oval tablets with markings on different sides of the BMS tablet and 528;
- 70 mg - white, biconcave, round tablets, marked 524 and BSM on different sides;
- 100 mg - white, biconcave, oval tablets with engraved inscriptions BSM 100 on one side, 852 - on the other;
- 140 mg - white, biconcave, round tablets with engraved inscriptions BSM 140 and 857 on different sides of the tablet.
Manufacturer
The drug is of American origin manufactured by Bristol-Myers Squibb Company, Mount Vernon, Indiana, 47620.
Indications for use
The drug is prescribed for:
- Acute lymphoblastic leukemia with a positive Philadelphia chromosome in case of intolerance or resistance to previous treatment;
- Chronic myelogenous leukemia in the phase of acceleration or chronization;
- Myeloid blast crisis with intolerance or resistance to previously conducted therapy, including Imatinib.
Contraindications
The drug is contraindicated in:
- Hypersensitivity to components;
- Pregnancy;
- Children under 18;
- Breastfeeding;
- Kidney deficiency.
Mechanism of action
The drug has an antitumor effect, it inhibits protein tyrosine kinase.
Also in the process of laboratory studies the active substance of the drug showed activity against leukemic cellular structures not only sensitive, but also resistant to Imatinib exposure.
The drug is rapidly absorbed and distributed in the extravascular space and vessels. It is excreted mainly with feces.
Instructions for using the preparation Sprite
The tablets should be swallowed completely without damaging their integrity.
- In chronic myelogenous leukemia in the phase of chronicization, the initial daily dosage is 100 mg / day.at one time in the evening or in the morning.
- In other clinical situations, tablets should be taken according to the following schedule: 70 mg twice daily, ie 140 mg / day.
With a decrease in platelets or neutrophils during treatment in taking the drug should take a break until the indicators are restored, then continue treatment with the same dosages. When appointing oncological patients of advanced age, dosage adjustment is not required.
Side effects of
The drug during the therapy can provoke many side reactions:
- Nausea-vomiting , diarrhea and constipation, epigastric pain and mucosal inflammation, lack of appetite and appearance of anal fissures, enterocolitis and gastritis, dysphagia or colitis. In rare cases, there are esophagitis and ulceration in the upper gastrointestinal tract, cholecystitis or pancreatitis, cholestasis and hepatitis, ascites, etc.
- Pneumonia and pulmonary edema , lung infiltrates or asthma, cough and pleural effusions, dyspnea, etc. Rarely - bronchospasm andreticular asphyxia, respiratory distress syndrome.
- Anemia and thrombocytopenia , less frequently erythroblastopenia and decreased coagulation.
- Angina pectoris or heart attack, palpitations and cardiomegaly, hot flashes and pressure jumps, less often ventricular tachycardia and myocarditis, pericarditis and coronary syndrome, myocarditis.
- Gynecomastia , less often - lowering of sexual desire and menstrual irregularities.
- Vertigo and noises in the ears.
- Superficial hyperthermia and hair loss , acne or dry skin, dermatitis and urticaria, fragility and lameness of the nail plates, pigmentation and photosensitization, less often - ulcerative skin lesions, palmar-plantar erythrodesis.
- Fainting and drowsiness , flavors and cramps, tremor and amnestic disorders, less often - problems with cerebral circulation or ischemic disorders.
- Muscle weakness and stiffness, myositis.
- Frequent urination of and kidney failure, less often proteinuria. Dry eyeballs or conjunctivitis.
- Sepsis or weakness , herpesviral infectious lesions, enterocolitis.
- Laboratory parameters are also changing, such as hypocalcemia or hypoalbuminemia, etc.
Overdose
Overdose was met only once, when a patient with chronic myeloid leukemia took 280 mg of the drug. But there were no laboratory abnormalities or clinical symptoms.
In case of overdose, medical supervision and symptomatic treatment are recommended.
Special instructions
In the process of treatment with Sprice there are many side changes, for the prevention of which it is recommended to follow special instructions.
- Bleeding often occurs with Spirajlom , most often they are associated with severe thrombocytopenia. Less than 1% of patients had severe cerebral hemorrhage, even fatal. Severe gastrointestinal bleeding was observed in 4% of cases, and other bleeding occurred in 2% of patients who received Sprysel.
- When treated with a similar drug in patients often develop neutropenia , anemic disorders and thrombocytopenia. Similar violations are found more often in cancer patients who have lymphoblastic leukemia or neglected chronic myelogenous leukemia. It is recommended to conduct a weekly extended laboratory blood diagnosis in the first 9 weeks of treatment, then the tests are performed monthly, if there is no other indication. Oppression of bone marrow activity has a reversible character and passes independently during a temporary break in taking or reducing the dosage of Sprice.
- The drug should be administered with great care to persons who have an extended QT interval. It is necessary to correct hypomagnesemia and hypokalemia before therapy.
- Hyperthermia is also a frequent satellite for Spicel therapy. A severe degree of edema is observed in 7% of oncological patients, including pericardial and pleural effusions( 1% and 4%, respectively).Generalized edema and ascites are detected in less than 1% of cancer patients. Approximately 1% of the host Sprisel suffers from severe pulmonary edema. To stop the fluid retention can be the intake of diuretic or glucocorticosteroid drugs.
- Laboratory abnormalities in Spryesel therapy are considered to be practically the norm. For the normalization of the tests, use a reduction in dosage or a temporary withdrawal of the tablets. Hypocalcemia is stopped by calcium-containing drugs.
Drug interaction
The herb of St. John's wort can provoke a sharp decrease in the concentration of the active substance of the drug in the blood, so you can not use it in the process of taking Spryesel.
Drugs inhibitors of CYP3A4( like Itraconazole and Clarithromycin, Ketoconazole or Indinavir, etc.) can cause an increase in the concentration of the drug in the blood, so they can not be combined. If you need a joint intake, you must necessarily reduce the dose of Sprice.
Proton pump inhibitors and H2-histamine receptor blockers reduce the drug concentration, therefore, are incompatible.
Inductors CYP3A4( like Phenytoin and Dexamethasone, Rifampicin or Phenobarbital, etc.) also reduce the concentration of the active substance of the drug, so do not apply in joint treatment regimens.
Reviews
Anna:
Mom suffers from chronic myelogenous leukemia. Doctors recommended Sprysel. The drug is expensive, but it's worth it. We took a course, then a break was made to normalize the blood. When it was necessary to continue treatment, they could not find it. Effective, but expensive and inaccessible in terms of absence in pharmacies.
Catherine:
We also got Sprisel, but we could not even get it. I had to get through acquaintances. While the effect is not visible, but the treatment has just begun. I hope my mother will feel better.
Price of the Sprinkler
- Sprice 30 tablets of 100 mg worth about 94,000-154,000 rubles;
- The preparation of 20 mg of 60 tablets will cost approximately 76,000-98,000 rubles;
- Sprice 50 mg 60 tablets costs about 164,000-170,700 rubles;
- The drug in a dosage of 70 mg of 60 tablets will cost approximately in 160000-180800 rubles.
Analogues of
Among the most well-known analogues of the drug are:
- Taxol;
- Sutent;
- Vargatef;
- Tarceva;
- Thorizel, etc.
Synonyms for drug
The synonym for the drug is Dasatinib.
Terms of dispensing from pharmacies
Formulation leave.
Storage conditions and shelf life
The product can be stored for no more than 2 years at a temperature of 15-30 ° C.