{"id":53271,"date":"2023-09-20T09:44:27","date_gmt":"2023-09-20T09:44:27","guid":{"rendered":"https:\/\/medsname.com\/estramustine\/"},"modified":"2026-04-30T16:30:24","modified_gmt":"2026-04-30T16:30:24","slug":"estramustine","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/estramustine\/","title":{"rendered":"Estramustin"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Estramustin<\/strong> \u2014 Estramustine Phosphate 140 mg (v\u00fdrobce certifikovan\u00fd WHO-GMP). Kombinovan\u00fd estrogen-dus\u00edkat\u00fd-ho\u0159\u010di\u010dn\u00fd alkyla\u010dn\u00ed prost\u0159edek \u2014 historicky pou\u017e\u00edvan\u00fd pro hormon\u00e1ln\u011b rezistentn\u00ed karcinom prostaty. V\u011bt\u0161inou nahrazen abirateronem a enzalutamidem; st\u00e1le se pou\u017e\u00edv\u00e1 v paliativn\u00ed p\u00e9\u010di.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Estramustine je dod\u00e1v\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, platba prob\u00edh\u00e1 p\u0159es regulovan\u00fd platebn\u00ed procesor (na v\u00fdpisu z karty se objev\u00ed n\u00e1zev regulovan\u00e9ho platebn\u00edho procesoru \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je kryta na\u0161\u00ed 20-pracovn\u00ed-denn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<div class=\"medsbase-specialist-strip\" style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0;\"><strong>\u26a0\ufe0f Specializovan\u00e1 onkologick\u00e1 l\u00e9\u010dba pod dohledem l\u00e9ka\u0159e<\/strong> \u2014 tento l\u00e9k je zahajov\u00e1n, monitorov\u00e1n a ukon\u010dov\u00e1n onkologem nebo hematologem. D\u00e1vkov\u00e1n\u00ed z\u00e1vis\u00ed na typu n\u00e1doru, stadiu, t\u011blesn\u00e9m povrchu, funkci org\u00e1n\u016f a sou\u010dasn\u00e9 terapii. Samol\u00e9\u010dba nen\u00ed vhodn\u00e1; n\u00ed\u017ee uveden\u00e9 informace jsou vzd\u011bl\u00e1vac\u00ed a podporuj\u00ed informovan\u00e9 rozhovory s va\u0161\u00edm specialistou.<\/p>\n<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Kardiovaskul\u00e1rn\u00ed + trombotick\u00e9 riziko<\/strong><br \/>Estramustine m\u00e1 silnou estrogenn\u00ed slo\u017eku \u2014 zv\u00fd\u0161en\u00e9 riziko DVT, PE, IM, gynekomastie, zadr\u017eov\u00e1n\u00ed tekutin. Vyvarujte se pod\u00e1v\u00e1n\u00ed u aktivn\u00edho kardiovaskul\u00e1rn\u00edho onemocn\u011bn\u00ed, ned\u00e1vn\u00e9 tromb\u00f3zy nebo t\u011b\u017ek\u00e9ho srde\u010dn\u00edho selh\u00e1n\u00ed. Monitorujte p\u0159\u00edznaky tromboembolie.<\/div>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Kdy se to pou\u017e\u00edv\u00e1?<\/h3>\n<p>Kombinovan\u00fd estrogen-dus\u00edkat\u00fd-ho\u0159\u010di\u010dn\u00fd alkyla\u010dn\u00ed prost\u0159edek \u2014 historicky pou\u017e\u00edvan\u00fd pro hormon\u00e1ln\u011b rezistentn\u00ed karcinom prostaty. V\u011bt\u0161inou nahrazen abirateronem a enzalutamidem; st\u00e1le se pou\u017e\u00edv\u00e1 v paliativn\u00ed p\u00e9\u010di.<\/p>\n<h3>Na kter\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky si d\u00e1t pozor?<\/h3>\n<p>N\u00e1valy horka, gynekomastie, \u00fanava, sexu\u00e1ln\u00ed dysfunkce (typick\u00e9 pro t\u0159\u00eddu antiandrogen\u016f). Monitorov\u00e1n\u00ed specifick\u00e9 pro tento l\u00e9k je uvedeno v bezpe\u010dnostn\u00edch upozorn\u011bn\u00edch v\u00fd\u0161e.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>Li\u0161\u00ed se podle molekuly \u2014 abirateron je substr\u00e1t CYP3A4; bicalutamid je substr\u00e1t CYP3A4. V\u017edy sd\u011blte v\u0161echny u\u017e\u00edvan\u00e9 l\u00e9ky. Siln\u00e9 inhibitory\/induktory CYP3A4 v\u00fdznamn\u011b ovliv\u0148uj\u00ed hladiny l\u00e9ku.<\/p>\n<h3>Kdy by m\u011bl b\u00fdt vysazen?<\/h3>\n<p>P\u0159i progresi onemocn\u011bn\u00ed, intolerovateln\u00e9 toxicit\u011b nebo \u00fasp\u011b\u0161n\u00e9 odpov\u011bdi s pl\u00e1novanou p\u0159est\u00e1vkou v l\u00e9\u010db\u011b. V\u017edy rozhodne specialista \u2014 n\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee v\u00e9st k p\u0159echodn\u00e9mu vzestupu PSA (abstinen\u010dn\u00ed reakce), co\u017e obvykle nen\u00ed d\u016fvodem k obav\u00e1m.<\/p>\n<h3>Monitorov\u00e1n\u00ed PSA?