Pomahope 1mg capsule - Pomalidomide | Myapplepharma

Pomahope 1mg is a Glenmark Pharmaceuticals product which is endorsed by FDA, containing an active anti-cancer drug called Pomalidomide.
Pomahope 1mg is available as orally bioavailable thalidomide derivative with various therapeutic activities such as;
Immuno modulatory
Anti-angiogenesis
Anti-neoplastic
Pomahope 1mg price in india  is like thalidomide & Lenalidomide with related to decreased rate of serum aminotransferase elevations during treatment.
This may lead to severe liver injury.
Pomahope 1mg capsule is involved in the treatment for regression & unmanageable multiple myeloma.
Pomahope 1mg is used in the patients who are failing to response for Lenalidomide treatment.
Pomahope 1mg is used in combination with dexamethasone.


INDICATION

The major therapeutic indication of  Pomahope 1mg capsule  is involved in the treatment of multiple myeloma.
This treatment is occurred by combining with dexamethasone for reducing the side effect associated with Pomahope 1mgomide.
Pomahope 1mg is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.

DOSAGE & ADMINISTRATION

The prescribed dose of Pomahope in multiple myeloma is 4mg should be administered orally as once a day on day 1 to 21 of reciprocated 28-day cycles.
Pomahope 1mg should be concomitant with dexamethasone.
Pomahope 1mg Capsules should be taken with or without food.
During hematological toxicities:
Neutropenia:
ANC (absolute neutrophils count) <500/mcl: Postpone the Pomahope therapy and provide CBC weekly
ANC more than or equal to 500/mcl: Continue the Pomahope3mg daily.
Thrombocytopenia:
Platelets count <25,000/mcL: postpone the Pomahope treatment & follow the CBC
>50,000/mcL: continue 3mg of Pomahope
Pomahope 1mg with potent CYP1A2 inhibitor:
During this combination reduce the dose of Pomahope by 50%
In renal impairment:
Initial dose of Pomahope is 3mg
In hepatic impairment:
Mild to moderate condition, an initial dose of Pomahope is 3mg; in severe condition, the initial dose of Pomahope is 2mg.

WORK AS

Pomahope 1mg exhibits various activities like;
Anti-neoplastic activity:
Prohibits proliferation
Promote apoptosis of hematopoietic cancer cells
Co adjuvant with dexamethasone in both Lenalidomide sensitive & resistant myeloma cells to activate the tumor cell apoptosis
Immuno modulatory:
Boosted the T-cells & natural killer cell mediate immunity.
The drug is prohibited the formation of pro-inflammatory cytokines by monocytes.
Anti-angiogenesis:
Interfere with formation of new vessels and leads to inhibit the cell division.

WARNING

There are two major worsening condition may occur during the treatment using with Pomahope 1mg.
Embryo fetal damage :
Pomahope 1mg Capsules are contraindicated to pregnancy period.
During the treatment, patients avoid to becoming pregnant.
Use effective contraceptives for preventing pregnancy during therapy.
Venous & arterial thromboembolism :
Patient who are receiving Pomahope 1mg Capsules price in india have chance of getting deep vein thrombosis, pulmonary embolism, myocardial infarction & stroke.
This type of condition should be treated by initiating prophylactic anti-thrombotic drugs.
The patients who are acquiring this condition then thromboprophylaxis should be provided.

DRUG INTERACTION

Pomalidomide metabolism is mediated by CYP1A2 & CYP3A4.
The concomitant use of Pomahope 1mg with CYP1A2 drugs like Fluvoxamine causes elevation of Cmax& AUC of Pomalidomide and concludes as increased concentration of Pomahope leads to higher extent of adverse effects associated with Pomalid
In this condition, reduce the dose of Pomahope 1mg capsule  and recommended.

CONTRAINDICATION

Pomahope 1mg should be contraindicated to pregnancy & lactating women. The pregnancy category of Pomahope 1mg is X.

SIDE EFFECTS

More common effects of Pomahope 1mg :
If taken during pregnancy, Severe life-threatening human birth defects
Fatigue
Weakness
Low white blood cell count
Anemia
Constipation
Nausea
Diarrhea
Shortness of breath
Upper respiratory infections
Back pain
Fever.
Less common effects of Pomahope 1mg
Neuropathy
Dizziness
Confusion.

CONTACT US : Phone Number: +91-9987711567

Email ID: applepharmaceutical@gmail.com

Address: Apartment No.304 A Wing, Shiva Shakthi chs ltd, JP Road, Near Apna Bazar, Andheri(West), Mumbai - 400058. Maharashtra.

