{"id":57629,"date":"2024-02-27T17:53:24","date_gmt":"2024-02-27T17:53:24","guid":{"rendered":"https:\/\/medsname.com\/veenat\/"},"modified":"2026-04-30T10:24:24","modified_gmt":"2026-04-30T10:24:24","slug":"veenat","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/veenat\/","title":{"rendered":"Veenat"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Veenat?<\/h3>\n<p style=\"margin:0;\"><strong>Veenat<\/strong> je peror\u00e1ln\u00ed tableta od Natco Pharma obsahuj\u00edc\u00ed <strong>imatinib mesyl\u00e1t<\/strong> na <strong>100 mg<\/strong> \u2014 origin\u00e1l <strong>inhibitor tyrozinkin\u00e1zy BCR-ABL<\/strong> a l\u00e9k, kter\u00fd prom\u011bnil chronickou myeloidn\u00ed leuk\u00e9mii (CML) ze smrteln\u00e9ho onemocn\u011bn\u00ed v chronick\u00fd stav. Standardn\u00ed indikace: <strong>chronick\u00e1 f\u00e1ze CML<\/strong> (400 mg\/den), <strong>akcelerovan\u00e1\/blastick\u00e1 f\u00e1ze CML<\/strong> (600\u2013800 mg\/den), <strong>Philadelphia-chromozom-pozitivn\u00ed ALL<\/strong>, <strong>gastrointestin\u00e1ln\u00ed strom\u00e1ln\u00ed tumor (GIST)<\/strong>, a n\u011bkolik dal\u0161\u00edch vz\u00e1cn\u00fdch n\u00e1dor\u016f zp\u016fsoben\u00fdch mutacemi v KIT\/PDGFRA. <strong>U\u017e\u00edvejte s j\u00eddlem a velkou sklenic\u00ed vody<\/strong> pro sn\u00ed\u017een\u00ed gastrointestin\u00e1ln\u00edch pot\u00ed\u017e\u00ed. Povinn\u00e9 monitorov\u00e1n\u00ed: CBC + jatern\u00ed testy ka\u017ed\u00e9 2 t\u00fddny po prvn\u00ed 2\u20133 m\u011bs\u00edce, pot\u00e9 m\u011bs\u00ed\u010dn\u011b; cytogenetick\u00e1 + molekul\u00e1rn\u00ed odpov\u011b\u010f (BCR-ABL transkript) ka\u017ed\u00e9 3 m\u011bs\u00edce u CML.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:0 0 24px 0;border-radius:4px;font-size:14px;\"><strong>\u26a0 Vy\u017eaduje se odborn\u00fd dohled.<\/strong> L\u00e9ky na rakovinu mus\u00ed b\u00fdt p\u0159edeps\u00e1ny o\u0161et\u0159uj\u00edc\u00edm onkologem s potvrzenou diagn\u00f3zou, vstupn\u00edm stagingem a definovan\u00fdm l\u00e9\u010debn\u00fdm pl\u00e1nem. Nikdy neza\u010d\u00ednejte, nep\u0159eru\u0161ujte, nem\u011b\u0148te d\u00e1vkov\u00e1n\u00ed ani neu\u017e\u00edvejte l\u00e9ky na rakovinu mimo onkologick\u00fd l\u00e9\u010debn\u00fd pl\u00e1n. V\u011bt\u0161ina l\u00e9k\u016f na rakovinu vy\u017eaduje pravideln\u00e9 monitorov\u00e1n\u00ed krevn\u00edch test\u016f (krevn\u00ed obraz, jatern\u00ed testy, funkce ledvin), je absolutn\u011b kontraindikov\u00e1na v t\u011bhotenstv\u00ed a m\u00e1 v\u00fdznamn\u00e9 l\u00e9kov\u00e9 interakce.<\/div>\n<div style=\"background:#f4f8fb;border:1px solid #d6e4ec;padding:12px 18px;margin:14px 0;border-radius:4px;font-size:14px;color:#3a5160;text-align:center;\">\n<strong>\ud83d\udd12 \u0160ifrovan\u00e9 platby<\/strong> \u00b7 <strong>\ud83d\udcb3 Ov\u011b\u0159en\u00fd platebn\u00ed procesor<\/strong> \u00b7 <strong>\ud83d\ude9a Doprava do cel\u00e9ho sv\u011bta<\/strong> \u00b7 <strong>\u2b50 4,9\/5 od 1 400+ z\u00e1kazn\u00edk\u016f<\/strong>\n<\/div>\n<h2 class=\"wp-block-heading\">Co je Veenat?