Zarcio

Zarcio has a wide range of applications. It is often used to reduce the duration of neutropenia and the frequency of febrile neutropenia in patients who received cytotoxic chemotherapy. 

Indications Zarcio

Indications for Zarcio use are mainly the use of the drug during the use of chemotherapy for malignant neoplasm. The exception in this case is myeloid leukemia and myelodysplastic syndromes.

A remedy is also used with a reduction in the duration of neutropenia in patients who received myeloablative therapy with further bone marrow transplantation. The drug is also used in the mobilization of peripheral stem cells also in myelosuppressive therapy.

It is widely used for hereditary periodic or idiopathic neutropenia in children and adults. And if the absolute number of neutrophils is 0.5 × 10 ⁹ / l or less.

Long-term treatment of medications is also indicated with an increase in the number of neutrophils to reduce the frequency and duration of undesirable effects. In particular, if all this is associated with infectious complications.

Apply the drug and as a preventive measure of bacterial infections and treatment of persistent neutropenia. Especially in those patients who have a developed stage of HIV infection, if others are capable of treatment do not give the desired effect. Zarcio has a wide range of applications. 

[1], [2]

Release form

Form release of the drug - a solution for intravenous and subcutaneous injection. The product is colorless or with a slight yellowish tinge. Usually it is transparent, but can change its appearance somewhat. Minor deviations are considered the norm.

In one syringe contains 500 ml of the drug. The main active substance is filgrastim. Auxiliary components are glutamic acid, sorbitol, polysorbate, water and sodium hydroxide.

The drug is sold in blisters, which are placed in card packs. In one syringe contains 0.5 ml of active substance. Glass "vessel" is colorless, which allows you to verify the amount of content and see its external data.

The product is produced exclusively in the form of a solution. There is no other "packaging". This medicine has a wide range of uses. Therefore, it is more effective to use it in the form of a solution that is administered intravenously or subcutaneously. Zarcio is a good remedy in the fight against the adverse effects of chemotherapy. 

[3], [4]

Pharmacodynamics

Pharmacodynamics preparation - the active substance is filgrastim. It belongs to the number of highly purified non-glycosylated proteins, which consist of 175 amino acids. A component is produced with K12 strain Escherichia coli.

In the genome, through his genetic engineering, a granulocyte colony-stimulating factor (G-CSF) gene of a human being is introduced. It is able to regulate production and release neutrophils from the bone marrow to the peripheral blood. The use of this active substance may be accompanied by a significant increase in the number of neutrophils in the vascular bed within 24 hours.

In some cases, an increase in the number of eosinophils and basophils is possible. True, such a phenomenon may be present before the treatment with this medication. An increase in the number of neutrophils is dose-dependent. Released neutrophils have increased or normal functional activity. This was confirmed more than once on the basis of tests conducted. After the drug therapy is stopped, the number of neutrophils is reduced by 50% in a couple of days. To normal value this indicator is returned within a week.

Patients taking filgrastim observed a decrease in the incidence and duration of neutropenia and febrile neutropenia. This allows them to use antibiotics in moderate doses. In addition, the need decreases, is in the hospital for a long time. After myeloablative therapy, the frequency of temperature increase did not decrease.

The use of the drug in monotherapy can mobilize the release of hematopoietic stem cells into the peripheral bloodstream. The use of PSKK, which was mobilized with the help of Zarcio, can accelerate the recovery of hematopoiesis. In addition, there is a decrease in the severity and duration of thrombocytopenia. It is possible to reduce the risk of hemorrhagic complications and the need for transfusion of the tumor mass after myeloablative or myelosuppressive therapy.

The use of drugs in children and adults with severe congenital neutropenia can stimulate a steady increase in the number of active neutrophils in peripheral blood. There is also a decrease in the frequency of infectious and other complications. The use of Zarcio's medication allows the number of neutrophils to be maintained within acceptable limits. 

[5], [6], [7], [8]

Pharmacokinetics

Pharmacokinetics of the drug - the distribution is carried out in the systemic circulation. Increased concentration of active substance in the blood plasma for intravenous and subcutaneous administration is achieved within 8-16 hours.

There was also a direct linear relationship, which is observed between the administered dose of filgrastim and its concentration in the blood plasma. To speak about exact figures in this case is meaningless. Much depends on the previously prescribed dosage.

