{"id":67946,"date":"2025-10-03T07:00:43","date_gmt":"2025-10-03T07:00:43","guid":{"rendered":"https:\/\/medsbase.com\/?post_type=product&#038;p=67946"},"modified":"2026-04-30T10:23:26","modified_gmt":"2026-04-30T10:23:26","slug":"bdenza","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/bdenza\/","title":{"rendered":"Bdenza"},"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 Bdenza?<\/h3>\n<p style=\"margin:0;\"><strong>Bdenza<\/strong> je peror\u00e1ln\u00ed tableta od spole\u010dnosti Beacon Pharmaceuticals obsahuj\u00edc\u00ed <strong>enzalutamid 40 mg<\/strong> \u2014 <strong>inhibitor signalizace androgenn\u00edch receptor\u016f druh\u00e9 generace<\/strong>. Pou\u017e\u00edv\u00e1 se na <strong>metastatick\u00fd kastra\u010dn\u011b rezistentn\u00ed karcinom prostaty (mCRPC)<\/strong>, <strong>nekastratn\u00ed CRPC<\/strong> a <strong>metastatick\u00fd hormon\u00e1ln\u011b senzitivn\u00ed karcinom prostaty<\/strong>. Standardn\u00ed d\u00e1vka: <strong>160 mg jednou denn\u011b (4 \u00d7 40 mg tablety)<\/strong>, s j\u00eddlem nebo bez j\u00eddla. Siln\u011bj\u0161\u00ed ne\u017e antiandrogeny prvn\u00ed generace (bikalutamid, flutamid) a \u00fa\u010dinn\u00fd u kastra\u010dn\u011b rezistentn\u00edho onemocn\u011bn\u00ed, kde tyto selh\u00e1vaj\u00ed. <strong>Riziko z\u00e1chvat\u016f \u2013 vyvarujte se pod\u00e1v\u00e1n\u00ed pacient\u016fm s anamn\u00e9zou z\u00e1chvat\u016f.<\/strong> Dal\u0161\u00ed kl\u00ed\u010dov\u00e1 rizika: hypertenze, \u00fanava, p\u00e1dy\/zlomeniny, kognitivn\u00ed \u00fa\u010dinky, syndrom zadn\u00ed reverzibiln\u00ed encefalopatie (vz\u00e1cn\u011b). Pokra\u010dujte v sou\u010dasn\u00e9 l\u00e9\u010db\u011b agonistou LHRH po celou dobu l\u00e9\u010dby. Povinn\u00e9 monitorov\u00e1n\u00ed: TK p\u0159i zah\u00e1jen\u00ed l\u00e9\u010dby + p\u0159i ka\u017ed\u00e9 n\u00e1v\u0161t\u011bv\u011b, periodick\u00e9 jatern\u00ed testy + KO.<\/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 Bdenza?<\/h2>\n<p>Bdenza jsou peror\u00e1ln\u00ed tablety od spole\u010dnosti Beacon Pharmaceuticals obsahuj\u00edc\u00ed <strong>enzalutamid 40 mg<\/strong>. Enzalutamid je <strong>inhibitor signalizace androgenn\u00edho receptoru (AR) druh\u00e9 generace<\/strong> \u2013 mechanisticky odli\u0161n\u00fd od antiandrogen\u016f prvn\u00ed generace (bikalutamid, flutamid). Je schv\u00e1len pro: <strong>metastatick\u00fd kastra\u010dn\u011b rezistentn\u00ed karcinom prostaty (mCRPC)<\/strong> u pacient\u016f bez p\u0159edchoz\u00ed chemoterapie a po l\u00e9\u010db\u011b docetaxelem; <strong>nekastratn\u00ed CRPC<\/strong> s rychle rostouc\u00ed hladinou PSA; a <strong>metastatick\u00fd hormon\u00e1ln\u011b senzitivn\u00ed karcinom prostaty (mHSPC)<\/strong> sou\u010dasn\u011b s ADT.<\/p>\n<h2 class=\"wp-block-heading\">Jak Bdenza funguje?<\/h2>\n<p>Enzalutamid je troj\u00fa\u010dinkov\u00fd inhibitor AR signalizace:<\/p>\n<ul>\n<li><strong>Kompetitivn\u00ed vazba na AR<\/strong> s mnohem vy\u0161\u0161\u00ed afinitou ne\u017e antiandrogeny prvn\u00ed generace.