Pomacel 2mg capsule - Pomalidomide | Myapplepharma

Pomacel 2mg is a Glenmark Pharmaceuticals product which is endorsed by FDA, containing an active anti-cancer drug called Pomalidomide.
Pomacel 2mg is available as orally bioavailable thalidomide derivative with various therapeutic activities such as;
Immuno modulatory
Anti-angiogenesis
Anti-neoplastic
Pomacel 2mg is like thalidomide & Lenalidomide with related to decreased rate of serum aminotransferase elevations during treatment. This may lead to severe liver injury.

INDICATION

The major therapeutic indication of Pomacel 2mg is involved in the treatment of multiple myeloma. This treatment is occurred by combining with dexamethasone for reducing the side effect associated with Pomacel 2mgomide.
Pomacel 2mg is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.

DOSAGE & ADMINISTRATION

The prescribed dose of Pomacelin multiple myeloma is 4mg should be administered orally as once a day on day 1 to 21 of reciprocated 28-day cycles.
Pomacel 2mg should be concomitant with dexamethasone.
Pomacel 2mg Capsules should be taken with or without food.
During hematological toxicities:
Neutropenia;
ANC (absolute neutrophils count) <500/mcl: Postpone the Pomaceltherapy and provide CBC weekly
ANC more than or equal to 500/mcl: Continue the Pomacel 3mg daily.

WORK AS

Pomacel 2mg exhibits various activities like;
Anti-neoplastic activity:
Prohibits proliferation
Promote apoptosis of hematopoietic cancer cells
Co adjuvant with dexamethasone in both Lenalidomide sensitive & resistant myeloma cells to activate the tumor cell apoptosis

WARNING

There are two major worsening condition may occur during the treatment using with Pomacel 2mg.

Embryo fetal damage :

Pomacel 2mg Capsules are contraindicated to pregnancy period.
During the treatment, patients avoid to becoming pregnant.
Use effective contraceptives for preventing pregnancy during therapy.

DRUG INTERACTION

Pomalidomide metabolism is mediated by CYP1A2 & CYP3A4.
The concomitant use of Pomacel 2mg with CYP1A2 drugs like Fluvoxamine causes elevation of Cmax& AUC of Pomalidomide and concludes as increased concentration of Pomacelleads to higher extent of adverse effects associated with Pomalid
In this condition, reduce the dose of Pomacel 2mg and recommended.

SIDE EFFECTS

More common effects of Pomacel 2mg :
If taken during pregnancy, Severe life-threatening human birth defects
Fatigue
Weakness
Low white blood cell count
Anemia
Constipation
Nausea
Diarrhea
Shortness of breath
Upper respiratory infections
Back pain
Fever.

Pomyelo 2mg capsule - Pomalidomide | Myapplepharma

Pomyelo 2mg is a product which is endorsed by FDA, containing an active anti-cancer drug called Pomalidomide.
Pomyelo 2mg is available as orally bioavailable thalidomide derivative with various therapeutic activities such as;
Immuno modulatory
Anti-angiogenesis
Anti-neoplastic
Pomyelo 2mg is like thalidomide & Lenalidomide with related to decreased rate of serum aminotransferase elevations during treatment.
This may lead to severe liver injury.
Pomyelo 2mg is involved in the treatment for regression & unmanageable multiple myeloma.
Pomyelo 2mg is used in the patients who are failing to response for Lenalidomide treatment.
Pomyelo 2mg is used in combination with dexamethasone.

INDICATION

The major therapeutic indication of Pomyelo 2mg is involved in the treatment of multiple myeloma.
This treatment is occurred by combining with dexamethasone for reducing the side effect associated with Pomyelo 2mg.
Pomyelo 2mg is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.

DOSAGE & ADMINISTRATION

Pomyelo 2mg should be concomitant with dexamethasone.
Pomyelo 2mg capsules should be taken with or without food.
During hematological toxicities:

Neutropenia:

ANC (absolute neutrophils count) <500/mcl: Postpone the Pomyelo therapy and provide CBC weekly
ANC more than or equal to 500/mcl: Continue the Pomyelo3mg daily.

Thrombocytopenia:

Platelets count <25,000/mcL: postpone the Pomyelo treatment & follow the CBC
>50,000/mcL: continue 3mg of Pomyelo
Pomyelo 2mg with potent CYP1A2 inhibitor:
During this combination reduce the dose of Pomyelo by 50%

WARNING

There are two major worsening condition may occur during the treatment using with Pomyelo 2mg.

