Precautions: the oppression of masteron cycle bone marrow hematopoiesis (including on the background of concomitant radiotherapy or chemotherapy), previous therapy with nephrotoxic drugs (eg cisplatin), hearing disorders, acute infectious diseases, viral, fungal or bacterial origin, post-vaccination period.
Dosing and Administration
Tsikloplatin can be applied as a monotherapy, or in combination with other anticancer agents. When selecting the dose and mode in each individual case, to use a special literature.
The drug is administered intravenously in a dose following modes:
• 300-400 mg / m iv infusion over 15-60 minutes or as a 24-hour infusion,
• 100 mg / m iv infusion over 15-60 minutes every day for 5 days;
Introduction Tsikloplatina repeated at intervals of not less than 4 weeks at a platelet indicators of not less than 100,000 cells / ml of blood and neutrophils at least 2000 cells / ml of blood at the time of the next administration.
Fluid introduction before or after applying Tsikloplatina, as well as the achievement of forced diuresis is not required .
Depending on the state of the bone marrow or kidney therapeutic dose can Tsikloplatina korregirovat follows:
- By reducing the number of masteron cycle platelets to 50,000 / l and / or 500 neutrophils / ml at previous courses of therapy with carboplatin dose adjustment is required.
- When observed minimum values of at least 50,000 platelets / mm and / or less than 500 neutrophils / ml at the previous course of therapy with carboplatin should consider the next dose reduction by 25% in both cases monotherapy or in combination regimens
- If the kidney function (. Creatinine clearance less than 60 mL / min) increases the risk of toxic effects of carboplatin, and therefore the recommended doses of carboplatin component in creatinine clearance 41-59 ml / min – 250 mg / m², with creatinine clearance 16-40 ml / min – 200 mg / m².
- Patients with risk factors such as, for example, previously performed training myelosuppressive therapy, age greater than 65 years, low performance status (ECOG-Zubrod 2-4 or by Karnovsky index below 80%) reduction recommended starting dose carboplatin 20-25% .
From the side of hematopoiesis: major masteron cycle toxic factor limiting the dose of carboplatin is the suppression of the function of bone marrow hematopoiesis. Myelosuppression is dose-dependent. The maximum low platelet count and leukocyte / granulocyte usually achieved within 2-3 weeks from the start of dosing, with thrombocytopenia is more common. Adequate recovery to a level that allows for your next dose of carboplatin, usually takes at least 4 weeks. At a sufficiently large number of patients may also show symptoms of anemia (hemoglobin less than 11 g / dL), the intensity of which depends on the total dose.
- There may be a need for transfusion therapy, particularly in patients undergoing long-term treatment (for example, more than six cycles of dosing). There is also the possibility of clinical complications such as fever, infections, sepsis / septic shock and haemorrhage. On the part of the digestive system: nausea, vomiting (can be prevented by pre-scheduled antiemetics, continuous intravenous infusion of carboplatin for 24 hours or fractional dosing during 5 days in a row), stomatitis, diarrhea or constipation, abdominal pain, decreased appetite, abnormal liver function (increase of masteron cycle activity of alkaline phosphatase and kontsentatsii serum bilirubin). From the nervous system: asthenia, peripheral neuropathy (paraesthesia, decreased deep tendon reflexes), decreased visual acuity up to complete loss of vision or loss of the ability to distinguish colors (improvement or complete recovery of vision usually occurs within several weeks after discontinuation of the drug, in patients with impaired renal function who were treated with high doses of carboplatin, was observed cortical blindness), hearing loss, tinnitus. Long-term therapy the drug can result in cumulative neurotoxicity. From the urogenital system: increased creatinine and urea concentrations in blood serum (acute renal disease has been rare, the risk of nephrotoxicity in patients receiving carboplatin increased with increasing doses of carboplatin as well as in patients who have previously been treated cisplatin), azoospermia, amenorrhea. From the water-electrolyte balance: hypokalemia, hypocalcemia, hyponatremia, and hypomagnesemia. allergic reactions:erythematous rash, fever, pruritus, urticaria, bronchospasm, hypotension, anaphylactoid reactions, allergic reactions to the injection site. Rarely – exfoliative dermatitis. Other: taste changes, alopecia, flu-like symptoms (fever, fever), hemolytic-uremic syndrome, myalgia / arthralgia, heart failure, cerebrovascular disorders.