<\/h3>\n<p>PSA ka\u017ed\u00e9 1-3 m\u011bs\u00edce b\u011bhem l\u00e9\u010dby. Vzestup PSA p\u0159i kastraci nazna\u010duje kastra\u010dn\u00ed rezistenci \u2014 m\u016f\u017ee b\u00fdt nutn\u00fd p\u0159echod na l\u00e9ky druh\u00e9 linie (abirateron, enzalutamid, docetaxel).<\/p>\n<h3>Kombinovan\u00e1 androgenn\u00ed blok\u00e1da?<\/h3>\n<p>LHRH agonista (goserelin, leuprolid) + bikalutamid je b\u011b\u017en\u00e1 kombinace. Maxim\u00e1ln\u00ed androgenn\u00ed blok\u00e1da m\u00e1 m\u00edrn\u00fd p\u0159e\u017eitkov\u00fd benefit oproti samotn\u00e9mu LHRH.<\/p>\n<h3>Zdrav\u00ed kost\u00ed?<\/h3>\n<p>Dlouhodob\u00e1 androgenn\u00ed deprivace urychluje \u00fabytek kostn\u00ed hmoty. P\u0159i osteopenii\/osteopor\u00f3ze p\u0159idejte bisfosfon\u00e1t (zoledron\u00e1t) nebo denosumab. Suplementace v\u00e1pn\u00edkem a vitaminem D.<\/p>\n<h3>T\u011bhotenstv\u00ed?<\/h3>\n<p>Antiandrogeny jsou teratogenn\u00ed \u2014 partne\u0159i mus\u00ed b\u011bhem terapie pou\u017e\u00edvat \u00fa\u010dinnou antikoncepci. Nejv\u00fdznamn\u011bj\u0161\u00ed pro mlad\u0161\u00ed mu\u017ee s lokalizovan\u00fdm onemocn\u011bn\u00edm.<\/p>\n<h3>Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>Vezm\u011bte, kdy\u017e si vzpomenete ten sam\u00fd den; jinak vynechejte. Specialista m\u016f\u017ee m\u00edt specifick\u00e9 pokyny pro vynechan\u00e9 d\u00e1vky v z\u00e1vislosti na re\u017eimu.<\/p>\n<h3>Kardiovaskul\u00e1rn\u00ed monitorov\u00e1n\u00ed?<\/h3>\n<p>Povinn\u00e9 u fosfestrolu; doporu\u010deno u abirateronu (TK, retence tekutin, elektrolyty); rutinn\u00ed u bikalutamidu (ob\u010dasn\u00e1 kardiovaskul\u00e1rn\u00ed kontrola).<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed rakovina a antiandrogenn\u00ed terapie<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/calutide\/\">Calutide<\/a> \u2014 bikalutamid 50 mg \u2014 alternativn\u00ed zna\u010dka antiandrogenu<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/xbira\/\">Xbira<\/a> \u2014 abirateron 250 mg \u2014 inhibitor CYP17 pro mCRPC<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/honvan\/\">Honvan<\/a> \u2014 fosfestrol 120 mg \u2014 difosf\u00e1t diethylstilbestrolu<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/estramustine\/\">Estramustin<\/a> \u2014 estramustin fosf\u00e1t \u2014 alkyla\u010dn\u00ed \u010dinidlo pro hormon\u00e1ln\u011b refraktern\u00ed onemocn\u011bn\u00ed<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zoldria\/\">Zoldria<\/a> \u2014 zoledronov\u00e1 kyselina IV pro kostn\u00ed metast\u00e1zy<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> L\u00e9\u010dba rakoviny je vysoce individualizovan\u00e1. Konkr\u00e9tn\u00ed l\u00e9k, d\u00e1vkov\u00e1n\u00ed, re\u017eim, monitorov\u00e1n\u00ed a podp\u016frn\u00e1 p\u00e9\u010de mus\u00ed b\u00fdt stanoveny kvalifikovan\u00fdm onkologem nebo hematologem na z\u00e1klad\u011b biologie n\u00e1doru, stadia onemocn\u011bn\u00ed, p\u0159idru\u017een\u00fdch chorob a c\u00edl\u016f l\u00e9\u010dby. Tyto informace jsou vzd\u011bl\u00e1vac\u00edho charakteru; nenahrazuj\u00ed odborn\u00e9 l\u00e9ka\u0159sk\u00e9 poradenstv\u00ed.<\/div>","protected":false},"excerpt":{"rendered":"<p>Estramustin (140 mg) \u2014 kombinovan\u00fd estrogen-alkyla\u010dn\u00ed prost\u0159edek pro hormon-refraktern\u00ed karcinom prostaty. V\u011bt\u0161inou nahrazen abirateronem, ale zachov\u00e1n v paliativn\u00ed p\u00e9\u010di.<\/p>","protected":false},"featured_media":53272,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3595,3141,3223],"product_tag":[],"class_list":{"0":"post-53271","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-cancer-medication","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/53271","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=53271"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/53272"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=53271"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=53271"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=53271"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=53271"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}