Embryo fetal damage:

Pomyelo 2mg capsules are contraindicated to pregnancy period.
During the treatment, patients avoid to becoming pregnant.
Use effective contraceptives for preventing pregnancy during therapy.

WORK AS

Pomyelo 2mg exhibits various activities like;

Immuno modulatory:

Boosted the T-cells & natural killer cell mediate immunity.
The drug is prohibited the formation of pro-inflammatory cytokines by monocytes.

Anti-angiogenesis:

Interfere with formation of new vessels and leads to inhibit the cell division.

SIDE EFFECTS

More common effects :

If taken during pregnancy, Severe life-threatening human birth defects
Fatigue
Weakness
Low white blood cell count
Anemia
Constipation
Nausea

Pomalid 1mg capsules (pomalidomide) - Buy Pomalid 1mg capsules Online at best Price in India -apple pharmaceuticals

Pomalid (pomalidomide) 1mg is a Natco pharma product which is endorsed by FDA, containing an active anti-cancer drug called pomalidomide. Pomalid(pomalyst) 1mg is available as orally bioavailable thalidomide derivative with various therapeutic activities such as; Immuno modulatory Anti-angiogenesis Anti-neoplastic Pomalid(pomalidomide) 1mg is similar to thalidomide & Lenalidomide with related to decreased rate of serum aminotransferase elevations during treatment. This may leads to severe liver injury.Pomalid(pomalyst) 1mg is involved in the treatment for regression & unmanageable multiple myeloma.Pomalid(pomalidomide) 1mg is used in the patients who are failing to response for Lenalidomide treatment.Pomalid(pomalyst) 1mg is used in combination with dexamethasone.

INDICATION

The major therapeutic indication of Pomalid(pomalidomide) 1mg is involved in the treatment of multiple myeloma.
This treatment is occurred by combining with dexamethasone for reducing the side effect associated with Pomalid(pomalyst) 1mg
Pomalid(pomalidomide) 1mg is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.

pomalid 1mg capsule 

DOSAGE & ADMINISTRATION

During hematological toxicities;

Neutropenia :

ANC (absolute neutrophils count) <500/mcl: Postpone the Pomalid therapy and provide CBC weekly ANC more than or equal to 500/mcl: Continue the Pomalid 3mg daily.

Thrombocytopenia :

Platelets count <25,000/mcL: postpone the Pomalid capsule treatment & follow the CBC >50,000/mcL: continue 3mg of Pomalid capsule
Pomalid(pomalidomide) 1mg with potent CYP1A2 inhibitor :
During this combination reduce the dose of Pomalid by 50%

In renal impairment :

Initial dose of Pomalid(pomalidomide) is 3mg

In hepatic impairment :

Mild to moderate condition, an initial dose of Pomalid(pomalyst) is 3mg; in severe condition, the initial dose of Pomalid(pomalidomide) is 2mg.

POMALID 1MG WORKS

Pomalid(pomalyst) 1mg exhibits various activities like;
Anti-neoplastic activity

Prohibits proliferation Promote apoptosis of hematopoietic cancer cells Co adjuvant with dexamethasone in both Lenalidomide sensitive & resistant myeloma cells to activate the tumor cell apoptosis
Immuno modulatory

Boosted the T-cells & natural killer cell mediate immunity. The drug is prohibited the formation of pro-inflammatory cytokines by monocytes.
Anti-angiogenesis

Interfere with formation of new vessels and leads to inhibit the cell division.

WARNING

There are two major worsening condition may occur during the treatment using with Pomalid(pomalidomide) 1mg.
Embryo fetal damage

Pomalid(pomalyst) 1mg capsules are contraindicated to pregnancy period. During the treatment, patients avoid to becoming pregnant. Use effective contraceptives for preventing pregnancy during therapy.
Venous & arterial thromboembolism

Patient who are receiving Pomalid(pomalidomide)1mg capsules have chance of getting deep vein thrombosis, pulmonary embolism, myocardial infarction & stroke. This type of condition should be treated by initiating prophylactic anti-thrombotic drugs. The patients who are acquiring this condition then thromboprophylaxis should be provided

DRUG INTERACTION

Pomalidomide(pomalyst) metabolism is mediated by CYP1A2 & CYP3A4. The concomitant use of Pomalid 1mg with CYP1A2 drugs like Fluoxamine causes elevation of Cmax & AUC of Pomalidomide and concludes as increased concentration of Pomalid capsule leads to higher extent of adverse effects associated with Pomalid In this condition, reduce the dose of Pomalid(pomalidomide) 1mg and recommended.