<\/h2>\n<p>Veenat jsou peror\u00e1ln\u00ed tablety od spole\u010dnosti Natco Pharma obsahuj\u00edc\u00ed <strong>imatinib mesyl\u00e1t 100 mg<\/strong>. Imatinib byl prvn\u00ed selektivn\u00ed <strong>inhibitor tyrozinkin\u00e1zy BCR-ABL<\/strong> schv\u00e1len\u00fd (Novartis, zna\u010dka Gleevec\/Glivec, 2001) a zrevolucionizoval l\u00e9\u010dbu chronick\u00e9 myeloidn\u00ed leuk\u00e9mie (CML) \u2013 zm\u011bnil d\u0159\u00edve smrteln\u00e9 onemocn\u011bn\u00ed v chronick\u00fd stav s t\u00e9m\u011b\u0159 norm\u00e1ln\u00ed d\u00e9lkou \u017eivota p\u0159i l\u00e9\u010db\u011b. Tak\u00e9 blokuje p\u0159\u00edbuzn\u00e9 kin\u00e1zy receptor\u016f KIT a PDGFRA, co\u017e jej \u010din\u00ed \u00fa\u010dinn\u00fdm u gastrointestin\u00e1ln\u00edho strom\u00e1ln\u00edho tumoru (GIST) a n\u011bkolika dal\u0161\u00edch vz\u00e1cn\u00fdch n\u00e1dor\u016f.<\/p>\n<h2 class=\"wp-block-heading\">Jak Veenat funguje?<\/h2>\n<p>Philadelphia chromozom (t(9;22) translokace) vytv\u00e1\u0159\u00ed konstitutivn\u011b aktivn\u00ed <strong>BCR-ABL f\u00fazn\u00ed kin\u00e1zu<\/strong> kter\u00e1 poh\u00e1n\u00ed chronickou myeloidn\u00ed leuk\u00e9mii. Imatinib se v\u00e1\u017ee na ATP-vazebn\u00e9 m\u00edsto BCR-ABL a uzamkne jej v neaktivn\u00ed konformaci, \u010d\u00edm\u017e zastav\u00ed prolifera\u010dn\u00ed signalizaci. Stejn\u00e1 slou\u010denina tak\u00e9 inhibuje p\u0159\u00edbuzn\u00fd receptor KIT (hyperaktivn\u00ed u GIST a mastocyt\u00f3zy) a receptor PDGFRA (hyperaktivn\u00ed u n\u011bkter\u00fdch sarkom\u016f).<\/p>\n<h2 class=\"wp-block-heading\">Pou\u017eit\u00ed a indikace<\/h2>\n<ul>\n<li><strong>Chronick\u00e1 f\u00e1ze Philadelphia-chromozom pozitivn\u00ed CML<\/strong> (prvn\u00ed linie; 400 mg\/den)<\/li>\n<li><strong>Akcelerovan\u00e1 f\u00e1ze nebo blastick\u00e1 krize CML<\/strong> (600\u2013800 mg\/den, \u010dasto jako p\u0159echod k alogenn\u00ed transplantaci)<\/li>\n<li><strong>Philadelphia-chromozom pozitivn\u00ed akutn\u00ed lymfoblastick\u00e1 leuk\u00e9mie (ALL)<\/strong>, v kombinaci s chemoterapi\u00ed<\/li>\n<li><strong>Neoperabiln\u00ed, recidivuj\u00edc\u00ed nebo metastatick\u00fd gastrointestin\u00e1ln\u00ed strom\u00e1ln\u00ed tumor (GIST)<\/strong><\/li>\n<li><strong>Adjuvantn\u00ed terapie po resekci GIST<\/strong> (3 roky, KIT-pozitivn\u00ed onemocn\u011bn\u00ed)<\/li>\n<li><strong>Hypereozinofiln\u00ed syndrom s f\u00faz\u00ed FIP1L1-PDGFRA<\/strong><\/li>\n<li><strong>Dermatofibrosarcoma protuberans<\/strong> (PDGFRB-driven)<\/li>\n<li><strong>Agresivn\u00ed syst\u00e9mov\u00e1 mastocyt\u00f3za<\/strong> (KIT D816V negativn\u00ed)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Veenatu a zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/h2>\n<p>Standardn\u00ed