Летрозол-Тева Таблетки, 30 шт, 2,5 мг, в пленочной оболочке

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Лечение летрозолом снижает смертность пациенток с вовлечением лимфатических узлов на 40%."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"- Ранние стадии рака молочной железы клетки которого имеют рецепторы к гормонам у женщин в постменопаузе в качестве адъювантной терапии."}},{"type":"paragraph","data":{"text":"- Ранние стадии рака молочной железы у женщин в постменопаузе после завершения стандартной адъювантной терапии тамоксифеном в качестве продленной адъювантной терапии."}},{"type":"paragraph","data":{"text":"- Распространенные гормонозависимые формы рака молочной железы у женщин в постменопаузе (терапия первой линии)."}},{"type":"paragraph","data":{"text":"- Распространенные формы рака молочной железы у женщин в постменопаузе (естественной или вызванной искусственно) получавших предшествующую терапию антиэстрогенами."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Повышенная чувствительность к летрозолу или любому другому компоненту препарата;"}},{"type":"paragraph","data":{"text":"- Эндокринный статус характерный для репродуктивного периода;"}},{"type":"paragraph","data":{"text":"- Беременность период кормления грудью;"}},{"type":"paragraph","data":{"text":"- Детский возраст (эффективность и безопасность для детей не установлена)."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Нет данных о применении летрозола у пациенток с клиренсом креатинина менее 10 мл/мин. Перед назначением летрозола таким пациенткам следует тщательно взвесить соотношение между потенциальным риском и ожидаемым эффектом лечения."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Противопоказано назначение препарата при беременности и в период лактации."}},{"type":"paragraph","data":{"text":"Во время терапии летрозолом, учитывая потенциальную возможность наступления беременности, женщинам в перименопаузном и раннем постменопаузном периоде следует использовать надежные способы контрацепции до установления стабильного постменопаузного гормонального уровня."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь независимо от приема пищи."}},{"type":"paragraph","data":{"text":"Взрослые: рекомендуемая доза препарата Летрозол-Тева составляет 25 мг один раз в сутки ежедневно длительно."}},{"type":"paragraph","data":{"text":"В качестве продленной адъювантной терапии лечение должно продолжаться в течение 5 лет (не дольше 5 лет)."}},{"type":"paragraph","data":{"text":"При появлении признаков прогрессирования заболевания прием препарата Летрозол-Тева следует прекратить."}},{"type":"paragraph","data":{"text":"У пациенток пожилого возраста коррекции дозы препарата Летрозол-Тева не требуется."}},{"type":"paragraph","data":{"text":"Пациентки с нарушением функции печени и/или почек: при нарушениях функции печени или почек (клиренс креатинина >10 мл/мин) коррекции дозы препарата не требуется. Тем не менее при тяжелых нарушениях функции печени (по шкале Child-Pugh С) пациентки должны находиться под постоянным наблюдением."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Как правило побочные реакции были слабо или умеренно выражены и в основном связаны с подавлением синтеза эстрогенов."}},{"type":"paragraph","data":{"text":"Частота возникновения побочных реакций оценивается следующим образом: возникающие \"очень часто\" - >10% \"часто\" - 1-10% \"иногда\" - 01-1% \"редко\" - 001- 01% \"очень редко\" - <001% включая отдельные сообщения."}},{"type":"paragraph","data":{"text":"Со стороны системы пищеварения: часто - тошнота рвота диспепсия запор диарея; иногда - боли в животе стоматит сухость во рту повышение активности \"печеночных\" ферментов."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: часто - головная боль головокружение депрессия; иногда - тревога нервозность раздражительность сонливость бессонница ухудшение памяти дизестезия парестезия гипестезия нарушения вкусового восприятия эпизоды нарушения мозгового кровообращения."}},{"type":"paragraph","data":{"text":"Со стороны органов кроветворения: иногда - лейкопения."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: иногда - ощущение сердцебиения тахикардия тромбофлебит поверхностных и глубоких вен повышение артериального давления (АД) ишемическая болезнь сердца (стенокардия инфаркт миокарда сердечная недостаточность) тромбоэмболия; редко - эмболия легочной артерии тромбоз артерий инсульт."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы: иногда - одышка кашель."}},{"type":"paragraph","data":{"text":"Со стороны кожи и кожных придатков: часто - алопеция повышенная потливость кожная сыпь (включая эритематозную макулопапулезную везикулярную сыпь псориазоподобные высыпания); иногда - кожный зуд сухость кожи крапивница; очень редко - ангионевротический отек анафилактические реакции."}},{"type":"paragraph","data":{"text":"Со стороны скелетно-мышечной системы: очень часто - артралгия; часто - миалгия боли в костях остеопороз переломы костей иногда - артрит."}},{"type":"paragraph","data":{"text":"Со стороны органов чувств: иногда - катаракта раздражение глаз \"затуманивание\" зрения нарушение вкусовых ощущений."}},{"type":"paragraph","data":{"text":"Со стороны мочевыводящей системы: иногда - учащенное мочеиспускание инфекции мочевыводящих путей."}},{"type":"paragraph","data":{"text":"Со стороны репродуктивной системы: иногда - вагинальные кровотечения выделения из влагалища сухость влагалища боль в молочных железах."