<\/li>\n<li><strong>Inhibuje nukle\u00e1rn\u00ed translokaci AR<\/strong> \u2014 i kdy\u017e je v\u00e1z\u00e1n androgenem, zabra\u0148uje receptoru vstupu do j\u00e1dra.<\/li>\n<li><strong>Inhibuje vazbu AR-DNA<\/strong> \u2014 i kdy\u017e AR vstoup\u00ed do j\u00e1dra, zabra\u0148uje vazb\u011b na androgen-responsivn\u00ed elementy c\u00edlov\u00fdch gen\u016f.<\/li>\n<\/ul>\n<p>Tento trojmechanismus \u010din\u00ed enzalutamid \u00fa\u010dinn\u00fdm v <strong>karcinom prostaty rezistentn\u00ed na kastraci<\/strong>, kde nadm\u011brn\u00e1 exprese AR a varianty sest\u0159ihu AR \u010din\u00ed antiandrogeny prvn\u00ed generace ne\u00fa\u010dinn\u00fdmi.<\/p>\n<h2 class=\"wp-block-heading\">Pou\u017eit\u00ed a indikace<\/h2>\n<ul>\n<li><strong>Metastatick\u00fd karcinom prostaty rezistentn\u00ed na kastraci (mCRPC)<\/strong> \u2014 bez p\u0159edchoz\u00ed chemoterapie (PREVAIL) a po docetaxelu (AFFIRM)<\/li>\n<li><strong>Nemetastatick\u00fd CRPC s dobou zdvojen\u00ed PSA &lt; 10 m\u011bs\u00edc\u016f<\/strong> (PROSPER)<\/li>\n<li><strong>Metastatick\u00fd hormon\u00e1ln\u011b senzitivn\u00ed karcinom prostaty (mHSPC)<\/strong> s ADT (ARCHES, ENZAMET)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed p\u0159\u00edpravku Bdenza a zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/h2>\n<p>Standardn\u00ed d\u00e1vka: <strong>160 mg jednou denn\u011b (4 \u00d7 40 mg tablety) ve stejnou denn\u00ed dobu<\/strong>, s j\u00eddlem nebo bez j\u00eddla.<\/p>\n<ol>\n<li>Polykejte tablety cel\u00e9 s vodou. NEROZ\u017dV\u00ddK\u00c1VEJTE, NEROZPU\u0160T\u011aJTE ani NED\u011aLTE.<\/li>\n<li>Pokra\u010dujte v sou\u010dasn\u00e9 terapii LHRH agonistou po celou dobu l\u00e9\u010dby enzalutamidem, pokud nebyla provedena chirurgick\u00e1 kastrace.<\/li>\n<li><strong>Povinn\u00e9 monitorov\u00e1n\u00ed:<\/strong> krevn\u00ed tlak na za\u010d\u00e1tku a p\u0159i ka\u017ed\u00e9 n\u00e1v\u0161t\u011bv\u011b kliniky; jatern\u00ed testy a FBC pravideln\u011b; PSA ka\u017ed\u00e9 3 m\u011bs\u00edce.<\/li>\n<li><strong>Prevence p\u00e1d\u016f a zlomenin:<\/strong> u star\u0161\u00edch pacient\u016f se zvy\u0161uje riziko p\u00e1d\u016f a zlomenin p\u0159i u\u017e\u00edv\u00e1n\u00ed enzalutamidu. Vyhodnocen\u00ed zdrav\u00ed kost\u00ed, v\u00e1pn\u00edk + vitamin D, zva\u017ete bisfosfon\u00e1ty.<\/li>\n<li><strong>\u00dapravy d\u00e1vkov\u00e1n\u00ed<\/strong> p\u0159i st\u0159edn\u011b t\u011b\u017ek\u00e9m po\u0161kozen\u00ed jater, z\u00e1va\u017en\u00fdch ne\u017e\u00e1douc\u00edch \u00fa\u010dinc\u00edch nebo toxicit\u011b stupn\u011b \u2265 3: sn\u00ed\u017eit na 80 nebo 120 mg\/den pod odborn\u00fdm dohledem.<\/li>\n<li>Nep\u0159eru\u0161ujte l\u00e9\u010dbu bez pokyn\u016f onkologa.<\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky Bdenzy<\/h2>\n<p><strong>\u010cast\u00e9:<\/strong> \u00fanava (dominantn\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinek), n\u00e1valy horka, hypertenze, riziko p\u00e1d\u016f a zlomenin (u star\u0161\u00edch pacient\u016f), artralgie, bolest hlavy, z\u00e1vrat\u011b, \u00fabytek hmotnosti, \u00fazkost, nespavost.