A cancerous tumor is extremely dangerous for human life. It consists of malignant and uncontrolled dividing cells, which are capable of penetrating into nearby tissues, as well as metastasizing to other organs.
The development of drugs and methods for treating such diseases is an essential task. Unfortunately, so far no one has decided to it. Although there are still drugs that can slow down the division of tumor cells. One of them includes the drug "Doxorubicin." Instructions for use and a photo of this drug will be discussed in this article. In it, you will find information on how to store the said product, 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 drug:
- Lyophilisate for solution for intravascular and intravesical injections. It is a red-yellow porous mass and contains such an active substance as doxorubicin hydrochloride. As additional ingredients, mannitol is used. The medicine goes on sale in bottles enclosed in cardboard boxes.
- Concentrate for the manufacture of a solution for intravascular and intravesical injections. It is a red and clear liquid that contains doxorubicin hydrochloride and is available in bottles and cardboard packaging.
Drug pharmacology
What is a medicine like doxorubicin? Instructions for use (the release form of the drug was indicated above) reports that it is an antitumor anthracycline antibiotic that is isolated from a culture of Streptomyces peucetius fungus. It is capable of exerting antimitotic and antiproliferative effects.
Interacting with DNA, this medication suppresses RNA polymerase, DNA polymerase and type 2 topoisomerase, and also activates the production of free radicals and acts on cell walls. As a result of this effect, DNA replication and biological synthesis of nucleic acids are slowed down.
It should also be noted that the agent under consideration has a direct cytotoxic effect. Cells are particularly sensitive to the drug in the G2 phase and S phase of their life.
Kinetic properties
What kinetic parameters are inherent in the drug "Doxorubicin"? The instruction for use states that after an intravenous injection, this agent is always distributed multiphase. During the first 5 minutes, the drug is quickly captured by the tissues, and its concentration in the blood decreases rapidly. As for the second phase, it slows the release of drug molecules from the tissues.
This drug is concentrated in the liver, kidneys, spleen, lungs and myocardium. It also crosses the placenta and is excreted along with breast milk.
The reaction with plasma proteins occurs at 75%. The metabolism of the drug is carried out in the liver, resulting in the formation of such an active derivative as doxorubicinol.
In the process of enzyme recovery, the synthesis of free radicals can affect the development of cardiotoxicity.
The half-life of doxorubicin and doxorubicinol is similar and is about 20-48 hours.
Approximately 40% of the accepted dose of the drug is excreted along with bile, and only 6-11% of doxorubicin, as well as its derivatives, are found in urine within 5 days.
Indications for use
What diseases can Doxorubicin be prescribed for?
Instructions for use (with bladder cancer this agent is used very often) states that this medicine works well with:
- thyroid cancer, Kaposi's sarcoma and Ewing;
- Wilms tumor, stomach cancer, small cell form of lung cancer;
- insulinoma, breast cancer, mesothelioma;
- esophageal cancer, carcinoid, neuroblastoma;
- osteogenic sarcoma, primary hepatocellular cancer, non-Hodgkin's lymphoma ;
- prostate cancer, oncological diseases of the neck and head, malignant thymoma;
- cervical cancer, some types of testicular tumor;
- uterine sarcoma, endometrial cancer, Hodgkin's disease;
- rhabdomyosarcoma, acute leukemia;
- chronic lymphocytic leukemia, multiple myeloma.
Contraindications
What conditions of the patient are forbidden to prescribe the drug "Doxorubicin"? Instructions for use, reviews of oncologists say that this tool does not work very effectively with:
- sensitization to doxorubicin or other substances of the drug, as well as representatives of anthracenedion and anthracyclines;
- previous therapy with other representatives of anthracyclines or anthracendion in limiting doses, as well as with liver failure (severe), myocardial infarction, arrhythmias, acute viral infections and heart failure (for intravenous administration);
- malignant tumors growing in the walls of the bladder, infectious diseases of the genitourinary tract and cystitis (for intravesical administration).
With extreme caution, 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 in question is carefully prescribed for children and the elderly, as well as as part of 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 tool is allowed to be used alone or in combination with other cytostatics in different dosages.
The reconstituted Doxorubicin medicinal solution should be used immediately after its manufacture.
Intravenous administration
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, the indicated dose can be administered for several injections (in the amount of 25-30 mg / sq. M per day for the first 3 days of the cycle).
To reduce the toxic effect, a weekly administration method of 10-20 mg / sq. Is used. m once a week.
When combined with other antitumor 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 the elimination of all symptoms of toxicity.
