liquid anavar (oxandrolone)

Liquid anavar (oxandrolone) is a vinca alkaloid (Catharanthus roseus), which binds to a protein leads to disruption of tubulin microtubule cells to rupture and apparatus of the mitotic spindle. It inhibits mitosis in metaphase. liquid anavar selectively blocks DNA repair mechanisms in tumor cells, and also inhibits RNA synthesis by blocking the action of a DNA-dependent RNA synthetase. Pharmacokinetics: liquid anavar is metabolized in the liver and excreted primarily in the bile (70-80%). From 10 to 20% of the drug excreted by the kidneys. liquid anavar accumulates in the pancreas, spleen, kidney, lung and liver. To select liquid anavar in humans is characterized by a three-phase curve with a half-lives:. 4-5 minutes, 2-3 hours and 19-155 hours Approximately 90% of the drug binds to plasma proteins. The drug does not penetrate the blood-brain barrier. The pharmacokinetic parameters have considerable individual variability.

Indications.
Acute leukemia, Hodgkin’s disease, non-Hodgkin’s lymphoma, Ewing’s sarcoma, neuroblastoma, Wilm’s tumor, rhabdomyosarcoma, multiple myeloma, Kaposi’s sarcoma, uterine choriocarcinoma.

. Contraindications
– Hypersensitivity to liquid anavar or any other constituents of the preparation
– neurodystrophic diseases (in particular dimielinizirovannaya form of the syndrome, Charcot-Marie-Tooth disease).
– Simultaneous radiation therapy involving the liver.
– Pregnancy and lactation. Precautions: while reducing liver function, inhibition of bone marrow hematopoiesis, in elderly patients, in the presence of a history of neuropathy, acute infectious diseases, with prior chemotherapy or radiotherapy.

. Dosage and administration
liquid anavar administered strictly intravenously (to avoid extravasation) at intervals of 1 week.
The duration of injection should be approximately 1 minute.
Intrathecal use of the drug is prohibited!
The dosage must be determined individually, depending on the applied treatment regimens and clinical condition of the patient. For adults: generally administered 1.0-1.4 mg / m 2 body surface area, single dose should not exceed 2 mg. The maximum total dose is 10-12 mg / m 2 . Babies: administered 1.5-2.0 mg / m 2 body surface. For children weighing ≥10 kg initial dose should be 0.05 mg / kg per week.The course of treatment is usually 4-6 weeks. By reducing liver (the concentration of direct bilirubin in serum ≥3 mg / 100 ml) liquid anavar dose must be reduced by 50%. The dry content of the vial must be dissolved by means of the applied solvent (the resulting solution contains 0.1 mg of liquid anavar per milliliter). This solution can then be diluted with 0.9% sodium chloride solution and administered by intravenous injection or intravenous infusion along with 0.9% sodium chloride solution, through the infusion set within 1 minute.

Side effects.
Side effects are usually reversible, and are dose-dependent.
Children are usually more resistant to liquid anavar than adults. In elderly patients there is an increased tendency to neurotoxicity. From the central and peripheral nervous system: cramps with an increase in blood pressure, paresthesias, neuralgia, neuropathy, pain in the jaw, throat, and in the area of the parotid glands, decreased muscle strength, loss of deep tendon reflexes, disturbance . gait, ataxia, headache, dizziness, depression, hallucinations, sleep disturbances, diplopia, ptosis, nystagmus, transient blindness and optic atrophy, hearing loss Neurotoxicity is the dose-limiting factor (oxandrolone for sale). On the part of the gastrointestinal tract: constipation, pain in the abdomen oral, nausea, vomiting, stomatitis, diarrhea, paralytic ileus (particularly common in children), necrosis of the small intestine and / or perforation, anorexia. from the urinary system: polyuria, dysuria, urinary retention due to bladder atony, edema, nephropathy due hyperuricemia. From the cardiovascular system: raising or lowering of blood pressure.In patients with previously irradiated mediastinum in the application of chemotherapy with liquid anavar inclusion may cause angina and myocardial infarction. The respiratory system: acute shortness of breath and severe bronchospasm have been observed in the application of liquid anavar with mitomycin C. From endocrine system: rarely seen, due to a violation of secretion of antidiuretic syndrome hormone (ADH), wherein a large amount of urine sodium, resulting in hyponatremia. In this case no evidence of renal disease, and adrenal glands, hypotension, dehydration, azotemia, and swelling. From the hematopoietic system: liquid anavar has no significant effect on the blood. However, there may be mild leukopenia, thrombocytopenia and anemia. Local reactions: in contact with the drug under the skin may develop inflammation of the subcutaneous fat, phlebitis, necrosis of surrounding tissues. Other: alopecia, allergic reactions (rash, swelling, anaphylaxis), weight loss, myalgia, arthralgia, fever, amenorrhea, azoospermia.