<\/p>\n<p><strong>D\u016fle\u017eit\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Z\u00e1chvaty (&lt; 1 % ve studi\u00edch)<\/strong> \u2014 sn\u00ed\u017een\u00ed prahu pro z\u00e1chvaty; vyvarujte se u pacient\u016f s anamn\u00e9zou z\u00e1chvat\u016f nebo u\u017e\u00edvaj\u00edc\u00edch l\u00e9ky sni\u017euj\u00edc\u00ed pr\u00e1h pro z\u00e1chvaty<\/li>\n<li>Kognitivn\u00ed \u00fa\u010dinky: obt\u00ed\u017ee s pam\u011bt\u00ed, poruchy koncentrace<\/li>\n<li>Hypertenze \u2014 nov\u011b vznikl\u00e1 nebo zhor\u0161en\u00e1; l\u00e9\u010dit agresivn\u011b<\/li>\n<li>Syndrom zadn\u00ed reverzibiln\u00ed encefalopatie (PRES) \u2014 vz\u00e1cn\u00fd, ale dokumentovan\u00fd; nov\u011b vznikl\u00e1 siln\u00e1 bolest hlavy, zmatenost, zm\u011bny vid\u011bn\u00ed, z\u00e1chvaty<\/li>\n<li>Hepatotoxicita (m\u00edrn\u00e9 zv\u00fd\u0161en\u00ed jatern\u00edch test\u016f b\u011b\u017en\u00e9; z\u00e1va\u017en\u00e9 vz\u00e1cn\u00e9)<\/li>\n<li>Neutropenie, an\u00e9mie<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Varov\u00e1n\u00ed a opat\u0159en\u00ed<\/h2>\n<ul>\n<li><strong>Anamn\u00e9za z\u00e1chvat\u016f (jak\u00e9hokoli typu):<\/strong> vyvarujte se enzalutamidu. Pokud je nezbytn\u00fd, odborn\u00fd neurologick\u00fd + onkologick\u00fd dohled.<\/li>\n<li><strong>L\u00e9ky sni\u017euj\u00edc\u00ed pr\u00e1h pro z\u00e1chvaty<\/strong> (bupropion, klozapin, tramadol, fluorochinolony, theofylin): opatrnost.<\/li>\n<li><strong>Riziko p\u00e1d\u016f a zlomenin:<\/strong> hodnocen\u00ed zdrav\u00ed kost\u00ed, podp\u016frn\u00e1 p\u00e9\u010de.<\/li>\n<li><strong>Hypertenze:<\/strong> vstupn\u00ed + pr\u016fb\u011b\u017en\u00e9 monitorov\u00e1n\u00ed krevn\u00edho tlaku.<\/li>\n<li><strong>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed (Child-Pugh C):<\/strong> nedoporu\u010duje se.<\/li>\n<li><strong>P\u0159\u00edznaky PRES:<\/strong> nov\u00e1 siln\u00e1 bolest hlavy, zm\u011bna vid\u011bn\u00ed, zmatenost \u2014 p\u0159eru\u0161it l\u00e9\u010dbu a vyhledat t\u00e9ho\u017e dne vy\u0161et\u0159en\u00ed.<\/li>\n<li><strong>T\u011bhotenstv\u00ed \/ plodnost:<\/strong> indikace pouze pro mu\u017ee. Pou\u017e\u00edvejte kondom + antikoncepci u \u017eensk\u00fdch partner\u016f v reproduk\u010dn\u00edm v\u011bku b\u011bhem l\u00e9\u010dby + 3 m\u011bs\u00edce po jej\u00edm ukon\u010den\u00ed.<\/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 CYP2C8 (gemfibrozil)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zvy\u0161uj\u00ed hladiny enzalutamidu \u2014 riziko toxicity<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sni\u017ete d\u00e1vku enzalutamidu na 80 mg\/den, pokud nelze kombinaci zabr\u00e1nit.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u00e9 induktory CYP3A4 (rifampicin, karbamazepin, fenytoin, t\u0159ezalka te\u010dkovan\u00e1)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ni\u017e\u0161\u00ed hladiny enzalutamidu \u2014 selh\u00e1n\u00ed l\u00e9\u010dby<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vyhnout se. Pokud nelze, zv\u00fd\u0161it na 240 mg\/den pod odborn\u00fdm dohledem.