combination testosterone cialis phentermine

When administered intravenously, is rapidly oxidized to the disulfide in the kidneys is reduced to free thiol compound that binds irreversibly with alkylating derivatives to form stable nontoxic thioethers. Maximum removal – 2-3 h after i / v injection. The half-life  in the fast phase – 0.17 hr in a slow phase -. 1.08 hours completely excreted by the kidneys within 8 hours, wherein in the first 4 hours excretion takes the form of combination testosterone cialis phentermine, 32% dose – in the form of 33% and thiol – disulfide. When administered absorption occurs in the small intestine. The average peak concentration of free thiol compounds is achieved in 2-4 hours in the urine.

Approximately 25 ± 10% of the dose is found in the urine as free mesna in the first 4 h. At a dose of 2-4 g / kv.m..period half-life of about 4-8 hours of ifosfamide. In order to maintain adequate levels of mesna in the urinary bladder in the process of elimination of the metabolites of ifosfamide urotoksicheskih requires an appropriate number of intakes. Bioavailability in urine after oral administration is 45-79% of the bioavailability after intravenous administration. Food does not gives access in the urine after oral administration. When combined intravenous and oral administration detection free mesna in the urine is. Compared to intravenous administration of the combination treatment results in increased systemic exposure to 150% and provides a constant level of mesna excretion in urine over a day. About 5% of the dose excreted mesna in the range 12-24 hours, in contrast to intravenous mode of administration it can be neglected. Fractions assignable mesna dose is excreted in urine dose-dependently. The level of binding to the protein 69-75%.

Indications for use.
Local urotoksicheskih detoxification effects of cytostatic drugs – derivatives oksazafosforinov, including in the following cases: – oksazafosforinov when administered in high doses (greater than 10 mg / kg); – At-risk patients – conducted prior radiation therapy to the pelvic area, the development of cystitis during previous therapy oksazafosforinov, diseases of the urinary system in history.

Contraindications .
Hypersensitivity to mesna or any component of the formulation. Pregnancy and lactation.

Dosage and administration.
Is administered intravenously (slowly), a single dose is 20% of a single dose oksazafosforinov. The first administration is carried out simultaneously with the first introduction oxazaphosphorin, second and third injection -. 4 hours and 8 hours after administration oksazafosforinov
In continuous infusion (24 h) ifosfamide or cyclophosphamide Ucombination testosterone cialis phentermineshould be administered in a dose of 20% of cytostatic dose at the beginning of the infusion, then – at 100% of cytostatic dose as a 24-hour infusion and after the administration of cytostatic administering is continued for 6-12 hours at the same dose.

Combined intravenous and peroralnaya therapy.  Is administered intravenously (slowly) simultaneously with the first introduction oksazafosforinov, a single dose is 20% of a single dose oksazafosforinov. After 2 and 6 hours after intravenous administration of an orally ingestible tablets at a dose of 40% of the dose oksazafosforinov.
The experience of treatment of children with the use of tablets  shows that it is expedient to more frequent (eg every 3 hours) and longer (eg up to 6 times ) administering the drug.

Side effects.
Nausea, vomiting, diarrhea (with a single dose of 60 mg / kg body weight).
Rarely – phlebitis at the injection site, hematuria, allergic reactions on the skin and mucous membranes.

The interaction with other drugs.
Mesna compatible with cyclophosphamide and combination testosterone cialis phentermine ifosfamide, therefore, can be administered to them in the same solution, with the antitumor activity of the latter is not changed.
Pharmaceutically drug is incompatible with cisplatin (binding and inactivation of the latter), in connection with which mesna should not be mixed in the same solution with cisplatin.
Mesna has no effect on the therapeutic effectiveness of adriamycin, carmustine, cisplatin, methotrexate, vincristine, as well as the activity of the cardiac glycosides.

Special instructions.
Mesna has a protective effect only mochevyvodyashuyu system and does not eliminate the other side effects of cytostatics, so the treatment group oksazafosforinov preparations necessary to use the full range of supportive and symptomatic therapy.
The treatment period marked lozhnopolozhitelytye reaction to the presence of ketone bodies in urine. Perhaps urine reddish purple color, which is unstable and immediately disappears into the urine by adding glacial acetic acid.