Phytoside

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

In medical practice, the drug is usually used as an antitumor substance. The therapeutic effectiveness of the 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 bronchial carcinoma;
• lymphoma and malignant Hodgkin's disease;
• active phase of recurrent non-lymphocytic leukemia;
• ovarian and testicular carcinoma and chorionic carcinoma;
• non-small cell pulmonary neoplasms, sarcoma and other solid neoplasms;
• gastric carcinoma, trophoblastic neoplasms and neuroblastoma.

Release form

The drug is released 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 processes of thymidine inclusion into the structure of DNA cells. Large doses of the drug lead to the development of lysis of cells in the mitotic phase. [ 2 ]

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

Pharmacokinetics

There is significant interindividual variability in pharmacokinetic parameters. Etoposide is distributed within the body at a high rate. Protein synthesis is approximately 94%.

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

The distribution half-life in the first stage is approximately 1.5 hours, and the half-life in the terminal stage is within 4-11 hours. Etoposide passes into the CSF with some difficulty.

About 45% of the dose is excreted in the urine; 2/3 of this amount is excreted unchanged over a 72-hour period.

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

Dosing and administration

The dosage is selected by an experienced oncologist, taking into account the severity and type of pathology, the patient's response to the drug and the chosen 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 prohibited to mix etoposide and other drugs in 1 bottle.

It is necessary to use Fitozid in a dose of 50-100 mg/m2, daily, for a period of 20 days. Therapeutic cycles are repeated after at least 3 weeks. In this case, a repeated course can be carried out only after stabilization of blood values.

• Application for children

There is insufficient information regarding the therapeutic effect and safety of the drug when used in pediatrics.

Taking into account the above information, it is necessary to carefully evaluate the need for the introduction of Fitozid, taking into account the benefit-risk ratio.

Use Phytoside during pregnancy

Phytoside is prohibited for use during pregnancy.

If there is a need to use drugs during breastfeeding, breastfeeding should be discontinued for the duration of therapy.

Contraindications

Main contraindications:

• the presence of strong personal intolerance to the main or auxiliary elements of the medication;
• myelosuppression;
• severe renal/liver failure;
• active phases of severe infections.
• If vaccination is required, it may be performed at least 3 months after completion of the last course of treatment using etoposide.

For people with moderate liver/kidney failure, the medication is prescribed with extreme caution.

Side effects Phytoside

Side effects include:

• thrombocytopenia or leukopenia (restoration of indicators is noted after 3 weeks);
• gastrointestinal poisoning – vomiting, diarrhea, anorexia, nausea and stomatitis;
• signs of allergy – tachycardia, dyspnea, fever, bronchial spasm;
• polyneuropathy and alopecia;
• fatigue, rashes, drowsiness, liver dysfunction and epidermal radiosensitivity.

Overdose

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

If such symptoms occur, immediate detoxification and symptomatic procedures are required.

Interactions with other drugs

The drug can potentiate the myelosuppressive and cytotoxic effects of other drugs (including cyclosporine). When used in combination with large doses of cyclosporine, exposure increases and clearance rates of etoposide decrease.

Use in combination with radiation therapy or chemotherapy (using substances with myelosuppressive activity) may potentiate the suppression of bone marrow activity caused by etoposide.

The drug may potentiate the effect of orally administered anticoagulants.

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

Testing revealed that the drug has cross-resistance with anthracyclines.

Vaccination with live vaccines in individuals with reduced immunity after chemotherapy can cause 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

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

Shelf life

Phytoside can be used within a 24-month period from the date of sale of the medicinal product.

Analogues

Analogues of the drug are the substances Lastet, Etoposide with Vepesid, Etopoz and Etoside.