Pharmacological action of Zavedos:
Antitumor agent from the group of anthracycline antibiotics. Interacts with topoisomerase II, disrupts DNA secondary coiling and nucleic acid synthesis. The antitumor effect is combined with cardiotoxic and myelosuppressive effects. In experiments on experimental models in vitro (including bacterial systems and mammalian cell cultures) and in vivo (female rats), the presence of mutagenic and carcinogenic properties of idarubicin was established. In studies on rats, embryotoxic and teratogenic properties were revealed, in experiments on rabbits – embryotoxic, but not teratogenic effects. In experiments on dogs, idarubicin caused testicular atrophy with suppression of spermatogenesis and maturation of spermatozoa, leading to a decrease in the number of mature spermatozoa or their absence.
Indications Zavedos:
Myeloid leukemia, acute non-lymphoblastic leukemia (in adults), acute lymphoblastic leukemia (in adults and children as part of combination therapy), lung cancer (as part of combination therapy).
Contraindications for Zavedos:
Hypersensitivity (including to other anthracyclines), pregnancy, lactation. With caution. Myelosuppression – leukopenia, thrombocytopenia (history, including those caused by chemotherapy and radiation therapy), myocarditis, myocardial infarction, arrhythmias, acute infectious diseases of a viral, fungal or bacterial nature (including chicken pox, shingles) , gout or urate nephrourolithiasis (history), liver and / or kidney failure, old age (over 60 years).
Side effects of Zavedos:
On the part of the hematopoietic organs: myelosuppression (leukopenia, thrombocytopenia, anemia). From the side of the CCC: CHF, arrhythmias, cardiomyopathy. From the digestive system: nausea, vomiting, esophagitis, stomatitis, mucositis, stomach cramps, diarrhea, increased activity of “liver” transaminases, rarely – enterocolitis with perforation. From the side of the kidneys: nephropathy due to increased formation of uric acid. Allergic reactions: peeling of the skin, skin rash, urticaria, erythematous rashes (more often in patients receiving radiation therapy). Local reactions: tissue necrosis at the injection site. Others: immunosuppression, hyperuricemia, alopecia. Overdose. Symptoms: manifestations of acute cardiotoxicity (arrhythmias, with a possible fatal outcome) in the first 24 hours. Severe myelodepression (within 1-2 weeks). Treatment: symptomatic, if necessary – blood transfusion, platelet mass, antibiotics. Dialysis is ineffective.
Dosage and administration of Zavedos:
Inside, without chewing and drinking a small amount of water, with acute non-lymphoblastic leukemia in adults – 30 mg / sq.m / day daily for 3 days as monotherapy or 15-30 mg / sq.m daily for 3 days in combination with others .Antineoplastic drugs. In / in. In acute non-lymphoblastic leukemia for adults – 12 mg / sq.m of body surface for 3-5 days (in combination with cytarabine); as monotherapy or in combination with other drugs – 8 mg / sq.m for 5 days. In acute lymphoblastic leukemia, adults – 12 mg / sq.m, children – 10 mg / sq.m, administered daily for 3 days. To prepare a solution, dissolve 5 mg of the drug in 5 ml of water for injection. It is injected in a stream (very slowly) together with a 0.9% NaCl solution for 5-10 minutes.
Special instructions Zavedos:
The treatment is carried out by specialists in the field of chemotherapy under the control of the blood picture, liver and kidney function, ECG. When choosing a dosing regimen, it is necessary to take into account the hematological status and doses of other cytostatic drugs. During treatment, urine may turn red. It should not be given to patients with a history of CHF unless the risk of treatment is justified by successful results. Personnel working with the drug must wear protective clothing. Irradiation of the mediastinal region may increase the risk of cardiotoxicity. It is necessary to refuse immunization (if it is not approved by a doctor in the range from 3 to 12 months after taking the drug); other family members who live with the patient should not be immunized with oral polio vaccine, and avoid contact with people who have received polio vaccine, or wear a protective mask that covers the nose and mouth. In patients over 60 years of age, the incidence of cardiotoxicity increases.
Interaction Zavedos:
Pharmaceutically incompatible with any alkaline solutions (destruction of idarubicin), with heparin (precipitation). Drugs with cardiotoxic and myelotoxic effects mutually reinforce side effects. When combined with uricosuric drugs, the risk of developing nephropathy increases.