}},{"type":"paragraph","data":{"text":"Прочие: очень часто - приступообразные ощущения жара (“приливы”); часто - повышенная утомляемость астения недомогание периферические отеки увеличение массы тела гиперхолестеринемия анорексия повышение аппетита; иногда - снижение массы тела жажда гипертермия (пирексия) сухость слизистых оболочек генерализованные отеки боли в опухолевых очагах."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Имеются отдельные сообщения о случаях передозировки летрозола. Какие-либо специфические методы лечения передозировки не известны. Показана симптоматическая и поддерживающая терапия. Летрозол выводится из плазмы посредством гемодиализа."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При одновременном назначении летрозола с циметидином и варфарином клинически значимых взаимодействий не наблюдается."}},{"type":"paragraph","data":{"text":"Клинического опыта по применению летрозола в комбинации с другими противоопухолевыми средствами в настоящее время не имеется."}},{"type":"paragraph","data":{"text":"Согласно результатам исследований invitro летрозол подавляет активность изоферментов цитохрома Р450 - CYP2A6 и CYP2C19 (последнего - умеренно). При решении вопроса о значении этих данных для клиники необходимо учитывать что изофермент CYP2A6 не играет существенной роли в метаболизме лекарственных препаратов. В экспериментах invitro было показано что летрозол в концентрациях в 100 раз превышающих равновесные значения в плазме не обладает способностью существенно подавлять метаболизм диазепама (субстрата для CYP2C19). Таким образом клинически значимые взаимодействия с изоферментом CYP2C19 маловероятны. Тем не менее следует соблюдать осторожность при совместном применении летрозола и препаратов метаболизирующихся преимущественно при участии вышеназванных изоферментов и имеющих узкий терапевтический индекс."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Пациентки с тяжелыми нарушениями функции печени должны находиться под постоянным наблюдением."}},{"type":"paragraph","data":{"text":"Во время терапии летрозолом учитывая потенциальную возможность наступления беременности женщинам в перименопаузальном и раннем постменопаузальном периоде следует использовать надежные способы контрацепции до установления стабильного постменопаузального гормонального уровня."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Некоторые побочные эффекты препарата такие как общая слабость и головокружение могут влиять на способность выполнения потенциально опасных видов деятельности требующих концентрации внимания и быстрых реакций. В этой связи следует соблюдать осторожность при управлении транспортными средствами и механизмами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки покрытые пленочной оболочкой 25 мг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Список Б."}},{"type":"paragraph","data":{"text":"Хранить в сухом месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать по истечении срока годности указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Интас Фармасьютикалс Лтд"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Тева Фармасьютикалз Юроп Б.В."}}]}],"source":null},"description_toggle":false,"short_description":"Противоопухолевый препарат, ингибитор синтеза эстрогенов. Летрозол оказывает антиэстрогенное действие, селективно ингибирует ароматазу (фермент синтеза эстрогенов) путем высокоспецифичного конкурентного связывания с субъединицей этого фермента - гемом цитохрома Р450. Блокирует синтез эстрогенов как в периферической, так и в опухолевой тканях. У женщин в постменопаузном периоде эстрогены образуются преимущественно при участии фермента ароматазы, который превращает синтезирующиеся в надпочечниках андрогены (в первую очередь, андростендион и тестостерон) в эстрон и эстрадиол. Ежедневный прием летрозола в суточной дозе 0.1-5 мг приводит к снижению концентрации эстрадиола, эстрона и эстрона сульфата в плазме крови на 75-95% от исходного содержания. Супрессия синтеза эстрогенов поддерживается на протяжении всего периода лечения. При применении летрозола в диапазоне доз от 0.1 до 5 мг нарушения синтеза стероидных гормонов в надпочечниках не наблюдается, тест с АКТГ не выявляет нарушений синтеза альдостерона или кортизола. Дополнительного назначения глюкокортикоидов и минералокортикоидов не требуется. Блокада биосинтеза эстрогенов не приводит к накоплению андрогенов, являющихся предшественниками эстрогенов. На фоне приема летрозола изменений концентраций лютеинизирующего и фолликулостимулирующего гормонов в плазме крови, изменений функции щитовидной железы, изменений липидного профиля, повышения частоты инфарктов миокарда и инсультов отмечено не было. На фоне лечения летрозолом слабо повышается частота остеопороза (6.9% по сравнению с 5.5% на плацебо). Однако частота переломов костей у пациенток, получающих летрозол, не отличается от таковой у здоровых людей того же возраста. Адьювантная терапия летрозолом ранних стадий рака молочной железы снижает риск рецидивов, увеличивает выживаемость без признаков заболевания в течение 5 лет, снижает риск развития вторичных опухолей. Продленная адьювантная терапия летрозолом снижает риск рецидивов на 42%. Достоверное преимущество по выживаемости без признаков заболевания в группе летрозола отмечалось вне зависимости от вовлеченности лимфатических узлов. 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