As for the derivation process, it does not have a particular linear dependence. The speed of this phenomenon depends on the dosage of the medicine. Basically, the drug is excreted with the participation of neutrophils. The rate of excretion upon repeated admission of the drug increases until the number of neutrophils increases.

Long-term use of Zarcio, which was 28 days, was not accompanied by cumulation. Even in those patients who underwent bone marrow transplantation. In addition, it had admissible values of T _1/2. 

[9], [10], [11], [12], [13], [14]

Dosing and administration

The dosage and dosage of Zarzio depends on the condition of the person. Therapy with medication is performed when interacting with the doctors of the cancer center. Use this drug can only those people who have experience with it. Therefore, you can not take the medication yourself.

With cytotoxic chemotherapy, the daily dose of the drug should not exceed 0.5 million units / kg of body weight. The first time the drug is administered no earlier than 24 hours after the chemotherapy. It is used until then (daily), until the number of neutrophils returns to normal. The duration of treatment does not exceed 14 days. In extremely difficult cases, it rises to 38 days. An increase in neutrophils is usually observed as early as the second day after the start of drug use. Patients who receive myeloablative therapy start taking the drug with 1 million units / kg of body weight. The first dose is administered 24 hours after chemotherapy and not later than the preset time after bone marrow transplantation. The dose adjustment is carried out on an individual basis. The drug is administered for 30 minutes.

When mobilizing peripheral blood stem cells, one million units / kg of body weight should be used. The drug is used for 5-7 days. In some cases, one additional session of leukapheresis is required. The recommended dose of the drug is 0.5 million units / kg. Starting from the first day of taking the medicine and ending with the last, until the level of neutrophils reaches the permissible value. Can be administered as a prolonged infusion over a period of 24 hours.

In severe chronic neutropenia which is congenital, it is worth taking 1.2 million units / kg. This is done once or in divided doses. For idiopathic or intermittent neutropenia, 0.5 million U / kg should be used. After 1-2 weeks, the dose may be increased.

HIV infection. The recommended initial dose is 0.1 million units / kg. In consequence, it can increase to 0.4 million units / kg. In rare cases, it reaches a figure of 1 million units / kg. As a supporting effect, you need to take 0.3 mg / day 2-3 times a week. Over time, the dose adjustment of Zarcio is possible. 

[17]

Use Zarcio during pregnancy

The use of Zarsio during pregnancy is limited. Special data regarding the use of this drug was not received. But, despite this, there are indications that indicate the possible passage of filgrastim through the placental barrier.

Studies were carried out on animals, during which the use of filgrastim did not lead to teratogenic effects. A large number of miscarriages were registered, but no abnormalities of fetal development were observed.

If it is necessary to use drugs for girls in the situation, it is necessary to really evaluate the benefit-risk criterion. After all, not always the expected therapeutic effect for the mother, can positively affect the development of the baby.

There is no data on the penetration of the drug into breast milk. Therefore, if there is a need to use the drug during breastfeeding, then the last activity should be stopped. In any case, you can find an alternative way to solve this problem. In many cases it is recommended to stop using Zarcio. 

Contraindications

Contraindications to the use of Zarcio are available, even more than they are quite a lot. The first step is to exclude the use of drugs for people suffering from hereditary intolerance to fructose. Because the composition of the drug contains sorbitol.

If a person has severe hereditary neutropenia, accompanied by cytogenetic disorders, do not use the medicine. The agent should not be used to increase the doses of cytotoxic chemotherapeutic drugs that exceed the norm.

With the simultaneous use of radiation or chemotherapy along with cytotoxic. The stage of chronic kidney failure is also prohibited. Newborns should not use the medicine in any way. Naturally, the risk consists of people with increased sensitivity to the drug or its main components.

With caution, the drug is used for myelodysplastic syndrome, chronic myelogenous leukemia and secondary acute myeloblastic leukemia. There is a special risk in people with a significantly reduced number of myeloid progenitor cells. In any case, you can use Zarcio only after consulting a doctor. 

Side effects Zarcio

Side effects of Zarcio are associated with a high content of the active ingredient. From the side of the immune system, anaphylactic reactions, urticaria, skin rash, angioedema, lowering of pressure and dyspnea may be manifested.

