Iriten

Iriten is an alkaloid, herbal medicine with anti-tumor properties. Its active element is irinotecan. In the production of the substance, camptothecin is used as a base.

The drug slows down the activity of the enzyme topoisomerase I (this is a monomeric protein that can affect DNA topology). Reviews of doctors specializing in this area show that the active element acts on neoplasms that have high cellular resistance in relation to modern therapeutic methods. [1]

Indications Iriten

It is used for therapy with locally advanced or metastatic form of colorectal carcinoma (as a second-line treatment medication).

Release form

The release of the drug is made in the form of a concentrate for the manufacture of infusion liquid, inside bottles with a volume of 2, 5 or 15 ml; inside the box there are 5 or 10 such bottles.

Pharmacodynamics

Iriten is an anticancer drug, the principle of which is associated with a slowdown in the activity of the cellular enzyme topoisomerase I, a participant in DNA binding processes. The drug has an immunosuppressive effect and slows down the action of acetylcholinesterase. [2]

Pharmacokinetics

After the introduction of intravenous infusion, the drug participates in metabolic processes with the formation of the active decay product SN-38. Metabolic processes mainly develop inside the liver. The average urinary excretion of irinotecan over a 24-hour period is 19.9%, and the degradation product of SN-38 is 0.25%. [3]

The pharmacokinetics of the drug does not depend on the size of the dosage.

Dosing and administration

The infusion should be administered within 30-90 minutes.

In the case of a malignant neoplasm in the region of the appendix and colon, monotherapy is used, 0.35 g of the substance in a period of 20 days.

When combined with 5-fluorouracil or Ca folinate, a dose of 80 mg / m2 should be used every week.

A mode with a single administration of 0.18 g at 2-week intervals is allowed.

With the additional use of bolus infusions with Ca folinate and 5-fluorouracil, it is necessary to use weekly at 0.125 g / m2.

It is necessary to use Iriten until diarrhea and vomiting are completely stopped; in addition, the neutrophil count should not exceed 1500 cells. In case of severe hematopoiesis disorders, severe diarrhea, concomitant infections and abnormal white blood cell counts with platelets, it is required to use reduced doses of drugs. It is also necessary to reduce the dosage of 5-fluorouracil to 15-20%.

• Application for children

Since there is no information on the safety of the use of drugs in pediatrics, it cannot be used for this age group.

Use Iriten during pregnancy

The medication should not be prescribed to pregnant or breastfeeding women.

Persons of fertile age need to use reliable contraception during therapy and for 3 months after its completion.

Contraindications

The main contraindications:

• intestinal pathologies of an inflammatory nature in a chronic form;
• intestinal obstruction;
• an increase in the blood parameters of bilirubin to a level exceeding the VGN by more than 1.5 times;
• severe myelodepression;
• a history of severe intolerance to irinotecan.

Side effects Iriten

Among the side signs:

• problems with hematopoietic function: thrombocytopenia or neutropenia (treatable), as well as anemia;
• digestive disorders: nausea, diarrhea and vomiting. Constipation, abdominal pain, or stomatitis may develop.
• dermatological symptoms: there may be treatable alopecia;
• manifestations of allergies: occasionally epidermal rashes occur;
• others: convulsions, asthenia, dyspnoea, paresthesias, involuntary muscle contractions and fever (with the condition of absence of infection and severe neutropenia) may be observed.
• The appearance of cholinergic syndrome in an active form (hyperhidrosis, decreased blood pressure, vasodilation, chills, asthenia, early diarrhea, abdominal pain, visual disturbances, runny nose and conjunctivitis, as well as increased salivation or lacrimation) is possible.

Overdose

In case of drug poisoning, intestinal upset (diarrhea) and agranulocytosis with granulocytopenia may occur due to a decrease in the blood count of neutrophils.

Symptomatic procedures are carried out (at the hospital, since it is easier to monitor the patient's condition this way). If the portion of the medicine is exceeded by half, complications hazardous to health can develop, sometimes fatal.

Interactions with other drugs

It is forbidden to mix the drug with other substances inside one bottle.

The drug slows down the activity of cholinesterase, which excites the activity of the NA, due to which, when combined with suxamethonium, neuromuscular blockade can be prolonged. The opposite effect is observed in the case of a combination of drugs with muscle relaxants that have a non-depolarizing effect.

Storage conditions

Iriten should be stored in a place protected from sunlight, at temperatures not exceeding 25 ° C.

Shelf life

Iriten can be applied within a 2-year term from the date of manufacture of the pharmaceutical product.