Lenalidomide - Lenangio 25mg tablet online | Myapplepharma

Lenangio 25mg is belongs to anticancer medication which contains Lenalidomide as an active substance which belongs to thalidomide analogue.
Lenangio 25mg is used to the disease condition by combining with dexamethasone.
Lenangio 25mg consist of some other pharmacological activities like immuno modulatory & anti-angiogenesis.
Lenangio 25mg is a prescription drug that can only use under the supervision of medical oncologist.

INDICATION

The indications of Lenangio 25mg are;
Lenangio combination with dexamethasone is indicated to treat the patients suffered from multiple myeloma
Lenangio is indicated for the patients having transfusion-dependent anemia because of intermediate 1 risk myelodysplastic syndrome along with deletion 5q cytogenetic abnormality without or without addition cytogenetic abnormalities
Lenangio is used to treat the patients with mantle cell lymphoma in which its used whose the disease was relapsed or progressed after two before treatment, especially the disease not response with the bortezomib therapy.

The adult usual dose of Lenangio 25mg in myelodysplastic syndromes is 10mg and administrated once a day.
For renal damaged patients;
CrCl >60ml/min In Patients should not needed dosage adjustment of Lenangio
CrCl 30 to 60ml/min In Patients, 5mg of Lenangio should administer orally as once daily
CrCl <30ml/min In Patient, 2.5mg of Lenangio should be given orally as a once daily.
Dosage variation;
Thrombocytopenia:
Drops to <50000/mcL, treatment should be interrupted. Back to > or equal to 50000/mcL, follow the Lenangio of 5mg per day.
Neutropenia;
Drops to <500/mcL, treatment should be delayed. Back to > or equal to 500/mcL, treatment should be follow to 5mg per day.
Multiple myeloma;
In this disease, concomitant use of dexamethasone with Lenangio. The regular dose of Lenangio is 25mg should be given as once in a day on day 1 to 21.
The dose of dexamethasone;
Dexamethasone 40mg should be continued on day 1 to 4, 9 to 12 & 17 to 20 of each period of 28-day cycles. Patient with greater than 75 years, dexamethasone 20mg should be prescribed on day 1, 8, 15, & 22.
Mantle cell lymphoma;
The usual dose of Lenangio for this disease is 25mg should be given orally as once daily.
For renal damaged patients;
CrCl 30 to 60ml/min in patient, Lenangio 10mg should be given as once daily. CrCl <30ml/min in patients, Lenangio 15mg should be used for q48hr.
Pediatrics;
The safety & efficiency of Lenalidomide has not been described in pediatric patients with age of <18 years.

MECHANISM

Lenangio 25mg involves in the prudence of tumor and factor alpha arrangement, that reinforcement the T-cells and leads to lessening plasma levels of cytokines vascular endothelial growth factor and fundamental fibroblast growth factor.
Lenangio 25mg is moreover engaged with the stave off angiogenesis.
Lenalidomide is furthermore authorized G1 cell cycle capture and apoptosis of ruinous cells.

PHARMACOKINETICS

Absorption:

Absorbed rapidly with peak plasma concentration is between 0.625 and 1.5 hrs. combining with food will not change the prolong of absorption but dose decrease in Cmax.

Distribution:

Bounding of plasma protein is 30%

Metabolism:

Mainly metabolized in two metabolites is hydroxy-lenalidomide and N-acetyl-lenalidomide.

Excretion:

Primarily eliminated in renal route and the dose excreted via urine 90% and feces 4% and half-life is 3hrs.

DRUG INTERACTION

Interaction of Lenangio 25mg with digoxin leads to increased concentration of digoxin causes increased risk of adverse effects related to digoxin.
Interaction of Lenangio 25mg with Erythropoietic agents, cause to produced rises in risk of thrombosis. Discuss with the patients prior to starting this combination treatment.
Interaction of Lenangio 25mg with warfarin, will produce increased exposure of hemorrhage disorders. check the INR value & prothrombin time.

CONTRAINDICATION

When pregnancy period the drug is contraindicated The patients are contraindicated to hypersensitivity reaction and the Lenangio 25mg component.

OVER DOSAGE

Over dosage of Lenangio 25mg will cause neutropenia & thrombocytopenia as mainly common side effects. Give the patient general supportive treatment. check the blood cells counts regularly during the treatment.

MISSED DOSE

The missed dose of Lenangio 25mg should be avoided. If missed dose founded, then patients should be consulting with doctor specialized in oncologist Regulate the usual dosing schedule.