Overdose

In case of accidental overdose should expect side effects liquid anavar gain.
The specific antidote is not known. Treatment should wear symptomatic and should include restriction of fluid intake, the appointment of diuretics (to prevent the syndrome of secretion of ADH), the use of phenobarbital (to prevent seizures), use of enemas and laxatives (warning ileus). It is also necessary to monitor the performance of the cardiovascular system and perform hematological control.
Implementation hemodialysis is not effective.
In addition to the above can be assigned leucovorin 100 mg intravenously every 3 hours for 24 hours and then every 6 hours for at least 48 hours.

Interaction with other medicinal products.
liquid anavar should not be used with drugs, inhibitors of CYP3A4, an enzyme of the liver (decrease liquid anavar metabolism and increase its toxicity).
The potential inducers of CYP3A4 reduce the effectiveness of liquid anavar.
liquid anavar may reduce the anticonvulsant effect of phenytoin.
While the use of neurotoxic drugs (isoniazid, itraconazole, nifedipine) and ototoxic drugs has been increasing side-effects in the nervous system and hearing system, respectively.
liquid anavar reduces the effectiveness of digoxin and ciprofloxacin.
verapamil increases toxicity of liquid anavar.
with simultaneous use of liquid anavar effect weakens protivopodagricakih drugs. While the use of uricosuric agents increase the risk of kidney disease.
In the appointment in combination with liquid anavar, mitomycin C can cause severe bronchospasm.
If necessary, use of the drug in combination with L-asparaginase liquid anavar should be administered 12-24 hours prior to application of L-asparaginase. Appointment of asparaginase before liquid anavar administration may impair its hepatic clearance.
The simultaneous use of liquid anavar mielodepressivnymi with other drugs and prednisone may enhance the inhibition of bone marrow hematopoiesis.
Do not mix with other drugs liquid anavar in the same syringe.
Dilute liquid anavar only 0.9% sodium chloride solution .

Cautions
liquid anavar treatment should be supervised by a professional with experience in cancer chemotherapy.
Intrathecal administration of liquid anavar can lead to death.
During the treatment should be carried out regular haematological monitoring. In the event of leukopenia should be particularly careful after repeated administration.
When the level of uric acid is recommended to alkalization of urine and the appointment urikosinteza inhibitors. An increase in liver samples viinkristina dose should be reduced. Periodically determine the concentration of sodium ions in serum. Recommended the introduction of appropriate solutions. For correction of hyponatremia
special control shall be subject to the patients who had a history of neuropathy.
When the neurotoxicity symptoms liquid anavar treatment should be discontinued.
In order to support regular bowel is recommended the use of laxatives or enemas.
In the event of extravasation of liquid anavar administration should be discontinued immediately. The rest of the dose should be introduced into another vein. Place extravasation can be shot up with a solution of hyaluronidase.
Precautions should be prescribed liquid anavar elderly patients, as neurotoxicity, they may be more pronounced
Any complaint of eye pain or decreased vision require a thorough ophthalmic examination.
Women and men during treatment with liquid anavar, and for at least 3 months after the need to use reliable methods of contraception.
Avoid contact with eyes liquid anavar. If this happens, immediately and abundantly and thoroughly rinse the eyes with plenty of fluids.
Some side effects of liquid anavar, particularly neurotoxicity, may adversely affect the ability to drive a car or perform potentially hazardous activities that require high concentration and speed of psychomotor reactions.

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