Kagocel, tablets 12 mg 20 pcs

The main mechanism of action of Kagocel® is the ability to induce production of interferons. Kagocel® induces formation in human body of so-called late interferons, which are mixture of α- and β-interferons with high antiviral activity.

Kagocel® causes production of interferons in all cell populations participating in antiviral response of the body: T- and B- lymphocytes, macrophages, granulocytes, fibroblasts, endothelial cells. After a single dose of Kagocel® administration interferon titer in blood serum reaches its maximum value in 48 hours.

Interferon response to Kagocel® administration is characterized by prolonged (up to 4-5 days) circulation of interferons in blood stream. The dynamics of interferon accumulation in the intestine when taking Kagocel® does not coincide with the dynamics of circulating interferon titers. In serum interferon production reaches high values only in 48 hours after Kagocel® administration, while in intestine maximum interferon production is observed in 4 hours.

Kagocel® is not toxic and does not accumulate in the body when administered in therapeutic doses. The drug has no mutagenic and teratogenic properties, is not carcinogenic and has no embryotoxic effect.

The highest effectiveness of Cagocel® treatment is achieved during the fourth day after the onset of acute infection. For preventive purposes the drug may be used at any time including immediately after contact with the infectious agent.

Pharmacokinetics

24 hours after administration Kagocel® accumulates mainly in liver, to a lesser degree in lungs, thymus, spleen, kidneys, lymph nodes. Low concentration is noted in adipose tissue, heart, muscles, testes, brain, blood plasma.

Low content of Kagocel® in brain is due to the high molecular weight of the drug that prevents its penetration through the blood-brain barrier. In blood plasma the drug is mainly in bound form.

With daily repeated administration of Kagocel® distribution varies over a wide range in all organs studied. Accumulation of the drug in spleen and lymph nodes is especially pronounced. When administered orally about 20% of the administered drug dose enters the general bloodstream.

Absorbed drug circulates in blood mainly in macromolecule-bound form: with lipids – 47%, with proteins – 37%. The unbound part of the drug is about 16%.

Evacuation

The drug is eliminated from the body mainly through the intestines: 88% of injected dose is eliminated from the body through 7 days after administration, including 90% – through the intestines and 10% – by kidneys. The drug is not detected in the exhaled air.

Indications

Active ingredient

Composition

Active ingredient:

Cagocel® 12 mg.

Excipients:

Potato starch – 10mg,

Calcium stearate – 0.65mg,

Ludipress (composition: lactose monohydrate, povidone (Collidon 30), crospovidone (Collidon CL)) – To obtain a tablet with a mass of 100 mg.

How to take, the dosage

– To reduce the toxic effects of doxorubicin, especially cardiotoxicity, a weekly regimen of 10-20 mg/m2 is used;

When used in combination with other antitumor drugs, doxorubicin is administered at a dose of 30-60 mg/m2 every 3-4 weeks.

Repeated administration of the drug is possible only when all signs of toxicity (especially gastrointestinal and hematologic) have disappeared.

The total dose of DOXORUBICIN should not exceed 550 mg/m2.

Patients who have previously received radiotherapy to the mediastinal/pericardial area or who have taken other cardiotoxic drugs should be given under close monitoring of cardiac function if the total dose of doxorubicin is to exceed 450 mg/m2.

Liver function impairment:

If serum bilirubin levels are 1.2-3 mg/dL, the administered dose of the drug should be reduced by 50% of the recommended dose;

If serum bilirubin levels are greater than 3 mg/dL, then the administered dose must be reduced by 75% of the recommended dose.

Other special patient groups:

Lower doses or longer intervals between cycles are recommended in patients who have previously received intensive chemotherapy, children, elderly patients, obese patients (if body weight is more than 130% of ideal, decreased systemic clearance of doxorubicin is noted), and patients with bone marrow tumor infiltration.

Preparation of solution and administration Doxorubicin is diluted with 0.9% sodium chloride solution to a concentration of not more than 1 mg/1 ml. The drug is administered intravenously slowly (within 3-10 minutes) into the injection port of the IV system, during rapid infusion of 5% dextrose solution or 0.9% sodium chloride solution.

Before injecting, make sure that the needle or catheter is positioned exactly in the vein. Small veins and veins above joints should be avoided; caution should be exercised not to perform venipuncture and subsequent injection of doxorubicin on (edematous areas where venous and lymphatic outflow is impaired.

Injection into the bladder

Injection into the bladder is used to treat superficial bladder tumors as well as to prevent recurrence after transurethral resection. Injection into the bladder is not suitable for the treatment of invasive tumors with penetration into the muscular wall of the bladder.

The recommended dose for intravesical administration is 30-50 mg per instillation, with intervals between injections of 1 week to 1 month, depending on the goals of therapy – treatment or prevention. Recommended solution concentration is 1 mg/1 ml of water for injection or 0.9% sodium chloride solution. In case of development of local toxicity (chemical cystitis) the dose intended for repeated instillations should be dissolved in 50 to 100 ml of 0.9% sodium chloride solution.

Instillation should be performed using a catheter and the drug should remain in the bladder for 1-2 hours. After injection, patients should be turned from side to side every fifteen minutes to ensure even exposure of the drug to the bladder mucosa.

In order to avoid excessive dilution of the drug with urine, patients should be warned to refrain from taking liquids for 12 hours prior to the procedure. At the end of the instillation, the patient should empty the bladder.

Intra-arterial administration

In patients with hepatocellular cancer, doxorubicin may be administered intra-arterially into the main hepatic artery at a dose of 30-150 mg/m2 at intervals of 3 weeks to 3 months to provide intense local effects while reducing overall toxic effects. Higher doses should be used only in cases of concomitant extracorporeal excretion of the drug.

Because this method is potentially dangerous and may lead to widespread tissue necrosis, intra-arterial injection should only be given by physicians who are proficient in this technique.

Interaction

Special Instructions

Contraindications

Side effects

Overdose