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Warfarin a dal\u0161\u00ed substr\u00e1ty CYP2C9\/CYP3A4 s \u00fazk\u00fdm terapeutick\u00fdm rozmez\u00edm<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Enzalutamid je siln\u00fd induktor CYP3A4 \u2014 sni\u017euje hladiny mnoha l\u00e9k\u016f<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">P\u0159echod z warfarinu na DOAC (apixaban, edoxaban) nebo t\u00fddenn\u00ed monitorov\u00e1n\u00ed INR.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">L\u00e9ky sni\u017euj\u00edc\u00ed pr\u00e1h pro z\u00e1chvaty (bupropion, tramadol, klozapin, fluorochinolony, teofylin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zv\u00fd\u0161en\u00e9 riziko z\u00e1chvat\u016f<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pokud mo\u017eno se vyhnout.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Analoga LHRH (goserelin, leuprorelin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Standardn\u00ed podp\u016frn\u00e1 terapie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pokra\u010dovat po celou dobu l\u00e9\u010dby enzalutamidem.<\/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.<\/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\/bicalumutide\/\"><strong>Bicalumutid (bikalutamid 50 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cytomid\/\"><strong>Cytomid (flutamid 250 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<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\/bicalumutide\/\">Bicalumutid (bikalutamid 50 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cytomid\/\">Cytomid (flutamid 250 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/endace\/\">Endace (megestrol 40\/160 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamilong\/\">Tamilong (tamoxifen 10\/20 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/votrient\/\">Votrient (pazopanib 200\/400 mg)<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Jak se Bdenza li\u0161\u00ed od bikalutamidu nebo flutamidu?<\/h3>\n<p>Enzalutamid je <strong>druh\u00e9 generace<\/strong> inhibitor AR signalizace se t\u0159emi mechanismy (vazba na AR + blok\u00e1da nukle\u00e1rn\u00ed translokace AR + blok\u00e1da vazby AR-DNA) oproti jedin\u00e9mu mechanismu l\u00e9k\u016f prvn\u00ed generace. Klinick\u00fd v\u00fdznam: <strong>enzalutamid p\u016fsob\u00ed u kastra\u010dn\u011b rezistentn\u00edho onemocn\u011bn\u00ed<\/strong> kde bikalutamid a flutamid selhaly. Je tak\u00e9 \u00fa\u010dinn\u011bj\u0161\u00ed a vyvol\u00e1v\u00e1 hlub\u0161\u00ed pokles PSA, ale s v\u011bt\u0161\u00edm v\u00fdskytem kognitivn\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f, hypertenze a rizika p\u00e1d\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d je anamn\u00e9za z\u00e1chvat\u016f kontraindikac\u00ed?