Description of the medicine: Chlorbutin (Chlorbutinum)
CHLORBUTIN (Chlorbutinum). 3- [para-bis-b-chloroethyl) -aminophenyl] butyric acid.
Synonyms: Leukeran, Chlorambucil, Amboclorin, Chlorambucil, Chloraminophene, Ecloril, Leukeran, Leukoran, Linfolysin.
Crystalline powder, white or white with a slight pinkish or creamy tint. Practically insoluble in water, easily soluble in alcohol.
Like other drugs of the bis- (b-chloroethyl) -amine group, chlorobutin is an alkylating cytostatic substance; It has a depressing effect on the blood-forming tissue and hyperplastic (tumor) tissues. The drug affects more selectively on lymphoid tissue than on granulocytic elements.
Chlorobutin is prescribed orally for chronic lymphocytic leukemia (mainly in leukemic forms), lympho-and reticulosarcoma, lymphogranulomatosis, as well as ovarian cancer.
Apply inside daily in the form of tablets. The daily dose for chronic lymphocytic leukemia is from 2 to 10 mg (depending on the degree of leukocytosis). The course of treatment is from 3 to 6 weeks. The total dose per treatment course is 200 to 400 mg.
With a decrease in the number of white blood cells in the blood to 25 - 20 x 10 9 / l, the patient is transferred to maintenance therapy, prescribing 2 - 6 mg per week for a year or more.
In patients with lymphogranulomatosis without leuko- and thrombocytopenia, they begin with a daily single dose of 20 mg; by the end of the course, reduce the dose to 10 mg. The amount of the drug per course 400 - 500 mg.
Chlorobutin is also used as an immunosuppressant. Dose 5 - 10 mg per day.
As with other bis (b-chloroethyl) amines, during treatment with chlorobutin, it is necessary to systematically (at least 2 to 3 times a week) perform a blood test (total) and differential count of leukocytes, determine the number of platelets, red blood cells, hemoglobin .
During treatment with chlorobutin, leukopenia, anemia, and thrombocytopenia may occur; with an overdose, significant leukopenia develops, progressing up to pancytopenia. The decrease in the number of leukocytes can continue for 10 to 12 days after discontinuation of the drug.
With the development of severe leukopenia, the drug is stopped, and if necessary, blood is transfused or a leukocyte and platelet mass is injected; hematopoietic stimulants, vitamins are prescribed. Blood transfusion (100 - 125 ml once a week) is recommended during the course of treatment.
Persons previously treated with other cytotoxic drugs or undergoing radiation therapy, chlorbutin is prescribed no earlier than 1, 5 -2 months after the end of the previous treatment, provided there is no severe leukopenia, thrombocytopenia and anemia. The drug is prescribed starting with small doses.
The drug is contraindicated in severe liver and kidney diseases, acute diseases of the gastrointestinal tract, immediately after the use of other cytostatic drugs and radiation therapy, with severe leukopenia, thrombocytopenia and anemia associated with the development of the malignant process.