d\u00e1vkov\u00e1n\u00ed podle indikace:<\/p>\n<ul>\n<li>Chronick\u00e1 f\u00e1ze CML: <strong>400 mg\/den<\/strong> (1 \u00d7 400 mg tableta)<\/li>\n<li>Akcelerovan\u00e1\/blastov\u00e1 f\u00e1ze CML, Ph+ ALL: <strong>600\u2013800 mg\/den<\/strong> (v 1\u20132 rozd\u011blen\u00fdch d\u00e1vk\u00e1ch)<\/li>\n<li>GIST: <strong>400 mg\/den<\/strong>; zv\u00fd\u0161it na 800 mg\/den p\u0159i progresi<\/li>\n<\/ul>\n<ol>\n<li><strong>U\u017e\u00edvejte s j\u00eddlem a velkou sklenic\u00ed vody<\/strong> \u2014 minimalizuje nevolnost a podr\u00e1\u017ed\u011bn\u00ed j\u00edcnu.<\/li>\n<li><strong>Ve stejnou dobu ka\u017ed\u00fd den.<\/strong><\/li>\n<li><strong>Polykejte cel\u00e9.<\/strong> Tablety lze rozpustit ve vod\u011b nebo jable\u010dn\u00e9 \u0161\u0165\u00e1v\u011b (ne grapefruitov\u00e9), pokud je polyk\u00e1n\u00ed obt\u00ed\u017en\u00e9.<\/li>\n<li><strong>Povinn\u00e9 monitorov\u00e1n\u00ed:<\/strong> FBC + LFT ka\u017ed\u00e9 2 t\u00fddny po prvn\u00ed 2\u20133 m\u011bs\u00edce, pot\u00e9 m\u011bs\u00ed\u010dn\u011b. Hladina transkriptu BCR-ABL (PCR) ka\u017ed\u00e9 3 m\u011bs\u00edce u CML \u2014 kl\u00ed\u010dov\u00fd ukazatel l\u00e9\u010debn\u00e9 odpov\u011bdi. Ro\u010dn\u00ed EKG\/echo pro funkci srdce.<\/li>\n<li><strong>Odpov\u011b\u010f kostn\u00ed d\u0159en\u011b + cytogenetick\u00e1:<\/strong> v\u00fdchoz\u00ed stav a po 3, 6, 12 m\u011bs\u00edc\u00edch u CML \u2014 ur\u010duje \u00fasp\u011b\u0161nost l\u00e9\u010dby nebo pot\u0159ebu p\u0159echodu na TKI druh\u00e9 linie (dasatinib, nilotinib, bosutinib, ponatinib).<\/li>\n<li><strong>Nep\u0159est\u00e1vejte bez pokyn\u016f onkologa<\/strong> \u2014 l\u00e9\u010dba bez udr\u017eovac\u00ed terapie je mo\u017en\u00e1 pouze po trval\u00e9 hlubok\u00e9 molekul\u00e1rn\u00ed odpov\u011bdi (MR4 nebo lep\u0161\u00ed) po dobu alespo\u0148 2 let pod odborn\u00fdm dohledem.<\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky Veenatu<\/h2>\n<p><strong>\u010cast\u00e9 (\u010dasto m\u00edrn\u00e9, ustupuj\u00edc\u00ed):<\/strong> nevolnost, pr\u016fjem, zadr\u017eov\u00e1n\u00ed tekutin (periorbit\u00e1ln\u00ed ed\u00e9m, perifern\u00ed ed\u00e9m), svalov\u00e9 k\u0159e\u010de, vyr\u00e1\u017eka, \u00fanava, p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze.<\/p>\n<p><strong>D\u016fle\u017eit\u00e9 \u2013 povinn\u00e9 monitorov\u00e1n\u00ed:<\/strong><\/p>\n<ul>\n<li><strong>Myelosuprese<\/strong> \u2014 neutropenie, trombocytopenie, an\u00e9mie (velmi \u010dast\u00e9); sn\u00ed\u017een\u00ed d\u00e1vky nebo p\u0159eru\u0161en\u00ed p\u0159i z\u00e1va\u017en\u00fdch<\/li>\n<li><strong>Hepatotoxicita<\/strong> \u2014 zv\u00fd\u0161en\u00ed LFT \u010dast\u00e9; m\u016f\u017ee se objevit t\u011b\u017ek\u00e1 hepatitida<\/li>\n<li>Srde\u010dn\u00ed dysfunkce \u2014 m\u011bstnav\u00e9 srde\u010dn\u00ed selh\u00e1n\u00ed (vz\u00e1cn\u00e9, ale dokumentovan\u00e9)<\/li>\n<li>Hypotyre\u00f3za