When choosing the route of administration, treatment and dosage in each individual case, reference should be made to the literature.
The dosage regimen is set depending on the chemotherapy regimen used (when choosing a dose, the myelosuppressive effect of other drugs in combination should be considered, as well as the effect of previous radiation therapy and chemotherapy). Etoposide-LENS® is administered intravenously drip for 30-60 minutes in the following doses:
- 50-100 mg / m2 a day for 4-5 days, with a repetition of cycles every 3-4 weeks;
- 100-125 mg / m2 on days 1, 3 and 5, with repetition of courses after 3 weeks;
In patients with impaired renal function (creatinine clearance 15-50 ml / min), the dose of etoposide should be reduced by 25%. At clearance of creatinine <15 ml / min there is no data on the use of etoposide.
Repeated courses are held only after the normalization of peripheral blood.
Before intravenous administration, Etoposide-LENS® is diluted in 250 ml of 0.9% sodium chloride solution or 5% dextrose solution to a final concentration of 0.2-0.4 mg / ml. Avoid contact with buffered aqueous solutions with a pH above 8.
Before use, a visual assessment of the solution should be carried out to identify solids or discoloration.
Precautions for use
Etoposide-LENS® should be used only under the constant supervision of a physician with experience of therapy with cytotoxic drugs.
When working with Etoposide-LENS®, the rules for handling cytotoxic drugs should be observed. In case of contact with skin or mucous membrane, the affected areas should be washed immediately with soap and water.
Suppression of bone marrow function is a dose-limiting toxicity. Regular monitoring of the blood composition should be performed before the beginning of treatment, in breaks and before each subsequent course of the drug. If radiation therapy and / or chemotherapy was performed prior to initiation of therapy with Etoposide-LENS®, the choice of the dosing regimen should be made taking into account the severity of bone marrow depression.
In case of a decrease in the number of platelets below 50,000 / μL and / or the absolute number of neutrophils to 500 / μl, therapy should be discontinued until the blood counts are fully restored.
- When anaphylactic reactions occur, the use of etoposide-LENS® it is necessary to stop and start treatment of benocorticosteroids and / or antihistamine drugs on the background of infusion therapy.
- When there are signs of extravasation, the etoposide-LENS® infusion should
immediately stop. The remaining drug is injected into another vein. Around
of the affected area, subcutaneous hydrocortisone injections are administered and a 1% hydrocortisone ointment is applied under a dry bandage (until the skin flies out, usually for 24 hours).
Patients with hepatic or renal failure need correction of the dosing regimen and regular monitoring of kidney and liver function.
- Men and women of childbearing age during treatment with Etoposide-LENS® should use reliable methods of contraception.
Rarely in patients receiving therapy with etoposide-LENS® in combination with other antitumor drugs, acute leukemia can develop, both with and without the preleukemous phase.
A solution of etoposide-LENS® for intravenous administration as an excipient contains ethyl alcohol, which can be a risk factor for patients suffering from liver diseases, alcoholism, epilepsy, and also in children.