Fotemustin

Synonym(s)

Fotemustine

Definition
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Cytostatic agent (nitrosourea derivative).

Half-life
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approx. 2 h

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Dermatology

Ink spot lentigo: characteristic criteria are sharp demarcation, dark brown-black reticular lines...

Lentigo, reticular

Deep dark, melanocytic nevus clinically resembling a malignant melanoma.

Indication
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Metastatic malignant melanoma (also brain metastases), Hodgkin and non-Hodgkin lymphomas, CML, glioblastomas.

Limited indication
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Restricted liver and kidney function.

Dosage and method of use
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Monochemotherapy: Induction treatment Day 1, 8, 15: 100 mg/m2 KO i.v. Followed by a 4-5 week break, then maintenance therapy every 3 weeks: 100 mg/m2 KO i.v.
Polychemotherapy: e.g. in combination with dacarbazine according to therapy protocol.

Notice! Under the therapy and up to 6 months afterwards, women and men should use effective contraception. In male patients a spermiogram should be carried out before and after therapy. Patients should be advised of the possibility of cryopreserving sperm! Regular checks of the BB, liver and kidney function!

Contraindication
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Pregnancy, nursing.

Preparations
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Muphoran (available through the international pharmacy)

Tables
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Side effects of Fotemustin

Organ System	Side effects
Airways	Pulmonary fibrosis after long-term therapy (> 1,500 mg/m2)
Blood, lymph	disorders of hematopoiesis, immunosuppression
Electrolytes, metabolism, endocrinium	Gynecomastia Disruption of spermiogenesis (possibly irreversible) and ovulation
Vessels	in case of rapid infusion reddening of the skin and conjunctival bleeding, intimate irritation
GIT	gastrointestinal disorders (nausea, vomiting, diarrhoea), liver damage
Urinary tract	hyperuricemia, kidney damage (cumulative, at doses > 1,200 mg/m2 ), cystitis
Skin	hair loss, dermatitis, stomatitis
Nervous System	neurotoxic disorders

Main interactions of Fotemustin

Cimetidine	Fotemustine effect ↑
Doxorubicin	Blindness
Hyperthermia	Fotemustine effect ↑
INF α	mutual effect ↑
INF β	mutual effect ↑
Metronidazole	Fotemustine effect ↑
Misonidazole	Fotemustine effect ↑
Ranitidine	Fotemustine effect ↑
Verapamil	Fotemustine effect ↑