Leukeran
Leukeran
Leukeran (Chlorambucil)Pharmacological action
The antitumoral preparation, concerns aromatic derivatives of nitrogen-bearing yperite. The alkylation occurs by means of formation of highly active radicals.
Indications
- A chronic lymphoid leukosis;
- Macroglobulinemias Valdensrem;
- The started adenocarcinoma of an ovary;
- A mammary gland cancer (in some cases).
Dosage regimen
Leukeranum is intended for intake.
Detailed schemes of application of Leukeranum are published in the medical literature.
The adult at Hojin illness in the form of monotherapy Leukeranum is prescribed usually in a dose by of 200 mkg/kg/day during 4-8 weeks.
Leukeranum usually is one of components of the combined therapy which spend under various schemes.
At a chronic lymphoid leukosis treatment by Leukeranum usually begin after occurrence of clinical symptoms or after occurrence of signs of disturbance of function of an osteal brain (but not medullar insufficiency) according to the analysis of peripheric blood.
The initial dose of Leukeranum makes 150 mkg/kg/sut until the general number of leucocytes of blood will not decrease to 10000/mkl. In 4 weeks after the termination of the first course of therapy treatment it is possible to renew of 100 mkg/kg/days in a maintenance dose
At a part of patients, usually after the first 2 years of treatment, the general number of leucocytes of blood is normalised, the lien and lymph nodes cease to be palpated earlier enlarged, and the relative maintenance of lymphocytes in an osteal brain makes less than 20 %.
To patients with signs of medullar insufficiency at first prescribe Prednisolonum, and Leukeranum can be applied only after occurrence of signs of neogenesis of a medullar hemopoiesis.
It is not taped significant differences of frequency of positive clinical effect and frequency of development of collateral reactions in case of Leukeranum application daily or intermittent courses in the big doses.
At macroglobulinemia Vandelstrem Leukeranum is a choice preparation. The initial dose makes 6-12 mg/sut daily, and after leukopenia development it is recommended to pass to a maintenance therapy in a dose of 2-8 mg/sut daily during the uncertain period of time.
At a cancer of an ovary as monotherapy Leukeranum is prescribed usually in a dose by of 200 mkg/kg/sut during 4-6 weeks.
In a dose of 300 mkg/kg/sut applied Leukeranum before leukopenia development. The maintenance therapy was spent in a dose by of 200 mkg/kg/sut, keeping quantity of leucocytes of blood at level 4000/mm3. In practice duration of courses of a maintenance therapy makes 2-4 weeks. With breaks between courses in 2-6 weeks.
At an advanced carcinoma of a mammary gland as monotherapy Leukeranum is prescribed usually in a dose by of 200 mkg/kg/sut during 6 weeks.
In a combination with Prednisolonum Leukeranum it is possible to apply in a dose of 14-20 mg/day irrespective of mass of a body during 4-6 weeks. And more under condition of absence of the expressed oppression of a hemopoiesis.
Leukeranum can be applied in a combination with Methotrexatum, 5-ftoruratsilom and Prednisolonum in a dose of 5-7 mg/m2/weeks
At an intact external cover use of tablets of Leukeranum does not represent risk. Tablets should not be divided into parts. At reception of tablets of Leukeranum it is necessary to carry out references on application of cytotoxic preparations.
Not used tablets should be destroyed according to rules of recycling dangerous and toxicants.
Side effect
From hemopoiesis system: often - oppression of function of an osteal brain.
From the alimentary system: seldom - a nausea, vomiting ; in single instances - hepatotoxic action and an icterus.
From respiratory system: seldom at patients with a chronic lymphoid leukosis at long Chlorambucil application the serious intersticial pneumosclerosis (after preparation cancellation can be exposed to an involution) developed; in single instances - an intersticial pneumonia.
Allergic reactions: seldom - a dermal eruption, in single instances passing in Stevens-Johnson's syndrome and a toxic epidermal necrolysis.
From party TSNS and peripheric nervous system: in single instances - a peripheric neuropathy. At children with the nephrotic syndrome, receiving Chlorambucil, convulsive attacks sometimes became perceptible. Seldom - focal and-or generalised cramps at Chlorambucil application in therapeutic doses daily.
The other: in single instances - a fever, an aseptic cystitis.
In case of excess of recommended therapeutic doses probably development of other by-effects.
Contraindications
Considering gravity of indications to application of Leukeranum, absolute contraindications to its appointment is not present.
Pregnancy and lactemia
It is necessary to avoid whenever possible Leukeranum appointment at pregnancy, especially in I trimester. In need of preparation application in each separate case it is necessary to weigh expected advantage of therapy for mother and potential risk for a foetus.
As well as at treatment by any cytotoxic preparations, at reception of Leukeranum it is necessary for partners to observe measures on a contraception.
In need of appointment of Leukeranum in a lactemia thoracal feeding should be stopped.
Special indicatings
Treatment by Leukeranum should be spent only under the control of the doctor having experience of application of similar preparations.
At application in therapeutic doses Leukeranum oppresses development of lymphocytes, to a lesser degree influences quantity of neutrophils and thrombocytes, and also on haemoglobin level. There is no necessity to stop Leukeranum reception at first signs of depression of quantity of neutrophils, however is necessary to remember, that depression of quantity of neutrophils can proceed within 10 and more days after reception of last dose.
Leukeranum should not be prescribed to patients who have passed recently a course of radiotheraphy or received other cytotoxic preparations.
At patients with lymphocytic infiltration of an osteal brain or with a hypoplasia of an osteal brain Leukeranum daily dose should not exceed 100 mkg/kg.
Leukeranum metabolism completely is not studied, therefore it is necessary to consider the problem on a dose decline of Leukeranum to patients with the expressed disturbance of function of a liver.
The control of laboratory indicators
As Leukeranum can cause irreversible oppression of function of an osteal brain, it is necessary to supervise quantity of formulated elements of blood in the course of treatment.
Overdosage
Symptoms: the basic implication of a casual Chlorambucil overdosage is the reversible pancytopenia. Cases of a toxic lesion of nervous system from the general excitation.
Treatment: it is necessary to carry out the careful control of analyses of blood and the general supporting actions, including a hemotransfusion or its components under indications.
The specific Chlorambucil antidote does not exist.
Medicinal interaction
Data about medicinal interaction of a preparation Leukeranum are not given.
Conditions and periods of storage
The preparation should be stored at temperature from 2 to 8 C. The Period of validity - 3 years.
Buy Leukeran online
Here you can order Leukeran online. Cheap Leukeran just klick the link below.
$3.98
