Dacogen

Dakogen refers to antitumor drugs. The main action is aimed at reducing some biochemical processes that are vital for the life and development of malignant organisms.  

Indications Dacogen

Dakogen is prescribed for myelodysplastic syndrome. This disease is characterized by a decrease in blood in some types of cells, a violation of bone marrow function, and the risk of developing acute leukemia increases.

[1], [2], [3], [4]

Release form

Dakogen is produced in the form of a powder for the preparation of an infusion solution. The drug is available in colorless vials, located in a cardboard box.

[5], [6], [7]

Pharmacodynamics

Dakogen has a strong effect on the enzyme DNA - reduces its activity, which leads to the suspension or complete destruction of cancer cells in the blood. The drug overcomes the drug resistance, facilitates the immune response.

The maximum manifestation of the effect of the Dacogen is observed after the cell reaches the phase S (DNA synthesis).

[8], [9]

Pharmacokinetics

The dacogen is excreted by the kidneys in the form of metabolites. The active substance is decitaben, less than 1% is excreted unchanged in urine.

In the late stages of the disease, extrahepatic metabolism is observed when removing the drug from the body. On average, the half-life is about half an hour.

After the dropper, the concentration in the blood of the active substance was increased and decreased in two phases, the drug showed extremely low binding to blood proteins (less than 1%).

The drug is metabolized mainly in the liver, also in the surface layer of the intestine, granulocytes, blood plasma.

The conducted laboratory studies in test tubes allowed specialists to assume that decitabine is not the basis of the liver enzyme P450.

A study of the pharmacokinetic properties of the Dacogen in hepatic or renal failure was not conducted, nor was the effect of the drug studied depending on age or sex.

[10], [11]

Dosing and administration

Dakogen is appointed, as a rule, in one of two modes, each of which consists of four cycles. In practice, for a complete or partial reduction in symptoms, long-term therapy with Dakogen may be required (duration of therapy may continue as long as the therapeutic effect of the drug persists). 

After 4 cycles of therapy, a specialist may note a lack of positive dynamics in treatment. If the blood counts (platelet count, neutrophil count, etc.) are not normalized, or the disease progresses, an alternative treatment is prescribed.

Each cycle involves the administration of the drug for several consecutive days (five or three days). The dacogen is administered intravenously with a dropper.

With a five-day dosage regimen, the drug is administered at a dose of 20 mg (the patient will receive 5 doses per cycle), the cycle is repeated every 4 weeks, with a three-day regimen, 15 mg every 8 hours (the patient receives 9 doses per cycle), the cycle every six weeks.

At the beginning of treatment, a blood test can show a deficit of some cells.

In the elderly, the dosage usually does not differ. Depending on the tests and the patient's condition, the doctor can adjust the dosage of Dacogen.

[15]

Use Dacogen during pregnancy

Dacogen is contraindicated in pregnant and lactating women, as it can provoke various violations of embryonic development.

Contraindications

Dakogen is contraindicated in case of increased susceptibility to some components of the drug. Also, treatment with Dacogen up to 18 years is not prescribed.

[12],

Side effects Dacogen

The dacogen can provoke sleep disturbances, dizziness, headaches, decreased sensitivity, nausea, stool disorders, vomiting, abdominal pain, rashes on the skin and mucous membranes, digestive disorders, febrile conditions, swelling at the injection site, bloating.

Also, Dakogen therapy can be complicated by the development of pneumonia, pharyngitis, wheezing in the lungs, asphyxiation. After the drug can develop simple herpes, candidiasis, pain in the joints, lower back, etc.

Treatment can cause a decrease in the level of neutrophils, platelets, leukocytes and other blood cells, a decrease in sugar, albumin, magnesium, potassium in the blood, an elevated level of urea.

Dacogen can cause infections of the urinary system, septic shock, inflammation of the nasal sinuses, bleeding from the nose.

[13], [14]

Overdose

Dakogen in case of exceeding the recommended dose leads to a decrease in granulocytes, platelets in the blood, increased serum creatinine.

With overdoses, maintenance therapy is prescribed.

[16], [17], [18]

Interactions with other drugs

Dacogen causes an increase in the effect of other antitumor drugs, with a decrease in platelet counts. The combination of Dakogen with tamoxifen leads to bleeding and the accumulation of large amounts of blood between the dura mater.

When the combination therapy is prescribed, the patient is closely monitored in order to identify possible negative reactions in a timely manner.

[19], [20], [21]

Storage conditions

Dakogen must be stored in a whole package, in a place where sunlight does not reach, moisture. The Dacogen solution dissolved in cold water is stored at a temperature of 2 to 8 ^° C for not more than 7 hours.

The temperature of storage of the preparation should not exceed 30 ⁰ С.

The drug should be kept out of the reach of children.

[22], [23], [24]

Special instructions

Dacogen can lead to a significant reduction in platelet and granulocyte count in the blood, so before starting treatment and subsequently before each new cycle, the doctor should prescribe an overall blood test to monitor the therapeutic as well as toxic effect of the drug.

[25], [26], [27], [28]

Shelf life

Dakogen is suitable for three years from the date of production, provided that the integrity of the package and the storage conditions are maintained.

Do not use Dacogen after the expiration date.

[29], [30]