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    3. Etoposide-Teva concentrate for solution for infusion 20mg/ml, 10 ml — Made in Czech Republic — Free Delivery

    Etoposide-Teva concentrate for solution for infusion 20mg/ml, 10 ml — Made in Czech Republic — Free Delivery


    Brand: TEVA
    Product Code: Etoposide-Teva
    Availability: In Stock
    $32.27
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    Pharmacological properties

    Etoposide is an antineoplastic agent, a semi-synthetic derivative of podophyllotoxin.
    The preparation disrupts DNA synthesis, inhibits mitosis, blocks cells mainly in the G2-phase and late S-phase of the cell cycle. The cytotoxic effect on healthy cells is observed only when the preparation is used in high doses.
    After intravenous administration, the pharmacokinetics of the preparation is biphasic with a half-life in the first phase of about 1.5 hours, in the second - 4-11 hours. The total clearance varies within 33-48 ml / min. Etoposide in a small amount penetrates into the pleural fluid, is determined in saliva, liver, spleen, kidneys, myometrium, in brain tissue. The minimum amount of the preparation enters the bile. Etoposide poorly penetrates the BBB (the concentration of etoposide in the CSF usually varies from an amount that cannot be determined to less than 5% of the concentration in blood plasma during the first 24 hours after IV administration). Etoposide in a high degree (97%) binds to blood plasma proteins.
    The preparation is metabolized in the liver with the formation of an inactive hydroxy acid, as well as glucuronides and sulfates (5–22%), which have minimal cytotoxic activity. It is excreted mainly in the urine, in a smaller amount (about 6%) in the bile. In children, about 55% of the administered dose is excreted in the urine as etoposide within 24 hours. The average renal clearance of etoposide is 7-10 ml / min, or about 35% of the total clearance when the preparation is prescribed at a dose of 80-600 mg / m2.

    Indications

    Germ cell tumors (testicular tumors, chorionic carcinoma), small cell lung cancer.

    Application

    Enter only intravenously drip (within 30-60 minutes). before use, concentrated etoposide for injection is dissolved in 5% dextrose solution or 0.9% sodium chloride solution to a final concentration of 0.2 mg / ml.
    For testicular tumors, the dose of etoposide in combination with other chemotherapeutic agents is usually 50-100 mg / m2 per day on the 1st, 3rd and 5th days of the course.
    In small cell lung cancer, the dose of etoposide in combination with other chemotherapy preparations is about 35 mg / m2 per day for 4–5 days. Chemotherapy courses are repeated at intervals of 3-4 weeks after the normalization of hematological parameters.

    Contraindications

    Hypersensitivity to the preparation, severe liver dysfunction, pregnancy and lactation.

    Side effects

    Possible leukopenia (with a level of leukocytes less than 4000 in 1 mm3 - in 60-91% of cases, less than 1000 in 1 mm3 - in 3-17% of cases), thrombocytopenia (with a level of platelets less than 100,000 in 1 mm3 - in 22-41% cases, less than 50,000 in 1 mm3 - in 1–20% of cases), anemia (less than 33%), the development of acute leukemia (isolated cases, in particular, in patients receiving polychemotherapy), nausea and vomiting (31–43%) , anorexia (10-13%), diarrhea (1-13%), abdominal pain (less than 2%), stomatitis (1-6%), hepatotoxic effect (less than 3%), dysphagia, constipation, short-term arterial hypotension on a background of rapid intravenous administration, not accompanied by manifestations of cardiotoxicity or changes in the ecg (in 1-2% of patients), hypersensitivity reactions (chills, fever, tachycardia, bronchospasm, dyspnea, arterial hypotension - in 0.7-2% of cases), increased blood pressure, hot flushes, reversible alopecia (66%), frequent infections, delayed wound healing, bleeding from the gums, bad taste in the mouth, skin rash, fever, flushing, and hyperpigmentation of the skin, dermatitis, metabolic acidosis (if the recommended doses are exceeded). most side effects are reversible; in the event of severe reactions, the dose of the preparation should be reduced or treatment discontinued.

    Special instructions

    Treatment with etoposide can only be carried out by an experienced chemotherapist in a specialized hospital.
    During and after treatment, it is necessary to control the composition of peripheral blood, the functional state of the liver and kidneys. The number of platelets less than 50,000 in 1 mm3 or the absolute number of neutrophilic granulocytes less than 500 in 1 mm3 is an indication for discontinuing further treatment until laboratory blood tests are completely normalized.
    The preparation is a potential embryotoxic, teratogenic and mutagenic agent. It is recommended to stop breastfeeding while taking the preparation. The safety and efficacy of use in children has not been established.
    With the development of anaphylactic reactions, the infusion of the preparation should be stopped immediately, corticosteroids, antihistamines should be prescribed, and the BCC should be corrected.
    Cloudy solutions, as well as solutions containing sediment, are unsuitable for use.
    When working with the preparation, medical personnel should use protective clothing (gloves, gown), as well as glasses and a mask. In case of contact with eyes or mucous membranes, rinse with plenty of running water or isotonic sodium chloride solution. Pregnant women should not be allowed to work with the preparation.

    Interactions

    Solution of etoposide should not be mixed in the same volume with other preparations for parenteral administration.

    Overdose

    It manifests itself as a hepatotoxic effect. there is no specific antidote, symptomatic treatment. it is recommended to monitor the functional state of the liver and kidneys for 3-4 weeks after preparation overdose.

    Storage conditions

    At room temperature, protected from light. ready-made solutions of etoposide in 5% dextrose solution or 0.9% sodium chloride solution remain stable for 96 hours when stored in a dark place at room temperature.

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