Treatment with the drug should be carried out only under the supervision of a doctor who has experience of antitumor therapy. Doses are set based on the real or ideal body weight of the patient, depending on which one is smaller.
The drug is used inside, without chewing, with a glass of water. If swallowing is difficult, the capsule can be opened, dissolved in a glass of water and drunk entirely. In this case, some water-insoluble auxiliary substances can float on the surface of the solution.
During treatment with the drug should take a fairly large amount of fluid.
Solid tumors, melanoma
Intermittent therapy: 80 mg / kg once a day every three days (6-7 doses).
Continuous therapy: 20-30 mg / kg daily for 3 weeks.
Carcinoma of the head and neck, cervical carcinoma
80 mg / kg once a day, every third day in combination with radiotherapy.
Treatment with the drug begins at least 7 days before the start of radiotherapy and continues during radiotherapy.After radiotherapy, the drug continues to be taken for an unlimited time, with strict observation of the patient and in the absence of unusual or severe toxicity reactions.
Resistant chronic myelogenous leukemia
Continuous therapy. The initial daily dose is 40 mg / kg. The dose reduction depends on the number of leukocytes in the blood plasma. The dose is reduced by 50%, if the number of white blood cells is less than 20x109/ l. In the case of leukopenia, the dose should be adjusted so as to maintain the number of leukocytes at the level 5-10x109/ l. With a decrease in the number of white blood cells less 5x109/ l, the dose should be reduced. Increase the dose can only after reaching the number of leukocytes no less than 10x109/ l. Treatment is suspended if the number of white blood cells is less than 2,5x109/ l or platelets less than 100x109/ l. Renewal of treatment is possible after recovery of the number of leukocytes and platelets. The evaluation period for the antitumor activity of the drug is 6 weeks. If there is a significant deterioration in the course of the disease, treatment should be discontinued. With clinically meaningful improvement, treatment is extended indefinitely.
True polycythemia
Treatment begins with a daily dose of 15-20 mg / kg. The dose is set individually, seeking to maintain a hematocrit below 45%, and the platelet count is lower 400x109/ l. In most patients, it is possible to achieve these parameters by constantly applying hydroxycarbamide in a daily dose of 500 to 1000 mg. If the hematocrit and platelet counts can be successfully controlled, treatment should continue for an unlimited time.
Essential thrombocythemia
Usually, the drug is prescribed in the initial daily dose of 15 mg / kg; then select a dose that maintains the number of platelets at a level below 600x109/ l, without leading to a decrease in the number of white blood cells below 4 x 109/ l.
Osteomyelophybrosis
The initial daily dose is from 5 to 20 mg / kg. The maintenance daily dose is 10 mg / kg.
Patients with impaired hepatic function
There are no instructions for correcting doses in this group of patients. It should be carefully monitored blood levels in patients with impaired liver function.
Patients with impaired renal function
Because the hydroxycarbamide is excreted mainly by the kidneys, in such patients it is necessary to reduce the dose of the drug. Patients with a creatinine clearance less than 60 ml / min are usually given a dose of 15 mg / kg.Patients in the terminal stage of renal failure receive the drug at a dose of 15 mg / kg twice, with an interval of 7 days between doses: the first time - at the end of the 4-hour hemodialysis session, the second time before the hemodialysis session.
Elderly patients
Since elderly patients are more likely to develop side effects when using hydroxycarbamide than younger patients, the recommended dose for patients in this group should not exceed 60 mg / kg per day.