u pacient\u016f po tyreoidektomii na levothyroxinu<\/li>\n<li>Hypofosfat\u00e9mie, hypokalc\u00e9mie<\/li>\n<li>Ren\u00e1ln\u00ed dysfunkce<\/li>\n<\/ul>\n<p><strong>Vz\u00e1cn\u00e9, ale z\u00e1va\u017en\u00e9:<\/strong> Stevens-Johnson\u016fv syndrom\/TEN, jatern\u00ed selh\u00e1n\u00ed, z\u00e1va\u017en\u00e1 retence tekutin, gastrointestin\u00e1ln\u00ed krv\u00e1cen\u00ed, syndrom n\u00e1dorov\u00e9 l\u00fdzy (vysok\u00e1 n\u00e1dorov\u00e1 z\u00e1t\u011b\u017e), mozkov\u00fd ed\u00e9m u pacient\u016f s metast\u00e1zami do mozku.<\/p>\n<h2 class=\"wp-block-heading\">Varov\u00e1n\u00ed a opat\u0159en\u00ed<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed:<\/strong> teratogenn\u00ed \u00fa\u010dinky v pokusech na zv\u00ed\u0159atech; hl\u00e1\u0161en\u00e9 p\u0159\u00edpady malformac\u00ed u lid\u00ed. D\u016fsledn\u00e1 antikoncepce po celou dobu l\u00e9\u010dby a po dobu 14 dn\u016f po posledn\u00ed d\u00e1vce. Konzultujte s onkologem p\u0159i pl\u00e1nov\u00e1n\u00ed t\u011bhotenstv\u00ed.<\/li>\n<li><strong>Kojen\u00ed:<\/strong> vyvarujte se \u2014 imatinib se vylu\u010duje do mate\u0159sk\u00e9ho ml\u00e9ka.<\/li>\n<li><strong>Anamn\u00e9za srde\u010dn\u00ed dysfunkce:<\/strong> monitorov\u00e1n\u00ed echokardiografie\/BNP na za\u010d\u00e1tku a pr\u016fb\u011b\u017en\u011b.<\/li>\n<li><strong>Onemocn\u011bn\u00ed jater:<\/strong> opatrn\u00e9 d\u00e1vkov\u00e1n\u00ed; monitorov\u00e1n\u00ed jatern\u00edch test\u016f zpo\u010d\u00e1tku t\u00fddn\u011b.<\/li>\n<li><strong>Hypotyre\u00f3za na levothyroxinu:<\/strong> imatinib zvy\u0161uje clearance levothyroxinu; kontrolujte TSH a podle pot\u0159eby zvy\u0161te d\u00e1vku levothyroxinu.<\/li>\n<li><strong>Operace:<\/strong> zv\u00fd\u0161en\u00e9 riziko krv\u00e1cen\u00ed v d\u016fsledku poruchy hojen\u00ed ran; p\u0159eru\u0161te pod\u00e1v\u00e1n\u00ed imatinibu v perioperativn\u00edm obdob\u00ed podle pokyn\u016f specialisty.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;\">Kombinujte s<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;\">\u00da\u010dinek<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;\">Co d\u011blat<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u00e9 inhibitory CYP3A4 (ketokonazol, ritonavir, klarithromycin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zv\u00fd\u0161en\u00ed hladiny imatinibu \u2014 toxicita<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sni\u017ete d\u00e1vku imatinibu p\u0159ibli\u017en\u011b o 50 %, pokud nelze zabr\u00e1nit.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u00ed induktory CYP3A4 (rifampicin, fenytoin, karbamazepin, t\u0159ezalka te\u010dkovan\u00e1)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ni\u017e\u0161\u00ed hladiny imatinibu \u2014 selh\u00e1n\u00ed l\u00e9\u010dby<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vynechat. Pokud nelze, zv\u00fd\u0161it d\u00e1vku o 50 % pod odborn\u00fdm dohledem.