Uses of Adrim 50mg

What is Adrim? This drug belongs to the group of anti-cancer and immunosuppressive drugs, which treat acute leukemia and certain types of cancer. The drug has the main ingredient doxorubicin hydrochloride and other excipients such as edetate disodium, sodium chloride, hydrochloric acid, sodium hydroxide and water for injection. So what is the use of Adrim 50mg?

Adrim is intended for use by adults and children over 18 years of age. Adrim is used for the remission of many neoplastic conditions such as acute lymphoblastic and myelogenous leukemia, Wilm's tumor, neuroblastoma, bone and soft tissue sarcoma, advanced multiple myeloma, and cancer. Advanced or recurrent endometrial cancer, metastatic gastric cancer ...
Besides, the drug is also indicated as a combination drug in the treatment regimen for women with evidence of lymph node involvement. in the armpit after mastectomy for breast cancer.
On the other hand, Adrim 50mg is not allowed to be prescribed if the patient has the following conditions:
Pre-treatment neutrophil count < 1500 cells/mm2 Severe liver failure Just experienced a heart attack Myocardial failure Severe Cardiac arrhythmia Previous treatment with cumulative doses of doxorubicin, daunorubicin, idarubicin, and/or other anthracyclines and anthracene. Hypersensitivity to doxorubicin, any of the excipients, or other anthracyclines and anthraceneions.

2.1. How to use Adrim 50mg should be given slowly by intravenous infusion, infusion of 0.9% NaCl solution or 5% Dextrose is available. She should be infused with a butterfly needle inserted into a large vein. Try to avoid veins just above the joint, with damaged veins or lymphatic drainage. The dose and the size of the vein will determine the rate of injection. However, the entire dose should not be injected in less than 3-5 minutes. If the spot along the vein identifies erythema or the patient has flushing, it is a warning sign of taking the drug too quickly. If a burning or stinging sensation occurs which may indicate perivenous infusion, the infusion should be discontinued and started in another vein. Warning: Doxorubicin should not be mixed with heparin or fluorouracil because these drugs are incompatible and a precipitate may form. Avoid contact with alkaline solutions as this may lead to hydrolysis of doxorubicin. 2.2. Dosage For Intravenous Administration: The dose of doxorubicin depends on the treatment regimen, the patient's general condition, and previous treatment.
Monotherapy, dose is calculated on the basis of body surface area (mg/m2). The recommended dose for monotherapy is 60-75 mg/m2 body surface area every 3 weeks.
For combination regimens
When doxorubicin is used in combination with other antineoplastic agents with overlapping toxicity, such as intravenous high doses of cyclophosphamide or anthracycline compounds (eg: daunorubicin, idarubicin and/or epirubicin). ), the dose of doxorubicin should be reduced to 30-60 mg/m2 every 3 to 4 weeks. For patients who cannot receive adequate therapy (e.g. immunocompromised, elderly), the alternate dose is 15-20 mg/m2 body surface area per week.
Bladder route:
Doxorubicin may be administered by drip into the bladder for the treatment of superficial bladder cancer or for the prevention of cancer recurrence after transurethral resection in patients at high risk of recurrence. The recommended dose for the treatment of superficial bladder cancer is a 30-50 mg intravenous drip in 25-50 mL of 0.9% NaCl solution. The optimal concentration is about 1 mg/ml. Normally, this solution should be kept in the bladder for 1 to 2 hours. During this period, the patient should be rotated 900 every 15 minutes. Patients should not drink any liquids for 12 hours prior to treatment to avoid unwanted dilution of the drug with urine. This can reduce urine output by about 50 ml/hour. The drip infusion can be repeated at intervals of 1 week to 1 month depending on whether the goal of treatment is prophylactic or curative.
Dosage adjustment in special subjects:
Patients with impaired liver function: because doxorubicin is eliminated mainly through the liver and bile, the elimination of the drug may be reduced in patients with impaired liver function. or obstruction of bile secretion and this can cause serious secondary effects. Dosage adjustment recommendations in patients with impaired liver function are based on serum bilirubin levels:
Bilirubin concentration 20 – 50 μmol/L with a recommended dose of 1⁄2 of the normal dose Bilirubin concentration > 50 μmol/L. L has a recommended dose of 1⁄4 of the normal dose Doxorubicin is contraindicated in patients with severe hepatic impairment. Patients with impaired renal function: In patients with renal impairment (GFR < 10 ml/min), only 75% of the normal dose should be used.
Patients with heart failure: Discontinue doxorubicin in patients with signs or symptoms of cardiomyopathy.
Dosage in children: Dosage in children should be reduced because children are at higher risk for cardiotoxicity, especially late toxicity. Bone marrow disease should be anticipated for a minimum of 10 to 14 days after initiation of therapy. The maximum cumulative dose in children is 400 mg/m2.
Obese patients: Reducing the starting dose or prolonging the dosing cycle should be considered in obese patients.