Organs of hematopoiesis are also able to react negatively to taking the medication. So, it manifests itself in the form of anemia and transient thrombocytopenia. Quite often you can see thrombocytopenia and splenomegaly. In extremely rare cases, there is a rupture of the spleen

From the side of the nervous system, there may be headaches. The cardiovascular system can also react negatively. In this case, there is a decrease in blood pressure, vascular disorders and in extremely rare cases, veno-occlusive disease.

Respiratory organs: epistaxis, rarely pulmonary edema, infiltrates in the lungs and hemoptysis. Possible shortness of breath, the appearance of pulmonary hemorrhage and hypoxemia.

From the skin and its appendages, it is often a vasculitis and a rash. In rare cases, febrile dermatosis. The musculoskeletal system: often manifests itself as a pain syndrome in the joints and muscles. There are also serious consequences, such as osteoporosis and exacerbation of rheumatoid arthritis.

The digestive system manifests itself often in the form of diarrhea and hepatomegaly. On the part of laboratory indicators, a reversible increase in the activity of AP and LDH is not ruled out. In some cases, Zarcio causes severe fatigue and direct reactions at the injection site. 

[15], [16]

Overdose

Overdose of Zarcio was not observed with medication. The fact is that it is used only under the guidance of a doctor. Therefore, a person can not influence the introduction of this medication in any way. On the basis of what, cases of an overdose and was not.

Naturally, to exclude this point is not necessary. After all, situations are different. So, an incorrectly calculated dose can lead to a high concentration of medication in the human blood plasma. This can negatively affect the patient's well-being.

This indicates that you can not take the drug yourself. The dose directly depends on the condition of a person and his disease. The medication has a wide range of effects and is used in many cases. Therefore, the dose adjustment is individual.

If you follow the basic rules for taking the drug and do not exceed the allowable dose, then there can be no overdose. Zarcio is a powerful drug that should be used with caution, because it is much easier to harm than to eliminate its consequences. 

[18], [19]

Interactions with other drugs

Interactions with other drugs are possible, but it should be done under the guidance of a doctor. So, the safety and efficacy of medication administration on the same day as chemotherapy was administered are not established.

The rapidly dividing myeloid cells are very sensitive to myelosuppressive cytotoxic chemotherapy, therefore it is not recommended to prescribe Zarcio within 24 hours for or after use. The severity of neutropenia may increase with the simultaneous administration of the drug together with fluorouracil.

It is possible that the drug interacts with other hematopoietic growth factors and cytokines. It is necessary to take into account the fact that lithium stimulates the release of neutrophils. All this can strengthen the action of Zarcio's medication. This effect is possible with the complex administration of the drug. There have been no studies concerning this.

There is a high risk of drug incompatibility along with 0.9% sodium chloride solution. Therefore, Zarcio is not recommended in this case. 

[20], [21]

Storage conditions

The storage conditions of Zarsio play a big role. But, due to the fact that the medication is used exclusively in medical institutions, it is not worth worrying about it at home.

But, despite this, it is worth following certain rules. The temperature of storage means should not exceed 25 degrees is a generally accepted norm. Keep Zarcio in the refrigerator and even more so you can not freeze it.

You need to monitor the humidity, it plays a significant role in the whole process of storage. It is desirable to allocate for the medicament a dry place, where direct sun rays will not penetrate.

In a medical institution, children will not be able to penetrate the drug, but at home it's fine. Therefore, you need to protect access to the medicine. After all, the use of his children is unacceptable in most cases and requires a certain dosage.

You need to pay attention to the appearance of the drug. The solution should not change its color and smell. If this happened, then most likely not observed certain conditions of storage of Zarcio. 

Shelf life

The expiry date is important, but only if the storage conditions are correctly observed. It is important to create a certain temperature regime. It is desirable that it does not exceed the permissible 25 degrees. Deviation from the norm is possible, but not significant.

Humidity plays a big role, because it can negatively affect the basic qualities of the medicine. After opening the "vial" you need to use the remedy immediately. Do not store the solution in the open. Put it in the refrigerator or let it freeze even more. This is not a drug that should be stored in such conditions. It is desirable to protect it from direct sunlight, which is an important criterion.

Pay attention to the appearance of the product. Color and odor should not be different from normal. Otherwise, you can not take the medicine. An important role is played by the storage conditions, since the expiration date, which is 2-3 years, depends on them. After the specified time, Zarcio is not recommended. 

[22], [23]