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Warfarin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zv\u00fd\u0161en\u00e9 riziko krv\u00e1cen\u00ed (inhibice CYP2C9 + \u00fa\u010dinky na trombocyty)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">P\u0159echod na LMWH nebo DOAC; monitorovat INR zpo\u010d\u00e1tku t\u00fddn\u011b.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Levothyroxin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Imatinib zvy\u0161uje clearance levothyroxinu \u2014 vzestup TSH<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Monitorovat TSH; upravit d\u00e1vkov\u00e1n\u00ed levothyroxinu dle pot\u0159eby.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Paracetamol (vysok\u00e9 d\u00e1vky, pravideln\u011b)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kumulativn\u00ed hepatotoxicita<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Omezit na ob\u010dasn\u00e9 u\u017eit\u00ed.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Grapefruitov\u00e1 \u0161\u0165\u00e1va<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zvy\u0161uje hladinu imatinibu<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vyhn\u011bte se grapefruitu a grapefruitov\u00e9 \u0161\u0165\u00e1v\u011b.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<ul>\n<li>Skladujte p\u0159i pokojov\u00e9 teplot\u011b, 15\u201330\u00b0C, v p\u016fvodn\u00edm blistru.<\/li>\n<li>Uchov\u00e1vejte mimo dosah d\u011bt\u00ed, \u017een v reproduk\u010dn\u00edm v\u011bku a dom\u00e1c\u00edch zv\u00ed\u0159at.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy na MedsBase<\/h2>\n<p>Dal\u0161\u00ed onkologick\u00e9 l\u00e9ky skladem vedle tohoto produktu:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/imat\/\"><strong>Imat (imatinib 400 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/imatib\/\"><strong>Imatib (imatinib 100 \/ 400 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/votrient\/\"><strong>Votrient (pazopanib 400 mg)<\/strong><\/a><\/li>\n<\/ul>\n<p><a href=\"https:\/\/medsbase.com\/cs\/anti-cancer-medication\/\">Prohl\u00e9dn\u011bte v\u0161echny protin\u00e1dorov\u00e9 l\u00e9ky \u2192<\/a><\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Jak \u00fa\u010dinn\u00fd je Veenat p\u0159i l\u00e9\u010db\u011b chronick\u00e9 myeloidn\u00ed leuk\u00e9mie?<\/h3>\n<p>Imatinib je jedna z nej\u00fasp\u011b\u0161n\u011bj\u0161\u00edch c\u00edlen\u00fdch protin\u00e1dorov\u00fdch terapi\u00ed, jak\u00e9 byly kdy vyvinuty. <strong>10let\u00e9 celkov\u00e9 p\u0159e\u017eit\u00ed u chronick\u00e9 f\u00e1ze CML p\u0159i l\u00e9\u010db\u011b imatinibem je p\u0159ibli\u017en\u011b 85%<\/strong>, ve srovn\u00e1n\u00ed s medi\u00e1nem p\u0159e\u017eit\u00ed 4\u20136 let p\u0159ed \u00e9rou TKI terapie. Asi 90 % pacient\u016f dos\u00e1hne kompletn\u00ed cytogenetick\u00e9 odpov\u011bdi b\u011bhem 12\u201318 m\u011bs\u00edc\u016f. V\u00fdznamn\u00e1 men\u0161ina (~50 % pacient\u016f s trvalou hlubokou molekul\u00e1rn\u00ed odpov\u011bd\u00ed) m\u016f\u017ee nakonec pod odborn\u00fdm dohledem zkusit l\u00e9\u010dbu bez udr\u017eovac\u00ed terapie.