During treatment with Adrim 50mg, patients may experience some unwanted effects on parts such as skin, digestive system, hematology, nerves, eyes,...
On the skin : nail base hyperpigmentation and increased skin wrinkling, onycholysis, rash, itching, or photosensitivity may occur. Gastrointestinal system: Acute nausea and vomiting, ulceration and necrosis of the colon, especially the cecum, anorexia, abdominal pain, dehydration, diarrhea and oral mucosal hyperpigmentation. Hematology: fever, chills and urticaria... Neurological: Peripheral neurotoxicity in the form of focal sensory and/or motor disturbances, convulsions, coma. Eyes: Conjunctivitis, keratitis and lacrimation Other adverse effects: Irritability, asthenia

Component Doxorubicin is an emetic, so patients should be cautious when using prophylactic antiemetics Doxorubicin should not be used in combination with other cardiotoxic drugs, unless the patient's cardiac function is monitored. rigid. Patients treated with doxorubicin following discontinuation of other cardiotoxic drugs, particularly those with long half-lives such as trastuzumab, may also be at increased risk of cardiotoxicity. Doctors should avoid these regimens. doxorubicin-containing regimen until 24 weeks after stopping trastuzumab. if possible. If doxorubicin is used before this time, careful monitoring of cardiac function is recommended. Women of childbearing age should be warned of the potential hazard to the fetus when using doxorubicin Women of childbearing age should be advised to avoid pregnancy during treatment Lactating women should It is advised to discontinue breastfeeding while being treated with doxorubicin. Patients taking doxorubicin are advised not to drive or operate machinery as nausea and vomiting are common.

Progesterone: Progesterone is given intravenously to patients with advanced malignancies (ECOG PS<2) at high doses (up to 10g over 24 hours) concomitantly with a fixed dose of doxorubicin (60mg/m2) by Injecting large amounts results in neutropenia and thrombocytopenia caused by increased doxorubicin. Cyclosporine: Co-administration of cyclosporine with doxorubicin may result in increased AUC for both doxorubicin and doxorubicinol. Dexrazoxan: In a clinical study of women with metastatic breast cancer, concurrent use of the cardioprotective drug, dexrazoxan, starting with a regimen consisting of fluorouracil, doxorubicin, and cyclophosphamide (FAC), response rates of the lower tumour. Later initiation of dexrazoxan (after an infusion of a cumulative dose of doxorubicin 300 mg/m2 as part of the FAC) was not associated with a reduction in the chemotherapy effect. Dexrazoxan is indicated for use only in women with metastatic breast cancer who have received a cumulative 300 mg/m2 dose of doxorubicin and are continuing daily for 7 days or longer. Cytarabine: Necrotic colitis presenting with inflammatory bowel disease (cecalitis), bloody stools, and serious fatal infections have been reported with the combination of daily intravenous doxorubicin for 3 days and cytarabine. continuous daily infusion for 7 days or longer. Sorafenib: In clinical studies, both an increase (21% and 47%) and no change in doxorubicin AUC values ​​were observed during concomitant treatment with sorafenib 400mg twice daily. The clinical significance of these findings is unknown. Cyclophosphamide: The addition of cyclophosphamide to a doxorubicin regimen has no effect on doxorubicin concentrations in the body, but may lead to an increase in doxorubicinol, a metabolite. Doxorubicinol has only 5% of the cytotoxic activity of doxorubicin. Concomitant cyclophosphamide treatment with doxorubicin aggravated hemorrhagic cystitis.