Anthracycline antibiotic, a cytostatic agent, has gained fame and has been used in medicine since the 60s of the 20th century. Adriamycin is produced by microorganisms Streptomyces coeruleorubidus and Streptomyces peucetius. Substance molecule consists of them anthraquinoid aglycon doxorubicinonewhich connects via a glycosidic bond with aminosugar daunosamine.
Most often sold in uniform doxorubicin hydrochloride. By its physical properties it is a red or orange amorphous or crystalline powder. The molecular weight of 580 grams per mole. It is well soluble in water, it is difficult in methanol and acetone. The substance is unstable in a solution with a hydrogen index greater than 7 and less than 3.
Pharmacodynamics and pharmacokinetics
Adriamycin inhibits the synthesis of DNA and RNA, integrates into a double helix of DNA between several pairs of nitrogen bases, disrupts the matrix and changes the spatial structure of the molecule, forming free radicals. Also, the antitumor effect of the drug is manifested in a change in cellular functions and the ability of the drug to interact with topoisomerase 2.
The drug has a fairly low selectivity, but it has a high degree of antileukemia and antitumor activity. The tool has a cardiotoxic and immunosuppressive effect. With prolonged treatment with Adriamycin, the risk of developing secondary tumors increases. The substance is carcinogenic, negatively affects sexual function, has a teratogenic and embryotoxic effect.
After intravenous administration, the substance is rapidly distributed throughout the tissues. It can be found in the heart, liver, kidneys and lungs within half a minute. Plasma concentration decreases according to a three-phase scheme, in the first 10 minutes, within 3 hours and within 40 minutes. The medicine does not penetrate blood-brain barrierhowever overcomes placental. Active metabolite doxorubicinol formed in the liver and excreted within 5 days with bile and urine.
Indications for use
Adriamycin is prescribed for the treatment of:
- sarcomas soft tissue, osteogenic sarcomas and Ewing's sarcomas;
- lymphoblastic leukemia, Wilms tumors;
- breast cancer, thyroid glands;
- neuroblastomas, lymphogranulomatosis;
- stomach cancerovaries, bladder;
- trophoblastic tumors, non-Hodgkin lymphomas;
- endometrial canceresophagus, stomach and so on.
The medicine is contraindicated for use:
- at anemiaexpressed leukopeniaacute hepatitis;
- thrombocytopeniain severe diseases of the heart and blood vessels;
- in patients with acute hepatitis;
- pregnant women
- if previously the patient received a cumulative dose anthracene and anthracyclines.
In the treatment with Adriamycin are observed:
- anemia, thrombocytopenia, leukopenia, cardiac arrhythmia;
- cardiomyopathyacute heart failure;
- vomiting stomatitisnausea diarrheapain in the abdomen;
- amenorrheaincreased body temperature azoospermia;
- hivesAnaphylactic and anaphylactoid reactions;
- nephropathy, hair loss, hyperuricemia;
- tissue necrosisvascular sclerosis (if the drug is injected into the thin veins or several times in the same place).
Instructions for use (Method and dosage)
The dosage is different, depending on the disease and treatment regimen. The medicine is administered intravenously or intravesically.
With an overdose, the toxic effects of taking the medicine intensify, develops leukopenia, thrombocytopenia and the mucous membranes become inflamed. Symptomatic treatment, antibiotics indicated, transfusion granulocyte mass.
Adriamycin should not be mixed in one container with dexamethasone, heparin, fluorouracil, aminophylline, hydrocortisone sodium succinate, cephalotin.
The half-life of the drug increases under the influence of streptozocin.
During treatment, the drug is able to enhance the toxic effect of other antitumor agents and radiation therapy.
Adriamycin causes an increase in plasma concentration of uric acid, reduces the effectiveness of treatment allopurinolantigout drugs colchicine.
Also, when conducting therapy, the effect of inactivated vaccines is weakened, side effects from the use of live viral vaccines are amplified.
Combined medication with cytarabine may lead to development necrotic colitissevere infectious complications.
Adriamycin treatment is carried out in a hospital under the supervision of a doctor. It is necessary to control blood counts, liver and heart function.
Particular caution is recommended for patients with insufficient reserve of bone marrow after radiation therapy and the use of other cytotoxic substances.
Dental surgery is recommended to be postponed. If during the injection the drug got under the skin, then the procedure must be stopped. The substance can not be re-prescribed more often than a month after the previous course.
During pregnancy and lactation
The medicine cannot be used during pregnancy and breastfeeding.
Preparations that contain (Analogs)Matches for ATX Level 4 code:MitoxantroneDoxorubicin
The substance has the following trade names: Kelix, Doxolec, Doxorubifer, Rastocin, Syndroxocin, Doxorubicin, Adriblastin Instant, Doxorubicin hydrochloride.
Reviews about the drug from doctors are mostly positive. The medicine is often prescribed for the treatment of cancer, its effectiveness depends on various factors, such as the type of disease, the patient's condition, concomitant diseases, and so on. Often the adverse reactions described in the instructions, hair loss, ulcers at the injection site, weakness and feeling unwell during treatment occur. However, in the end, it is often possible to achieve prolonged remission.
Adriamycin price, where to buy
The price of Adriamycin in the form of Kelix preparation, for one bottle, with a capacity of 25 ml and a dosage of 2 mg per ml is about 30 thousand rubles.