Medication

Fludarabine

Structure

In 1 tablet fludarabine phosphate 10 mg MCC, lactose monohydrate, carmellose sodium, silicon dioxide, magnesium stearate, talc, iron oxide, titanium dioxide, as excipients.

In 1 bottle of lyophilisate fludarabine phosphate 50 mg Mannitol, sodium hydroxide, as excipients.

Release form

Lyophilisate in a vial - Fludarabine 50 mg.

10 mg film-coated tablets.

Pharmachologic effect

Antitumor.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Antitumor agent, is a fluorinated nucleotide analogue vidarabina. In the body, the active substance turns into an active metabolite that inhibits DNA primase, RNA reductase, DNA polymerase, as a result, synthesis is disturbed DNTO.

Pharmacokinetics

When administered intravenously, it is dephosphorylated to nucleoside. To a small extent binds to proteins. After one infusion Max active substance 3.5-3.7 μm. It is well transported to leukemic cells, there it is phosphorylated into a metabolite that has a cytotoxic effect. The concentration in leukemic cells is higher than in plasma. Excretion occurs in 3 phases: the initial half-life is 5 minutes, the final - 20 hours. It is excreted from target cells in 15-23 hours. It is excreted by the kidneys, with Chronic renal failure clearance is reduced.

When administered, bioavailability is 50-60%. Max determined in 1-2 hours.

Indications for use

  • non-Hodgkin lymphoma;
  • chronic lymphocytic leukemia.

Additional indications for tablets:

  • lymphomas from the cells of the mantle zone;
  • follicular b-cell lymphoma.

Contraindications

  • hypersensitivity;
  • pregnancy;
  • hemolytic anemia;
  • lactation.

With caution is prescribed for acute diseases of a fungal, viral and bacterial nature, significant inhibition of bone marrow, liver failure,immunodeficiency and debilitated patients.

Side effects

  • inhibition of bone marrow function (T lymphopenia dangerous development of opportunistic infections);
  • tumor lysis syndrome (metabolic acidosisside pain hematuria, crystalluria, hypocalcemia and hyperphosphatemia);
  • decreased appetite diarrhea, stomatitis, nausea, elevated liver transaminases, gastrointestinal bleeding;
  • excitationconfusion epileptiform seizures, neuropathyimpaired vision, and blindness;
  • hemorrhagic cystitis;
  • skin rash, toxic necrolysis;
  • shortness of breath, cough, pneumonia, pneumonitis;
  • arrhythmiaswelling;
  • feverchills;
  • autoimmune thrombocytopenia and hemolytic anemia.

Fludarabine, instructions for use (method and dosage)

The drug is administered intravenously drip or stream. The contents are dissolved in 2 ml of water, the required dose is additionally diluted for jet administration in 10 ml of physical. solution, and for drip administration in 100 ml of physical. solution. An administered daily dose of 25 mg / m2 of body surface is administered for 5 consecutive days every 28 days.

At non-Hodgkin lymphoma usually 8 cycles.

At chronic lymphocytic leukemia most often spend 6 cycles to achieve remission.

Fludarabine Tablets (Fludara, Flutothera) taken whole, on an empty stomach or with food. The daily dose is 40 mg / m2 of body surface, they drink 5 days in a row every 28 days. At Chronic renal failure the dose is reduced by 50%.

During treatment, blood counts are periodically monitored (anemia, neutropenia and thrombocytopenia), as well as biochemical parameters (creatinine) Inhibition of bone marrow is reversible (from a month to a year).

Overdose

Overdose manifests itself pronounced thrombocytopenia and neutropenia. When applying, neurotoxicity was observed in doses exceeding the recommended 4 times and appeared 1.5-2 months after the last dose. Symptomatic and supportive treatment is carried out. At hemolytic anemia - transfusion of irradiated blood and GKS.

Interaction

The risk of pulmonary complications and mortality increases when prescribed with pentostatin. This combination is not recommended. Dipyridamole reduces the effectiveness of the drug. The solution cannot be combined in the same syringe with other drugs.

Terms of sale

Released by prescription.

Storage conditions

Temperature 2-8 ° С.

Shelf life

2 years.

Analogs of Fludarabine

Matches for ATX Level 4 code:Puri Netol

Lyophilisates: Flugarda, Fludara. Pills: Fludara, Flutothera, Fludarabine TL, Flidarin.

Reviews about Fludarabine

In the 80s of the twentieth century. purine analogues were synthesized. In chronic lymphocytic leukemia most effective is fludarabine - He is part of the traditional chemotherapy regimen. Long and often complete remission can be obtained in most patients, but it is still temporary. Therefore, combined treatment regimens are used (with cyclophosphamide, doxorubicin or mitoxantrone) The most effective combination was with cyclophosphamide and the third drug - rituximab. Appearance in 1990 the tablet form allowed patients to switch to outpatient treatment and combine it with taking cyclofamide in pills.

  • "... For three years about hr. I take leukoran lymphocytic leukemia, but the remissions were short-lived. Prescribed this drug, it is more effective".
  • "... I received this drug in monotherapy, and after 8 months, they repeated the course, adding cyclophosphamide. The remission was complete and lasted 2 years".
  • "... The first cycle with cyclophosphamide (3 days in a row) went fine, and the subsequent ones were accompanied by a rash".
  • "... After the first course, after 2 weeks the condition worsened".

Fludarabine price, where to buy

You can buy fludarabine in many pharmacies. The cost depends on the manufacturer and ranges from 1591-3114 rubles. for one bottle.

  • Online pharmacies in UkraineUkraine

Pharmacy24

  • Fludarabine-Vista 50 mg N1 powder Sindan Pharma SRL, Rumuniya 1660 UAH order

Pani Pharmacy

  • Fludarabine concentrate for injection or infusion 25mg / ml 2ml №1 Ukraine, TEVA 693 UAH order
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