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Nolvadex - the preparation is intended for treatment of the people suffering on a cancer tumor of a chest and mammary gland, on a cancer of a kidney, sarcoma and a melanoma of soft fabrics.
Nolvadex let out in the form of tablets containing Tamoxifen citrate (It is shaven. Farm. ) in the quantity equal to 10 mg Tamoxifen
Tamoxifen is a nesteroidy anti-estrogen. At people of preparation works mainly as the anti-estrogen inhibiting influences of an endogenous estrogen probably by means of linkng with estrogenovy receptors.
Clinical data testify to some favorable influence of a preparation on RE-negativnye tumors, and it testifies to influence of other mechanisms of action.
Recognized is that fact that Tamoxifen has estrogen-like effect on a number of systems of an organism, including endometry, bones and blood lipids.
After peroralny reception of preparation it is quickly absorbed, and the maximum concentration in serum are reached within 4-7 hours.
Steady concentration (about 300 ¡ú/ml) are reached after four-week treatment with a daily dose of reception of 40 mg. This medicine well contacts serumal albumine (> 99%). As a result of a metabolism, in the course of a hydroxylation, demethylation and conjugation, there is a formation of a number of the metabolites having indicators of a pharmacological profile, similar to an initial chemical compound that, thus, promotes achievement of therapeutic effect. Allocation happens mainly through kcal. The semi-removal period for the medicine was defined at a rate of about seven days, while for H-desmetilTamoxifena, the main circulating metabolite, at a rate of 14 days.
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NECESSARY QUANTITY OF THE PREPARATION
For adults (including people of advanced age); The Daily dose makes from 20 to 40 mg and is accepted by the divided doses twice a day.
PROTIVOPOKAZNIYA, CHARACTERISTIC FOR THIS MEDICINE
Tamoxifen it isn't necessary to apply during pregnancy. There is a small amount of messages concerning cases of congenital defects, spontaneous abortions and pre-natal death after reception by women of a preparation of Nolvadex though to relationship of cause and effect it wasn't established.
Experiences in the field of the reproductive toxicology, conducted with participation of rats, rabbits and monkeys, showed lack of potential teratogenny action.
In cases of sexual activity during application of a preparation of preparation women should recommend to prevent pregnancy and to use barrier or other not hormonal contraceptive means. Before beginning treatment of patients in the preclimacteric period, they should be surveyed carefully to exclude pregnancy existence. At women it is necessary to estimate potential risk for a fruit in those cases if approach of pregnancy takes place during application of a preparation of Nolvadex or within two months after the therapy termination.
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At many of the women accepting Nolvadex for a cancer therapy of a mammary gland in the predklemakterichesky period, lack of periods is observed.
Application of a preparation of tablets in a combination with anticoagulants of kumarinovy type can cause considerable strengthening of anti-coagulating action. When simultaneous application of these preparations takes place, it is recommended to exercise careful control of the patient.
At Nolvadex application in combination with cytotoxic means there is an increased risk of emergence the tromboembolicheskikh of the phenomena.
At treatment by this preparation the increase in cases the endometrialnykh of changes, including a giperplaziya, polyps and a cancer was noted. Frequency and picture of this growth say that the mechanism which was cornerstone of it is connected with Nolvadex's estrogenny properties. Patients all accepting or accepting before Nolvadex at whom abnormal vaginal bleeding takes place, should be subjected to timely inspection.
Lactation: Data on Nolvadex allocation in breast milk at women are absent therefore its application during a lactation isn't recommended. The decision on the termination or feedings, or applications of a preparation of preparation, has to proceed from importance of its application for mother.
At long treatment by-effects aren't so numerous or aren't so serious in cases of application of a preparation of Nolvadex, as in case of application of androgens and an estrogen which also use for a cancer therapy of a mammary gland. Noted by-effects can be classified as resulting or anti-astrogene action of a preparation, for example, inflow, vaginal bleeding, vaginal allocations and an itch in external genitals, or as by-effects more the general character, such as gastrointestinal intolerance, retsidirovany tumors, dizziness, skin rash, and in some cases, a delay of liquid and an alopetion.
Possibly to control onto emergence of side effects by means of simple reduction of a dose, thus keeping control of a course of disease. At a small number of patients with metastasises in bones when carrying out therapy giperkaltsiyemiya emergence was observed.
From time to time were observed cystous swelling of ovaries at the women applying Tamoxifens in the preclimacteric period.
After application of a preparation of Tamoxifen leykopeniya cases, sometimes in connection with anemia and/or thrombocytopenia were observed. Neytropeniya was marked out in rare instances; sometimes it can have very serious character.
During therapy by a preparation of Tamoxifen there were exceptional cases the tromboembolicheskikh of the phenomena. Though it is known that these phenomena meet at patients a malignant course of disease more often, to relationship of cause and effect with preparation wasn't established.
Nolvadex application connect with change of levels of enzymes of a liver, and in rare instances, with more serious violations, including a fatty infiltration of a liver, холестаз and hepatitis.
Theoretically, at overdose it is necessary to expect strengthening the antiestrogennykh of by-effects about which it was mentioned above. Supervision at animals testify that excessive overdose (is 100-200 times higher than a recommended daily dose) can cause estrogenny actions.;