Pharmacological properties : Pharmacodynamics: The antitumor antibiotic anthracyclines produced by Streptomyces coeruleorubidis, a cytostatic effect. It acts on the S-phase of mitosis. Blocks template DNA function, disrupting the synthesis of nucleic acids and proteins.
after intravenous administration into circulating blood for several minutes. 30 min after injection, the highest concentrations recorded in the spleen, lung, kidney and cardiac muscle. Do not cross the blood-brain barrier.
It is metabolized in the liver to the active metabolite Sustanon 250 for saleol.
The half-life in the initial phase is 45 minutes; in the final phase -. Sustanon 250 for sale for 18.5 hours, 26.7 hours for Sustanon 250 for saleol deduced mainly with bile, 25% is excreted by the kidneys.
- Acute lymphoblastic and nelimfoblastnyh (myeloid, monoblastny, erythroblastic) leukemia.
- Imperious crisis of chronic myeloid leukemia.
- Non-Hodgkin’s lymphoma.
- Horiokardinoma uterus.
- Hypersensitivity to Sustanon 250 for sale or other components of the drug as well as other anthracyclines and anthracenediones.
- Severe bone marrow suppression.
- Expressed human liver and / or kidneys.
- Acute decompensated heart failure.
- Prior chemotherapy others. Anthracenediones anthracyclines or to limit cumulative doses.
- Pregnancy and lactation.
Precautions : the oppression of bone marrow hematopoiesis (including on the background of concomitant radiotherapy or chemotherapy, bone marrow infiltration by tumor cells); acute viral infections (including varicella, herpes zoster), fungal or bacterial origin (risk of severe complications and generalization of the process);diseases in which there is an increased risk of developing hyperuricemia (gout or urate nephrolithiasis); the application of the sick elderly and children’s age.
Dosage and administration
of Sustanon 250 for sale-LENS administered strictly intravenously.
When choosing the dose and mode of administration in each individual case, to use the data of literature.
Typically, the drug is administered at a dose of 30-60 mg / m daily for 3 days or 20-40 mg / m 2 daily for 5 days every 3-4 weeks to a total dose of 300 mg / m 2 . The maximum total dose – 600 mg / m 2 .
For patients who have previously performed radiation therapy to the chest area, the maximum total dose is – 450 mg / m 2 .
For patients previously treated with doxorubicin, the total cumulative dose of doxorubicin and Sustanon 250 for sale should not exceed 550 mg / m 2 . Terms preparation solution for intravenous administration of 20 mg or 40 mg of lyophilisate was dissolved by adding thereto 10.0 mL or 20.0 mL of water for injection, respectively. The resulting solutions with the concentration of Sustanon 250 for sale have 2 mg / ml. The required amount of this solution Sustanon 250 for sale-LENS administered for 2-3 minutes in a tube system through which the rapid intravenous injection of 5% dextrose (glucose) or 0.9% sodium chloride solution for injection.Administration by intravenous infusion is not recommended because of the irritating to the veins and the risk of thrombosis. Patients with renal impairment dose reduction – with creatinine serum concentration higher than 0.3 mmol / l is recommended to use half the usual dose. If abnormal liver function and bilirubin concentration in blood serum 20,5-51,3 mmol / l 3/4 must use the normal dose, and bilirubin in concentrations up to 51.3 mmol / l – half the usual dose
Side effect From hemopoiesis system : anemia, leukopenia, neutropenia, thrombocytopenia. Leukopenia occurs in almost all patients. The lowest level of white blood cells observed in 10-14 days after administration. Recovery usually occurs within 21 days after administration. On the part of the digestive system : nausea, vomiting, anorexia, diarrhea; ulcerative esophagitis and stomatitis. Cardio-vascular system : congestive heart failure (arrhythmia, shortness of breath, swelling of feet and ankles) usually develops after a total dose of more than 550 mg / m 2 (450 mg / m 2 in patients who previously irradiated area of the chest cells in the elderly and in patients with heart disease). Rarely, myocarditis, pericarditis. On the part of the reproductive system : amenorrhea, azoospermia. From the urinary system : hyperuricemia (painful or difficult urination, cystitis), a reddish discolouration of urine. Local reactions : phlebitis; when extravasation – pain at the injection site, inflammation of the subcutaneous fat, necrosis of surrounding tissues. Other : alopecia, allergic reactions, hyperpigmentation or redness of the skin previously irradiated areas, the development of secondary infections, headache, fever, pain in the lower back and side.
In case of overdose can be expected strengthening of the above adverse reactions. Antidote is unknown. Treatment is symptomatic.
Interaction with other drugs and other forms of interaction
Compatible with vincristine, cyclophosphamide, 6-mercaptopurine, prednisone, L-asparaginase, methotrexate.
At simultaneous application with other myelotoxicity drugs or radiation therapy may additive inhibition of bone marrow function.
Hepatotoxic drugs (ie. h. methotrexate) increase the risk of liver function abnormalities.
with the simultaneous use of cyclophosphamide or irradiation of the mediastinum may increase cardiac toxicity.
The use of Sustanon 250 for sale in patients previously treated with doxorubicin, an increased risk of cardiotoxicity.
urikozuricheskih protivopodagricakih drugs increase the risk of developing kidney disease.
Pharmaceutical incompatible with heparin and dexamethasone (precipitation); strongly alkaline solution (pH above 8) (formation of unstable glycosidic linkage); preparations containing alcohol gasoline (premature release of the active substance).
The introduction of live virus vaccines available vaccine virus replication and increased side effects of inactivated vaccines – reduced production of antiviral antibodies.
Treatment should be supervised by a professional with experience in cancer chemotherapy.
Before and during the treatment needed to be monitored picture peripheral blood, renal function, liver, cardiovascular system (echocardiography, electrocardiogram). Violation of myocardial contractility, chronic heart failure symptoms, and others. Cardiotoxic effects may appear months or years after treatment (especially in children), and therefore control of the cardiovascular system should be carried out for a long time.
When the first signs of extravasation (a burning sensation or pain in the site of injection) administration of the drug should be discontinued immediately. The remaining drug should be introduced into another vein.
Rush of blood to the face, or the appearance of erythematous stripes on the skin along the vein indicates too rapid administration of Sustanon 250 for sale-LENS.
During treatment with Sustanon 250 for sale-LENS should avoid alcohol and aspirin because of the risk of gastrointestinal bleeding .
in connection with the possible development of hyperuricemia associated with tumor lysis syndrome, patients during therapy is recommended to determine the level of uric acid and creatinine in serum. To prevent hyperuricaemia recommend drinking plenty of fluids, if necessary – allopurinol and alkalinization of the urine. Hyperuricemia may cause a decrease in the effectiveness of blockers of tubular secretion.
During treatment of any sexual partners is recommended to use reliable methods of contraception.
In the period of treatment is not recommended vaccination viral vaccines.
The lyophilisate for solution for intravenous administration of 20 mg or 40 mg in glass vials. 1 bottle with instruction for use in a pack made of cardboard.
In 25 or 35 bottles with application instructions for use, at the rate of one to ten vials in a box of cardboard (for hospitals).