Lanvis

Lanvis is an antineoplastic medicine, is included in the category of antimetabolites.

[1]

Indications of the lanvis

Indicated for elimination:

• acute forms of leukemia (mainly acute form of myeloid leukemia, as well as acute form of lymphoblastic leukemia);
• chronic form of granulocyte-type leukemia.

[2], [3]

Release form

Produced in tablets, 25 pieces in a vial. Inside one package of medicine contains 1 bottle.

Pharmacodynamics

Thioguanine is a sulfhydryl analog of guanine, which has similar properties to purine antimetabolite. When activated, it is converted into a nucleotide - thioguanyl acid. Decay products of thioguanine slow down the binding of purines, as well as the process of interconversion of nucleotides of the purine series.

In addition, thioguanine is introduced into the structure of nucleic acids and as a result, it is believed to acquire toxic properties. The active ingredient has cross-resistance with mercaptopurine, therefore it is necessary to take into account that patients with insensitivity to one of the drugs may be resistant to the other.

Pharmacokinetics

Thioguanine has a strong in vivo metabolism. There are 2 main ways of its biotransformation: the process of methylation to the formation of 2-amino-6-methylthiopurine, as well as the process of deamination with the formation of 2-hydroxy-6-mercaptopurine, which is subsequently oxidized to 6-thiocarbic acid.

With oral administration of drugs at a rate of 100 mg / m  ^{2, the}  peak of the plasma index is observed after 2-4 hours and is 0.03-0.94 nmol / ml. Reduction of this value occurs in the case of the use of the drug with food or when vomiting.

Dosing and administration

The duration of the therapeutic course and dosage depends on the size of the dose and the type of other drugs used in combination with Lanvis.

Short courses of taking thioguanine are possible at any stage of treatment, which precedes the supporting course (among them the stages of consolidation, induction, and intensification of the therapeutic process). But at the same time, it is not allowed to use it during the period of maintenance treatment or other similar long-term courses, since this can provoke intoxication of the liver.

The standard adult dose per day is 60-200 mg / m ²  of body area. In children, dosages are similar to adults, correction is carried out only in relation to the area of the body.

[6], [7]

Use of the lanvis during pregnancy

Lanvis, like other cytotoxic drugs, can potentially have teratogenic properties. There is some information that when husbands used combinations of cytotoxic drugs in women, babies with congenital malformations were born.

For the period of pregnancy, it is required to abandon the use of Lanvis, especially in the 1st trimester. If the application is necessary, you should carefully evaluate the benefits and risks of using this medication.

As with other chemotherapeutic agents, patients should be advised to use only quality contraception.

There is no information about the ingestion of the drug and its breakdown products into breast milk. But all the same it is considered, that at treatment Lanvis it is necessary to stop feeding by a breast.

Contraindications

Among the contraindications: intolerance to the patient of certain substances from the drug, as well as a simultaneous process of treatment of non-malignant pathologies.

[4],

Side effects of the lanvis

Lanvis is often an integral part of combined chemotherapy, as a result of which negative reactions of the body can not be attributed solely to the use of this drug.

Among the main side effects arising from taking the medicine:

• lymph and hematopoiesis: suppression of bone marrow function;
• Gastrointestinal organs: development of nausea, stomatitis, anorexia and vomiting, and in addition perforation or necrosis of the intestinal wall;
• digestive system: liver intoxication, which is combined with damage to the vascular endothelium (in the case of using Lanvis as a supporting agent or in other similar long-term treatment - this method of therapy is not recommended in these conditions). In general, this negative reaction develops as a hepato-veno-inclusive disease (hepatomegaly or hyperbilirubinemia, and in addition weight gain due to a delay in the body's fluid and ascites), and at the same time, manifestations of portal type of hypertension (spleen enlargement, thrombocytopenia, and varicose veins veins inside the esophagus). It is possible to increase the transaminase values of the liver, AP and gamma-GT, and with it the development of jaundice. Among the histopathological signs of hepatotoxicity, the development of Banty syndrome, the regenerative form of the nodal type hyperplasia, liver fibrosis, as well as its periportal form is possible. Often, liver intoxication (as a result of a short therapeutic course) is expressed in the form of veno-inclusive pathologies. Signs of hepatotoxicity pass after the abolition of therapy. There are also separate data on the development of the centrolobular form of liver necrosis (appeared in people who underwent a course of combined chemotherapy, took oral contraceptives, drank alcohol or consumed Lanvis in large doses);
• other recorded adverse drug reactions: electrolyte balance disorder, photosensitivity, deafness with tinnitus, and also rashes, oculogic crisis, ataxia and cardiovascular disorders.

[5]

Overdose

In case of an overdose, the main poisoning effect is directed to the work of the bone marrow. The appearance of hematologic toxicity will be stronger if the overdose is chronic.

Since there is no antidote to eliminate such a violation, careful monitoring of blood counts is required. Also, if necessary, you should perform blood transfusion and, at the same time, conduct general treatment aimed at supporting the patient's condition.

Interactions with other drugs

It is prohibited to vaccinate with live vaccines of immunocompromised individuals.

In combination with the allopurinol substance, which is used to inhibit the processes of formation of uric acid, Lance's dosage reduction is not required (in contrast to cases of combination with substances such as azathioprine or mercaptopurine).

When tested in vitro, it was found that the derivatives of aminosalicylate (such as mesalazine with olsalazine or sulfasalazine) inhibit the activity of the TPMT enzyme, which is why it is necessary to be careful when concurrently administering such drugs with Lanvis.

[8], [9]

Storage conditions

The drug should be kept out of reach for young children, under standard conditions. Temperatures are a maximum of 25 ° C.

[10]

Shelf life

Lanvis can be used for 5 years after the release of the medicine.