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d mus\u00edm u\u017e\u00edvat Veenat s j\u00eddlem?<\/h3>\n<p>Dva d\u016fvody: (1) j\u00eddlo v\u00fdrazn\u011b sni\u017euje nevolnost a riziko podr\u00e1\u017ed\u011bn\u00ed j\u00edcnu; (2) imatinib se dob\u0159e vst\u0159eb\u00e1v\u00e1 za ka\u017ed\u00fdch okolnost\u00ed, ale konzistentn\u00ed u\u017e\u00edv\u00e1n\u00ed s j\u00eddlem sni\u017euje denn\u00ed variabilitu hladin. U\u017e\u00edvejte s nejv\u011bt\u0161\u00edm j\u00eddlem dne a plnou sklenic\u00ed vody. Vyhn\u011bte se u\u017e\u00edv\u00e1n\u00ed nala\u010dno nebo s grapefruitovou \u0161\u0165\u00e1vou (kter\u00e1 zvy\u0161uje hladinu a riziko toxicity).<\/p>\n<h3 class=\"wp-block-heading\">Jak\u00e9 krevn\u00ed testy pot\u0159ebuji?<\/h3>\n<p><strong>Povinn\u00e9:<\/strong> Kompletn\u00ed krevn\u00ed obraz a jatern\u00ed testy ka\u017ed\u00e9 2 t\u00fddny po dobu prvn\u00edch 2\u20133 m\u011bs\u00edc\u016f, pot\u00e9 m\u011bs\u00ed\u010dn\u011b. <strong>Hladina transkriptu BCR-ABL metodou PCR ka\u017ed\u00e9 3 m\u011bs\u00edce<\/strong> U CML \u2014 toto je kl\u00ed\u010dov\u00fd ukazatel l\u00e9\u010debn\u00e9 odpov\u011bdi a rozhoduje o pokra\u010dov\u00e1n\u00ed v imatinibu nebo p\u0159echodu na TKI druh\u00e9 generace (dasatinib, nilotinib). Ro\u010dn\u00ed kardiologick\u00e9 vy\u0161et\u0159en\u00ed (EKG, echo nebo BNP) je rozumn\u00e9 u pacient\u016f s kardiovaskul\u00e1rn\u00edmi rizikov\u00fdmi faktory.<\/p>\n<h3 class=\"wp-block-heading\">Mohu m\u00edt d\u011bti p\u0159i u\u017e\u00edv\u00e1n\u00ed Veenatu?<\/h3>\n<p>Imatinib je teratogenn\u00ed v pokusech na zv\u00ed\u0159atech a existuj\u00ed p\u0159\u00edpadov\u00e9 zpr\u00e1vy o malformac\u00edch u lid\u00ed. <strong>B\u011bhem l\u00e9\u010dby a po dobu nejm\u00e9n\u011b 14 dn\u016f po posledn\u00ed d\u00e1vce je nutn\u00e1 spolehliv\u00e1 antikoncepce<\/strong>, a to u pacient\u016f obou pohlav\u00ed. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby proberte pl\u00e1nov\u00e1n\u00ed rodiny s onkologem \u2014 v n\u011bkter\u00fdch p\u0159\u00edpadech m\u016f\u017ee pl\u00e1novan\u00fd pokus o l\u00e9\u010dbou navozenou remisi bez l\u00e9\u010dby vytvo\u0159it p\u0159\u00edle\u017eitost k po\u010det\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Co je \u201cl\u00e9\u010dbou navozen\u00e1 remise bez l\u00e9\u010dby\u201d u CML?