Phytoside

Phytoside is a medication that belongs to a subgroup of anticancer drugs used for treatment in oncology. Its main active ingredient is the substance etoposide, a semi-artificial derivative of the thyroid podophila extract (lignan, which has a non-alkaloid nature).

In medical practice, the drug is usually used as an anticancer agent. The therapeutic efficacy of a drug is determined by the frequency of treatment cycles with its use. [1]

Indications Phytoside

It is used in the treatment of oncological pathologies, including:

• small cell type bronchial carcinoma;
• malignant lymphoma and Hodgkin's disease ;
• active phase of recurrent non-lymphocytic leukemia;
• ovarian and testicular carcinoma and chorionic cancer;
• pulmonary neoplasms of a non-small cell nature, sarcoma and other solid neoplasms;
• gastric carcinoma, trophoblastic neoplasms and neuroblastoma.

Release form

The release of drugs is realized in the form of an injection liquid, inside ampoules with a volume of 5 ml.

Pharmacodynamics

Testing has shown that etoposide is able to interrupt the cell cycle in the G2 phase (the final stage of the interphase stage of the cell cycle).

Etoposide demonstrates the ability to inhibit the incorporation of thymidine into the DNA cell structure. Large portions of the drug lead to the development of cell lysis, which is in the mitosis phase. [2]

Under certain conditions, a drug can suppress cells at the initial stage of prophase (the initial phase of cell mitosis).

Pharmacokinetics

Significant interindividual variability of pharmacokinetic parameters is noted. Etoposide is distributed at a high rate within the body. Protein synthesis is approximately 94%.

The pharmacokinetic characteristics of etoposide after intravenous injection are consistent with the biexponential 2-chamber model.

The half-distribution term at the 1st stage is approximately 1.5 hours, and the term of the half-life at the terminal stage is within 4-11 hours. Etoposide passes into the CSF with some difficulty.

About 45% of the dosage is excreted in the urine; 2/3 of the specified volume is excreted over a period of 72 hours in an unchanged form.

Salicylate Na, phenylbutazone and salicylic acid are able to displace etoposide synthesized with protein.

Dosing and administration

The selection of the dosage is made by an experienced oncologist, taking into account the severity and type of pathology, the patient's response to the drug and the selected therapeutic regimen.

To dilute the medication, use a NaCl solution or glucose liquid. The duration of the infusion is at least half an hour. It is forbidden to mix etoposide and other medicines inside the 1st bottle.

It is required to apply Phytozide in portions of 50-100 mg / m2, every day, for a period of 20 days. The therapy cycles are repeated after at least 3 weeks. In this case, a second course can be carried out only after stabilization of blood values.

• Application for children

There is not enough information regarding the therapeutic effect and safety of the drug when used in pediatrics.

Taking into account the above information, you need to carefully evaluate the need for the introduction of Phytozide, taking into account the balance of benefits and risks.

Use Phytoside during pregnancy

Phytozide should not be prescribed during pregnancy.

If you need to use drugs during hepatitis B, you should stop breastfeeding for the period of therapy.

Contraindications

The main contraindications:

• the presence of a strong personal intolerance in relation to the main or auxiliary elements of the medication;
• myelosuppression;
• severe kidney / liver failure;
• active phases of severe infections.
• If there is a need for vaccination, it is allowed to perform it at least 3 months after the completion of the last treatment course using etoposide.

For persons with a moderate form of liver / kidney failure, the medication is prescribed with extreme caution.

Side effects Phytoside

Among the side effects:

• thrombocyto- or leukopenia (recovery of indicators is noted after 3 weeks);
• gastrointestinal poisoning - vomiting, diarrhea, anorexia, nausea and stomatitis;
• signs of allergies - tachycardia, dyspnea, fever, bronchial spasm;
• polyneuropathy and alopecia;
• fatigue, rashes, drowsiness, hepatic dysfunction and epidermal radiosensitization.

Overdose

With intoxication, the development of toxic bone marrow lesions or inflammation of the mucous membranes, metabolic acidosis, and liver poisoning are noted.

In the event of such signs, detoxification is required immediately, as well as symptomatic procedures.

Interactions with other drugs

The drug is able to potentiate the myelosuppressive and cytotoxic effects of other drugs (including cyclosporine). During combined use with large portions of cyclosporine, an increase in exposure occurs, as well as a decrease in etoposide clearance rates.

Use in combination with radiation therapy or chemotherapy (with the help of substances with myelosuppressive activity) can potentiate the suppression of bone marrow activity provoked by etoposide.

The drug can potentiate the effect of oral anticoagulants.

Salicylic acid, phenylbutazone and Na salicylate are capable of weakening the protein synthesis of etoposide.

Through testing, it was found that the drug has cross-resistance with anthracyclines.

Vaccination with the use of live vaccines in persons with reduced immunity after chemotherapy can provoke the appearance of severe and fatal infections.

The combination of etoposide with other cytotoxic drugs (including cisplatin and methotrexate) leads to the development of a synergistic drug effect.

Storage conditions

Phytoside must be stored in a dark place, out of the reach of small children. It is forbidden to freeze the medicine. Temperature indicators - no more than 25 ° C.

Shelf life

Phytoside can be used within a 24-month term from the date of sale of the drug.

Analogs

The analogs of the drug are the substances Lastet, Etoposide with Vepesid, Etopos and Etozid.