The total dose of this medicine should not be more than 550 mg / sq. m
Intraarterial administration
How is the intra-arterial administration of the drug “Doxorubicin” carried out? The instruction says that to ensure a local effect for people with hepatocellular cancer, this medication should be injected into the common artery of the liver at a dosage of 35-150 mg / sq. m. In this case, the intervals between cycles should be equal from 3 weeks to 3 months.
The introduction of the drug into the bladder
How is Doxorubicin-Teva Medication injected into the bladder? Instructions for use informs that the dosage of this agent for intravesical administration should be 35-50 mg per installation.
Treatment procedures should be carried out 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. At the end, the patient should empty the bladder.
Side effects
The drug "Doxorubicin", the instruction of which was described above, can cause the following adverse reactions:
- vomiting, abdominal pain, nausea, colitis, stomatitis, diarrhea, esophagitis, hyperpigmentation of the oral mucosa, anorexia, increased concentration of bilirubin in the blood, gastrointestinal bleeding, increased liver transaminases;
- reversible dose-dependent leukopenia, thrombocytopenia, anemia, leukopenia, neutropenia;
- sinus tachycardia, atrioventricular block, tachyarrhythmias, congestive heart failure, bradycardia, thrombophlebitis, blockage of the branches of the bundle of His, anomalies on the ECG, ventricular extrasystole, pulmonary embolism, phlebitis, thromboembolic complications;
- amenorrhea, oligospermia, hyperuricemia, red staining of urine, azoospermia;
- conjunctivitis, keratitis, lacrimation;
- peripheral neurotoxicity, epileptic seizures, coma;
- edema, reversible alopecia, photosensitivity, skin hyperpigmentation, rash, itching, severe pain, urticaria, erythema, wet epidermitis;
- dermatitis, skin rash, bronchospasm, hyperemia of the skin, anaphylaxis;
- local phlebitis, severe inflammation, phlebosclerosis, thrombophlebitis, local pain, 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;
- 12 duodenal ulcer / stomach, bile duct sclerosis.
Overdose symptoms
What are the signs of an overdose when using a large amount of Doxorubicin? Instructions for use states that an overdose of the drug in question can lead to toxic symptoms that appear on the part of the digestive system, as well as severe myelosuppression. In addition, increased doses of this medication can quite easily cause acute heart disease.
The antidote to the drug "Doxorubicin" does not exist. In case of an overdose, symptomatic therapy is prescribed to the victim. He is also hospitalized and treated with antibacterial drugs.
Drug interaction
Can the Doxorubicin Medication be combined with other drugs? Instructions for use indicate that when using this tool in combination with other cytotoxic drugs, their additive toxicity is very often manifested.
When combining the drug 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 treatment with Doxorubicin, the patient may show signs of exacerbation of hemorrhagic cystitis after treatment with Cyclophosphamide, as well as the effects of hepatotoxicity after treatment with Mercaptopurin.
The use of Paclitaxel before the direct administration of Doxorubicin can provoke an increase in blood concentrations of the latter.
What drugs are forbidden to use Doxorubicin? Instructions for use (not prescribed for animals) reports that this drug should not be mixed with other medicines. For example, it is pharmaceutically incompatible with Heparin, Dexamethasone, sodium succinate, Hydrocortisone, Cephalotin, Aminophylline, Fluorouracil, and other anticancer drugs.
When combined with live viral vaccines, virus replication is possible, as well as increased adverse reactions and decreased synthesis of antibodies in the patient's body in response to the use of the vaccine.
Special recommendations for the use of the drug
What should I know before using Doxorubicin-Lance? Instructions for use indicate that in the process of treatment with anticancer agents, it is necessary to regularly monitor liver function, a picture of peripheral blood counts, ECG and ultrasound of the heart.
Terms of sale, storage method and expiration date
Where should Doxorubicin-Lance be stored? Instructions for use informs that this product must be kept in a dry and dark place where the air temperature does not exceed five degrees.
The medicine is dispensed in pharmacies only with a prescription. Shelf life is two years.
Price and analogues
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-Ebeve, Doxorubicin-Ronz and others.
Consumer drug reviews
Now you know how to use Doxorubicin. Instructions for use, storage of this medication were presented above.
A fairly large number of consumer reviews are associated with severe adverse reactions that occur with the use of the drug. Such effects include damage to internal organs, long-lasting poor health, hair loss and the formation of ulcers at injection sites.
As for the positive messages, they are extremely rare. And this is not surprising, since the effectiveness of an anticancer 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, long-term results, and others.