<\/h3>\n<p>Asi 50 % pacient\u016f s CML, kte\u0159\u00ed dos\u00e1hnou trval\u00e9 <strong>hlubok\u00e9 molekul\u00e1rn\u00ed odpov\u011bdi (MR4 nebo lep\u0161\u00ed) po dobu nejm\u00e9n\u011b 2\u20133 let<\/strong> m\u016f\u017ee pod pe\u010dliv\u00fdm dohledem zkusit vysadit imatinib. Asi polovina t\u011bch, kte\u0159\u00ed l\u00e9\u010dbu vysad\u00ed, z\u016fstane v remisi bez l\u00e9\u010dby neomezen\u011b dlouho. Druh\u00e1 polovina zaznamen\u00e1 molekul\u00e1rn\u00ed relaps a obnov\u00ed imatinib (kter\u00fd obvykle znovu navod\u00ed remisi). Toto je rozhodnut\u00ed specialisty \u2014 nikdy nevysazujte imatinib jednostrann\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Veenat vs nov\u011bj\u0161\u00ed TKI (dasatinib, nilotinib, bosutinib)?<\/h3>\n<p>Imatinib je l\u00e9kem prvn\u00ed volby u v\u011bt\u0161iny nov\u011b diagnostikovan\u00fdch CML v chronick\u00e9 f\u00e1zi \u2014 dlouhodob\u00e1 bezpe\u010dnostn\u00ed data, ni\u017e\u0161\u00ed n\u00e1klady, ov\u011b\u0159en\u00e9 \u00fadaje o l\u00e9\u010dbou navozen\u00e9 remisi bez l\u00e9\u010dby. <strong>Dasatinib a nilotinib<\/strong> jsou TKI druh\u00e9 generace s rychlej\u0161\u00edmi a hlub\u0161\u00edmi molekul\u00e1rn\u00edmi odpov\u011b\u010fmi; preferov\u00e1ny jako prvn\u00ed volba u vy\u0161\u0161\u00edho rizika onemocn\u011bn\u00ed nebo u mlad\u0161\u00edch pacient\u016f, kte\u0159\u00ed up\u0159ednost\u0148uj\u00ed l\u00e9\u010dbou navozenou remisi bez l\u00e9\u010dby. <strong>Bosutinib, ponatinib<\/strong> jsou vyhrazeny pro rezistenci nebo intoleranci. Volba je vysoce individu\u00e1ln\u00ed \u2014 rozhodnut\u00ed hematologick\u00e9ho specialisty.<\/p>\n<h3 class=\"wp-block-heading\">Bude Veenat \u00fa\u010dinn\u00fd na m\u016fj GIST n\u00e1dor?<\/h3>\n<p>U GIST z\u00e1vis\u00ed odpov\u011b\u010f na imatinibu na podkladov\u00e9 mutaci KIT nebo PDGFRA. <strong>Mutace exonu 11 KIT<\/strong> maj\u00ed ~85% m\u00edru parci\u00e1ln\u00ed odpov\u011bdi p\u0159i d\u00e1vce 400 mg\/den. <strong>Mutace exonu 9 KIT<\/strong> vy\u017eaduj\u00ed 800 mg\/den. <strong>GIST s divok\u00fdm typem KIT\/PDGFRA a mutace PDGFRA D842V<\/strong> reaguj\u00ed \u0161patn\u011b \u2014 jsou pot\u0159eba alternativn\u00ed TKI (avapritinib pro D842V). Mutan\u010dn\u00ed testov\u00e1n\u00ed je povinn\u00e9 p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby imatinibem u GIST.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d zadr\u017euji tekutiny p\u0159i u\u017e\u00edv\u00e1n\u00ed Veenatu?<\/h3>\n<p>Zadr\u017eov\u00e1n\u00ed tekutin \u2014 otoky kolem o\u010d\u00ed, kotn\u00edk\u016f, p\u0159\u00edr\u016fstek hmotnosti \u2014 je jedn\u00edm z nejtypi\u010dt\u011bj\u0161\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f imatinibu, postihuje a\u017e 60 % pacient\u016f. Mechanismus zahrnuje inhibici PDGFR a m\u00edrnou ren\u00e1ln\u00ed retenci sod\u00edku. Zvl\u00e1d\u00e1 se n\u00edzkosolnou dietou a p\u0159i pot\u0159eb\u011b m\u00edrn\u00fdm diuretikem. T\u011b\u017ek\u00e9 zadr\u017eov\u00e1n\u00ed tekutin (plicn\u00ed ed\u00e9m, pleur\u00e1ln\u00ed v\u00fdpotek) vy\u017eaduje sn\u00ed\u017een\u00ed d\u00e1vky nebo p\u0159eru\u0161en\u00ed l\u00e9\u010dby.