ইঙ্গিত ও ব্যবহার
Sindoxplatin এর জন্য নির্দেশিত:
ডোজ নির্দেশিকা
শুধুমাত্র নির্দেশিকা তথ্য
প্রদর্শিত ডোজগুলি সরকারি উৎসের সাধারণ নির্দেশিকা। ব্যক্তিগতকৃত ডোজের জন্য সর্বদা আপনার ডাক্তার বা ফার্মাসিস্টের পরামর্শ নিন।
Adults:
Oxaliplatin is given together with 5-fluorouracil and folinic acid, with the cycle repeated every 2 weeks. In advanced disease, treatment is recommended to continue until the disease progresses or side effects become unacceptable. When used as adjuvant treatment, the recommended course lasts a total of 6 months (12 cycles). Day 1: Oxaliplatin 85 mg/m² is given as an intravenous infusion in 250 to 500 mL of 5% Dextrose Injection, USP, and folinic acid 200 mg/m² is given as an intravenous infusion in 5% Dextrose Injection, USP. Both are infused over 120 minutes at the same time, in separate bags connected through a Y-line. This is followed by 5-fluorouracil 400 mg/m² as an intravenous bolus over 2 to 4 minutes, and then 5-fluorouracil 600 mg/m² as an intravenous infusion in 500 mL of 5% Dextrose Injection, USP (recommended), given as a continuous infusion over 22 hours. Day 2: Folinic acid 200 mg/m² is given as an intravenous infusion over 120 minutes. This is followed by 5-fluorouracil 400 mg/m² as an intravenous bolus over 2 to 4 minutes, and then 5-fluorouracil 600 mg/m² as an intravenous infusion in 500 mL of 5% Dextrose Injection, USP (recommended), given as a continuous infusion over 22 hours.
পার্শ্বপ্রতিক্রিয়া
The most common side effects (reported in 40% or more of patients) are numbness or tingling in the hands and feet (peripheral sensory neuropathy), low white blood cell counts (neutropenia), low platelet counts (thrombocytopenia), anaemia, nausea, raised liver enzymes (transaminases and alkaline phosphatase), diarrhoea, vomiting, tiredness and mouth sores (stomatitis). Other side effects, including serious ones, have also been reported.
সতর্কতা ও নিষেধাজ্ঞা
Warnings & Precautions
Allergic Reactions: Grade 3/4 hypersensitivity, including anaphylactic or anaphylactoid reactions, to Oxaliplatin has been observed in 2 to 3% of colon cancer patients. These allergic reactions, which can be fatal, can occur within minutes of administration and at any cycle. They are usually managed with standard epinephrine, corticosteroid and antihistamine therapy, and require discontinuation of treatment. Rechallenge is contraindicated in these patients. Neurological Toxicity: The neurological toxicity of Oxaliplatin should be carefully monitored, especially when it is co-administered with other medicines that have specific neurological toxicity. A neurological examination should be performed before each administration and periodically thereafter. It is not known whether patients with pre-existing medical conditions associated with peripheral nerve damage have a reduced threshold for Oxaliplatin induced peripheral neuropathy. For patients who develop acute laryngopharyngeal dysaesthesia during or within 48 hours after the two hour infusion, the next Oxaliplatin infusion should be given over six hours. To prevent such dysaesthesia, patients should be advised to avoid exposure to cold and to avoid taking cold food or drinks during or within 48 hours after Oxaliplatin administration. Pulmonary Toxicity: Oxaliplatin has been associated with pulmonary fibrosis (in less than 1% of study patients), which may be fatal. If unexplained respiratory symptoms occur, such as non-productive cough, breathlessness, crackles or radiological pulmonary infiltrates, Oxaliplatin should be discontinued until further pulmonary investigation has excluded interstitial lung disease or pulmonary fibrosis. Hepatotoxicity: Reactions related to liver sinusoidal obstruction syndrome, including nodular regenerative hyperplasia, have been reported. Where abnormal liver function test results or portal hypertension cannot be explained by liver metastases, reactions related to liver sinusoidal obstruction syndrome should be investigated, and very rare cases of drug induced hepatic vascular disorders should be considered. Cardiovascular Toxicity: QT prolongation and ventricular arrhythmias, including fatal Torsade de Pointes, have been reported in postmarketing experience following Oxaliplatin administration. ECG monitoring is recommended if therapy is started in patients with congestive heart failure, bradyarrhythmias, electrolyte abnormalities, or those taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics. Hypokalaemia or hypomagnesaemia should be corrected before starting Oxaliplatin, and these electrolytes should be monitored periodically during therapy. Oxaliplatin should be avoided in patients with congenital long QT syndrome.
নিষেধাজ্ঞা
Oxaliplatin must not be given to patients with a known allergy to oxaliplatin or to other platinum-based medicines.