Description of the medicine: Bruneomycin (Bruneomycinum)
Antibiotic substance isolated from the culture fluid Аtinomyces albus var. bruneomycini. 5-amino-6- (6-methoxy-5, 8-dihydro-7-amino-5, 8-dioxoquinolyl-2) -4 (2-hydroxy-3, 4-dimethoxyphenyl) -3-methylpicolinic acid.
Synonyms: Rufocromomycin, Streptonigrin.
Bruneomycin has a cytostatic effect and inhibits the development of proliferating tissue. It has a pronounced antitumor activity. Inhibition of DNA synthesis plays an important role in the mechanism of action of the drug.
Bruneomycin (acid) is a brown crystalline powder, insoluble in water. Bruneomycin sodium salt (for injection) - brown porous mass, easily soluble in water; pH of solutions 7, 0 - 7, 8.
Bruneomycin is used intravenously for lymphogranulomatosis, reticulosarcoma and lymphosarcoma, chronic lymphocytic leukemia, Wilms tumor.
Immediately before use, the contents of the vial (0.5 mg of bruneomycin) are dissolved in 20 ml of isotonic sodium chloride solution. The drug is administered intravenously at 200 - 400 mcg 2 to 3 times a week. For the course of treatment 2000 - 4000 mcg.
Bruneomycin is administered to children at a dose of 5-10 μg / kg 2 times a week. The course dose is 40-60 mcg / kg. After 1, 5 - 2 months, repeated courses of treatment can be carried out, and the doses are reduced by 25 - 50% compared with the first course.
Bruneomycin can be combined with other antitumor drugs (cyclophosphamide, etc.), radiation therapy, as well as corticosteroids.
When using bruneomycin, a decrease in appetite, nausea, and vomiting are possible (they often occur with a single dose above 500 mcg). Reducing the dose to 200 - 400 mcg avoids such reactions. At the end of the course, abdominal pain, diarrhea, stomatitis may appear. To prevent stomatitis and other fungal infections of the mucous membranes, nystatin or levorin is prescribed.
Bruneomycin can cause severe leuko- and thrombocytopenia, and a damaging effect on hematopoiesis can occur 1 to 3 weeks after the last dose. Therefore, the introduction of the drug is stopped even with moderate leuko- and thrombocytopenia (with a white blood cell count of less than 4 x 10 9 / l and a platelet count of less than 120 x 10 9 / l). Blood tests are performed during and after a course of treatment with bruneomycin.
The use of bruneomycin is contraindicated in case of leukopenia (white blood cell count below 4 x 10 9 / l) and thrombocytopenia (platelet count below 150 x 10 9 / l) associated with previous chemotherapy or radiation treatment, with tumor damage to the bone marrow, impaired renal function (increased level creatinine and blood urea).
Enter strictly intravenously; if it gets under the skin, tissue necrosis is possible.
Release form: in bottles containing 0.0005 g (500 μg) of Bruneomycin for injection <Bruneomycinum prо injectionibus) - brown porous mass, easily soluble in water.
Storage: List A. In a dry, dark place at a temperature of no higher than + 20 C.