<\/p>\n<h3 class=\"wp-block-heading\">Mohu p\u00edt alkohol p\u0159i u\u017e\u00edv\u00e1n\u00ed Veenatu?<\/h3>\n<p>Omezte alkohol \u2014 jak alkohol, tak imatinib jsou metabolizov\u00e1ny j\u00e1try a jejich kombinace zvy\u0161uje riziko hepatotoxicity. Ob\u010dasn\u00e9 mal\u00e9 mno\u017estv\u00ed je obvykle tolerovateln\u00e9; denn\u00ed nebo nadm\u011brn\u00e9 pit\u00ed by se m\u011blo vyvarovat. Informujte sv\u00e9ho onkologa, pokud se zv\u00fd\u0161\u00ed hodnoty jatern\u00edch test\u016f.<\/p>\n<p><!-- medsbase-why-order --><\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Ka\u017ed\u00e1 \u0161ar\u017ee je dod\u00e1v\u00e1na od <strong>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong>. Objedn\u00e1vky jsou expedov\u00e1ny v nen\u00e1padn\u00fdch obalech bez loga od na\u0161ich partnersk\u00fdch sklad\u016f a jsou pokryty na\u0161\u00ed <a href=\"\/cs\/medsbase-re-shipment-assurance-policy\/\">Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>: pokud z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, za\u0161leme zdarma n\u00e1hradn\u00ed z\u00e1silku, bez dotaz\u016f.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed protin\u00e1dorov\u00e9 l\u00e9ky<\/h3>\n<p>Dal\u0161\u00ed onkologick\u00e9 l\u00e9ky skladem vedle tohoto produktu:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/imat\/\">Imat (imatinib 100\/400 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/imatib\/\">Imatib (imatinib 100\/400 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/votrient\/\">Votrient (pazopanib 200\/400 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/hydrosar\/\">Hydrosar (hydroxyurea 500 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/riborea\/\">Riborea (ribociclib 200 mg)<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 L\u00e9\u010d\u00ed leuk\u00e9mii<br \/>\n\u2705 L\u00e9\u010d\u00ed gastrointestin\u00e1ln\u00ed strom\u00e1ln\u00ed tumory<br \/>\n\u2705 Inhibuje r\u016fst n\u00e1dorov\u00fdch bun\u011bk<br \/>\n\u2705 Zvy\u0161uje m\u00edru p\u0159e\u017eit\u00ed<br \/>\n\u2705 Zlep\u0161uje kvalitu \u017eivota<\/p>\n<p>Veenat obsahuje Imatinib.<\/p>","protected":false},"featured_media":57630,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3595,3141,3223],"product_tag":[4330,4338],"class_list":{"0":"post-57629","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","9":"product_tag-imatinib","10":"product_tag-veenat","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/57629","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=57629"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/57630"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=57629"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=57629"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=57629"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=57629"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}