The mechanism of antitumor effect is not completely elucidated, but preliminary data suggest that the drug by embedding between the bases of the DNA molecule, blocks replication and transcription processes. Furthermore, mitoxantrone inhibits topoisomerase II. It has a non-specific effects on the cell cycle.
After intravenous administration of mitoxantrone quickly penetrates and is distributed in the tissues, where it is then there is a gradual release. Is found in high concentrations in the liver, lungs, dianabol for sale and in descending order in the bone marrow, heart, thyroid, spleen, pancreas, adrenal, and kidney. It permeates through gematoentsef & matic barrier.Relationship to plasma proteins – 90%. It is metabolized in the liver. In patients with impaired liver function decreased rate of elimination of the drug.
- nelimfoblastnyh acute leukemia in adults
- mammary cancer
- malignant non-Hodgkin’s lymphoma
- primary hepatocellular carcinoma
- ovarian cancer
- hormone-refractory prostate cancer with pain
- Hypersensitivity to migoksantronu or any other part of the preparation
- neutrophil count less than 1500 cells / mm (except for the treatment of leukemia nelimfoblastnyh)
- Pregnancy and lactation
Precautions: used in patients with heart disease, with prior mediastinal irradiation, with myelosuppression with severe liver function impairment or renal disease, bronchial asthma, acute infectious diseases, viral (including chicken pox, herpes zoster) fungal or bacterial origin (risk of severe complications and generalization of the process), a disease in which there is an increased risk of developing hyperuricemia (gout or urate nephrolithiasis) and in patients previously treated with anthracyclines.
Dosage and administration
of mitoxantrone is part of many chemotherapy regimens, and therefore, the choice of route of administration, regime and doses in each individual case should be guided by the data of literature.
The drug is administered intravenously slowly for at least 5 minutes or intravenously infusion over 15-30 minutes. Preferably administered in an infusion tube was slowly amid the rapid infusion of 0.9% sodium chloride or 5% glucose solution. Intrarectal, intraarterial, intramuscular, subcutaneous administration of the drug allowed! Maximum total dose – 200 mg / m 2 body surface area. In breast cancer, non-Hodgkin’s lymphoma, liver cancer and ovarian cancer monotherapy dianabol for sale used in a dose of 14 mg / m 2 I three times a week. In patients previously treated with chemotherapy, as well as in combination with other anticancer drugs to reduce the dose of 10-12 mg / m 2 . If repeated courses of dose Onkotrona selected taking into account the severity and duration of suppression of bone marrow hematopoiesis. In the case of reducing the number of neutrophils in previous courses <1500 and / or a platelet count <50,000 cells / microliter of blood dose onkotrona reduced by 2 mg / m 2 , with a decrease in the number of neutrophils <1000 and / or a platelet count <25,000 cells / microliter of blood subsequent doses reduced to 4 mg / m 2 . in the treatment of acute leukemia in adults nelimfoblastnyh for remission induction prescribed in doses of 10-12 mg / m 2 for 5 days every day until a total dose of 50-60 mg / m 2 . Perhaps use of high doses of 14 mg / m 2 or more daily for 3 days. For the treatment of hormone refractory prostate cancer administered at a dose of 12-14 mg / m 2 1 every 21 days in combination with daily administration of low doses of glucocorticoids (prednisone 10 mg / day or hydrocortisone 40 mg / day). if intrapleural installation metastases in the pleura (in breast cancer and non-Hodgkin’s lymphoma), the recommended single dose of 20-30 mg. For intrapleural installation diluted in 50 ml of 0.9% sodium chloride solution. Before therapy evacuate as far as possible, pleural exudate. Diluted in 50 ml of 0.9% sodium chloride solution was warmed to body temperature and is introduced slowly over 5-10 minutes, without effort. The delay period first dose in the pleural cavity is 48 hours. During this period, patients must move to ensure optimum intrapleural distribution of the drug. After the end of said period (48 hours) is performed again thoracostomy. If the amount of effusion is less than 200 ml, the first treatment cycle is terminated. When the number exceeds 200 mL effusion appointed re-install 30 mg Onkotrona. Prior dianabol for sale to re-installation of the drug requires monitoring of hematological parameters. Onkotrona second dose may be in the pleural cavity. The maximum dose for a single treatment cycle is 60 mg. If the number of neutrophils and platelets is normal, intrapleural installation can be repeated after 4 weeks. During the 4 weeks before and 4 weeks after administration vnutriplevrapnogo Onkotrona avoid systemic treatment with cytotoxic agents.
Side effect From hemopoiesis system: a leukopenia (usually 6-15 day recovery on day 21), neutropenia, thrombocytopenia, erythropenia, rarely – anemia. From the digestive system: nausea, vomiting, anorexia, decreased appetite, diarrhea, abdominal pain cavity, constipation, gastrointestinal bleeding, stomatitis, rarely – increased activity of “liver” enzymes, abnormal liver function. Since the cardiovascular system: ECG changes, tachycardia, arrhythmia, myocardial ischemia, decreased left ventricular ejection fraction, congestive heart failure. The toxic damage of myocardium, in particular congestive heart failure (CHF) may develop during treatment both mitoxantrone and months or years after therapy. The risk of cardiotoxicity increases when the total dose of 140 mg / m 2 . From the side of respiratory system: cases of interstitial pneumonitis reported. Allergic reactions: itching, rash, hives, shortness of breath decrease in blood pressure, anaphylactic reactions (including anaphylaxis) . Local reactions:phlebitis; at extravasation – erythema, swelling, pain, burning, necrosis of surrounding tissues. Cases of intense blue color of veins in which to inject the drug and the surrounding tissues. Other: alopecia, fatigue, general weakness, fever, nonspecific neurological symptoms were back pain, headache, menstrual disorders, amenorrhea, rarely – blue color skin and nails, very rarely – nail dystrophy and reversible blue coloration of the sclera, secondary infection, hyperuricemia, hypercreatininemia.
In case of overdose dianabol for salemay be increased, in the first place, mnelotoksichnosti and the above side effects. Application diatiza not effective. In case of overdose should closely monitor the patient and, if necessary, to carry out symptomatic therapy. The specific antidote for mitoxantrone is not known. boldever