<\/h3>\n<p>Enzalutamid p\u0159ekon\u00e1v\u00e1 hematoencefalickou bari\u00e9ru a sni\u017euje pr\u00e1h pro z\u00e1chvaty. Ve studi\u00edch byla incidence z\u00e1chvat\u016f &lt; 1 %, ale zv\u00fd\u0161ila se u pacient\u016f s predisponuj\u00edc\u00edmi faktory. Enzalutamid se nesm\u00ed pod\u00e1vat pacient\u016fm s p\u0159edchoz\u00edmi z\u00e1chvaty (jak\u00e9hokoli typu), mozkov\u00fdmi metast\u00e1zami nebo sou\u010dasn\u00fdm u\u017e\u00edv\u00e1n\u00edm l\u00e9k\u016f sni\u017euj\u00edc\u00edch pr\u00e1h pro z\u00e1chvaty (bupropion, tramadol, klozapin, fluorochinolony, theofylin). Pokud je enzalutamid u takov\u00e9ho pacienta nezbytn\u00fd, mus\u00ed neurolog a onkolog posoudit pom\u011br rizika a p\u0159\u00ednosu.<\/p>\n<h3 class=\"wp-block-heading\">Mus\u00edm p\u0159estat s ADT (LHRH agonistou), kdy\u017e za\u010dnu u\u017e\u00edvat Bdenza?<\/h3>\n<p>Ne \u2014 pokra\u010dujte v u\u017e\u00edv\u00e1n\u00ed LHRH agonisty (goserelin, leuprorelin apod.) po celou dobu l\u00e9\u010dby enzalutamidem. Kombinace kastrace a inhibice AR signalizace je z\u00e1sadn\u00ed. P\u0159eru\u0161en\u00ed LHRH agonisty umo\u017e\u0148uje obnovu testosteronu, co\u017e m\u016f\u017ee zru\u0161it \u00fa\u010dinek enzalutamidu.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d je \u00fanava p\u0159i u\u017e\u00edv\u00e1n\u00ed Bdenzy tak \u010dast\u00e1?<\/h3>\n<p>\u00danava je nej\u010dast\u011bj\u0161\u00ed a klinicky v\u00fdznamn\u00fd vedlej\u0161\u00ed \u00fa\u010dinek \u2014 postihuje p\u0159ibli\u017en\u011b 35 % pacient\u016f ve studi\u00edch. P\u0159\u00ed\u010dina je multifaktori\u00e1ln\u00ed: hlubok\u00e1 androgenn\u00ed deprivace, mo\u017en\u00e9 p\u0159\u00edm\u00e9 \u00fa\u010dinky na CNS, an\u00e9mie. Zvl\u00e1d\u00e1 se strukturovan\u00fdm cvi\u010den\u00edm (p\u0159ekvapiv\u011b \u00fa\u010dinn\u00e9), spr\u00e1vnou sp\u00e1nkovou hygienou, screeningem a l\u00e9\u010dbou an\u00e9mie a p\u0159\u00edpadnou redukc\u00ed d\u00e1vky (160 \u2192 120 mg\/den), pokud je nesnesiteln\u00e1.<\/p>\n<h3 class=\"wp-block-heading\">Co je PRES a jak ho pozn\u00e1m?<\/h3>\n<p>Syndrom posteriorn\u00ed reverzibiln\u00ed encefalopatie (PRES) je vz\u00e1cn\u00e1, ale dokumentovan\u00e1 komplikace enzalutamidu charakterizovan\u00e1 <strong>silnou bolest\u00ed hlavy, zmatenost\u00ed, zrakov\u00fdmi zm\u011bnami (kortik\u00e1ln\u00ed slepota), z\u00e1chvaty a alterac\u00ed v\u011bdom\u00ed<\/strong>. P\u0159i v\u00fdskytu t\u011bchto p\u0159\u00edznak\u016f okam\u017eit\u011b p\u0159eru\u0161te l\u00e9\u010dbu enzalutamidem a vyhledejte l\u00e9ka\u0159sk\u00e9 vy\u0161et\u0159en\u00ed je\u0161t\u011b tent\u00fd\u017e den. V\u011bt\u0161ina p\u0159\u00edpad\u016f se po vysazen\u00ed l\u00e9ku uprav\u00ed, ale v\u010dasn\u00e9 rozpozn\u00e1n\u00ed zabr\u00e1n\u00ed trval\u00e9mu neurologick\u00e9mu po\u0161kozen\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Je t\u0159eba se ob\u00e1vat mnoha l\u00e9kov\u00fdch interakc\u00ed?