Medication Description: Chlorbutin (Chlorbutinum)
HLORBUTIN (Chlorbutinum). 3- [para-bis-b-Chlorethyl) -aminophenyl] butyric acid.
Synonyms: Lakeran, Chlorambucil, Amboclorin, Chlorambucil, Chloraminophene, Ecloril, Leukeran, Leukoran, Linfolysin.
White or white with a faint pinkish or creamy tinge crystalline powder. Practically insoluble in water, easily soluble in alcohol.
Like other preparations of the bis- (b-chloroethyl) -amine group, chlorbutin is an alkylating cytostatic agent; It has a depressant effect on hematopoietic tissue and hyperplastic (tumor) tissue. The drug affects more selectively on lymphoid tissue than on granulocyte elements.
Chlorbutin is prescribed orally for chronic lymphocytic leukemia (mainly in leukemic forms), lympho- and reticulosarcoma, lymphogranulomatosis, and also for 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 from 3 to 6 weeks. The total dose per treatment 200 - 400 mg.
When reducing the number of leukocytes 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 Hodgkin's disease without leuko- and thrombocytopenia, start 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 in the course of 400 - 500 mg.
Chlorbutin is also used as an immunosuppressant. Dose 5 - 10 mg per day.
In the same way as in the treatment of other bis (b-chloroethyl) -amines, during the treatment with chlorbutine it is necessary to systematically (at least 2-3 times a week) perform a blood test (total) and differential leukocyte count, platelet count, red blood cells, hemoglobin .
During treatment with chlorbutine, leukopenia, anemia and thrombocytopenia may occur; in case of overdose, significant leukopenia develops, progressing up to pancytopenia. The decrease in the number of leukocytes may continue for 10 to 12 days after discontinuation of the drug.
With the development of severe leukopenia, they stop taking the drug, and if necessary, blood is transfused or leukocyte and platelet mass is injected; prescribe blood stimulants, vitamins. Blood transfusions (100-125 ml 1 time per week) are recommended during the course of treatment.
Persons previously treated with other cytotoxic drugs or undergoing radiation therapy should be given chlorbutin no earlier than 1.5-2 months after the end of the previous treatment, provided that there is no pronounced leukopenia, thrombocytopenia, and anemia. The drug is prescribed, starting with small doses.
The drug is contraindicated in severe diseases of the liver and kidneys, acute diseases of the gastrointestinal tract, immediately after the use of other cytotoxic drugs and radiation therapy, with severe leukopenia, thrombocytopenia and anemia associated with the development of a malignant process.