<\/h3>\n<p>Ano \u2014 enzalutamid je <strong>siln\u00fd induktor CYP3A4<\/strong> a sni\u017euje hladiny v krvi u mnoha sou\u010dasn\u011b pod\u00e1van\u00fdch l\u00e9k\u016f. Nejv\u00fdznamn\u011bj\u0161\u00ed klinick\u00e9 dopady: <strong>warfarinem<\/strong> (p\u0159echod na DOAC nebo kontrola INR t\u00fddn\u011b), <strong>p\u0159\u00edm\u00e1 peror\u00e1ln\u00ed antikoagulancia<\/strong> (specialistick\u00e1 revize), n\u011bkter\u00e9 statiny, n\u011bkter\u00e1 antihypertenziva, opioidy, n\u011bkter\u00e1 antiepileptika. Informujte ka\u017ed\u00e9ho l\u00e9ka\u0159e, \u017ee u\u017e\u00edv\u00e1te enzalutamid.<\/p>\n<h3 class=\"wp-block-heading\">Mohu \u0159\u00eddit p\u0159i u\u017e\u00edv\u00e1n\u00ed Bdenzy?<\/h3>\n<p>Opatrnost \u2013 \u00fanava, z\u00e1vrat\u011b a (vz\u00e1cn\u011b) z\u00e1chvaty mohou ovlivnit schopnost \u0159\u00eddit. V\u011bt\u0161ina pacient\u016f se p\u0159izp\u016fsob\u00ed a bezpe\u010dn\u011b \u0159\u00edd\u00ed po prvn\u00edch n\u011bkolika t\u00fddnech. Vyhn\u011bte se \u0159\u00edzen\u00ed nebo obsluze stroj\u016f, pokud poci\u0165ujete v\u00fdraznou \u00fanavu, z\u00e1vrat\u011b nebo jak\u00e9koli kognitivn\u00ed p\u0159\u00edznaky.<\/p>\n<h3 class=\"wp-block-heading\">Bdenza vs abirateron \u2013 co je lep\u0161\u00ed?<\/h3>\n<p>Ob\u011b jsou mo\u017enosti druh\u00e9 volby po selh\u00e1n\u00ed antiandrogen\u016f prvn\u00ed generace. P\u0159\u00edm\u00e1 srovn\u00e1vac\u00ed data jsou omezen\u00e1; v\u00fdb\u011br z\u00e1vis\u00ed na preferenci vedlej\u0161\u00edch \u00fa\u010dink\u016f a komorbidit\u00e1ch. <strong>Enzalutamid:<\/strong> v\u011bt\u0161\u00ed \u00fanava, kognitivn\u00ed \u00fa\u010dinky, hypertenze, riziko p\u00e1d\u016f; nen\u00ed pot\u0159eba sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed steroid\u016f. <strong>Abiraterone:<\/strong> vy\u017eaduje sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed prednisonu 5 mg dvakr\u00e1t denn\u011b; vy\u0161\u0161\u00ed riziko hypertenze a zadr\u017eov\u00e1n\u00ed tekutin; m\u016f\u017ee zhor\u0161it kontrolu diabetu. Proberte se sv\u00fdm onkologem.<\/p>","protected":false},"excerpt":{"rendered":"<p>\u2705 Zpomaluje progresi rakoviny<br \/>\n\u2705 Sni\u017euje r\u016fst n\u00e1doru<br \/>\n\u2705 Zlep\u0161uje v\u00fdsledky p\u0159e\u017eit\u00ed<br \/>\n\u2705 Podporuje l\u00e9\u010dbu prostaty<br \/>\n\u2705 Zlep\u0161uje kvalitu \u017eivota<\/p>\n<p><strong>Bdenza<\/strong> obsahuje <strong>Enzalutamide<\/strong> 40 mg.<\/p>","protected":false},"featured_media":67947,"comment_status":"open","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[3595],"product_tag":[5422,5423],"class_list":{"0":"post-67946","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-cancer-medication","7":"product_tag-bdenza","8":"product_tag-enzalutamide","10":"first","11":"instock","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\/67946","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=67946"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/67947"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=67946"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=67946"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=67946"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=67946"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}