SIDE EFFECTS

Second primary malignancies Hepatotoxicity , Hypersensitivity reactions, Thyroid dysfunction, Fetal toxicity, Hematological toxicity, Tumor lysis syndrome, Tumor flare reactions, Increase of mortality rate.
Common side effects;
Diabetes mellitus, Rash, Insomnia, Depression, Deep vein thrombosis, Myocardial infraction, Renal failure, Squamous cell carcinoma, Basal cell carcinoma, Fatigue, Asthenia, Pyrexia, Pain, Diarrhea, Dyspepsia, Bone pain, Neck pain, Respiratory infections, UTI, Influenza, Sepsis, Headache, Anemia, Loss of appetite, Hypokalemia, Hyperglycemia, Hypocalcaemia, Dehydration, Gout.

WARNING

The some of the common life-threatening condition like :
Venous & arterial thromboembolism
Blood clotting effects
Embryo fetal damage
Hypersensitivity reactions
Hematological disorders
For all these conditions, some supportive measures should be used and provide safety measures.

Lenalidomide - Lenangio 10mg tablet online | Myapplepharma

Lenangio 10mg is belongs to anticancer medication which contains Lenalidomide as an active substance which belongs to thalidomide analogue.
Lenangio 10mg is used to the disease condition by combining with dexamethasone.
Lenangio 10mg consist of some other pharmacological activities like immuno modulatory & anti-angiogenesis.
Lenangio 10mg is a prescription drug that can only use under the supervision of medical oncologist.

INDICATION

The indications of Lenangio 10mg are;
Lenangio combination with dexamethasone is indicated to treat the patients suffered from multiple myeloma
Lenangio is indicated for the patients having transfusion-dependent anemia because of intermediate 1 risk myelodysplastic syndrome along with deletion 5q cytogenetic abnormality without or without addition cytogenetic abnormalities
Lenangio is used to treat the patients with mantle cell lymphoma in which its used whose the disease was relapsed or progressed after two before treatment, especially the disease not response with the bortezomib therapy.

The adult usual dose of Lenangio 10mg in myelodysplastic syndromes is 10mg and administrated once a day.
For renal damaged patients;
CrCl >60ml/min In Patients should not needed dosage adjustment of Lenangio
CrCl 30 to 60ml/min In Patients, 5mg of Lenangio should administer orally as once daily
CrCl <30ml/min In Patient, 2.5mg of Lenangio should be given orally as a once daily.
Dosage variation;

Thrombocytopenia:

Drops to <50000/mcL, treatment should be interrupted. Back to > or equal to 50000/mcL, follow the Lenangio of 5mg per day.
Neutropenia;
Drops to <500/mcL, treatment should be delayed. Back to > or equal to 500/mcL, treatment should be follow to 5mg per day.
Multiple myeloma;
In this disease, concomitant use of dexamethasone with Lenangio. The regular dose of Lenangio is 25mg should be given as once in a day on day 1 to 21.
The dose of dexamethasone;
Dexamethasone 40mg should be continued on day 1 to 4, 9 to 12 & 17 to 20 of each period of 28-day cycles. Patient with greater than 75 years, dexamethasone 20mg should be prescribed on day 1, 8, 15, & 22.
Mantle cell lymphoma;
The usual dose of Lenangio for this disease is 25mg should be given orally as once daily.
For renal damaged patients;
CrCl 30 to 60ml/min in patient, Lenangio 10mg should be given as once daily. CrCl <30ml/min in patients, Lenangio 15mg should be used for q48hr.
Pediatrics;
The safety & efficiency of Lenalidomide has not been described in pediatric patients with age of <18 years.

MECHANISM

Lenangio 10mg involves in the prudence of tumor and factor alpha arrangement, that reinforcement the T-cells and leads to lessening plasma levels of cytokines vascular endothelial growth factor and fundamental fibroblast growth factor.
Lenangio 10mg is moreover engaged with the stave off angiogenesis.
Lenalidomide is furthermore authorize G1 cell cycle capture and apoptosis of ruinous cells.

PHARMACOKINETICS

Absorption:

Absorbed rapidly with peak plasma concentration is between 0.625 and 1.5 hrs. combining with food will not change the prolong of absorption but dose decrease in Cmax.

Distribution:

Bounding of plasma protein is 30%

Metabolism:

Mainly metabolized in two metabolites is hydroxy-lenalidomide and N-acetyl-lenalidomide.

Excretion:

Primarily eliminated in renal route and the dose excreted via urine 90% and feces 4% and half-life is 3hrs.

DRUG INTERACTION

Interaction of Lenangio 10mg with digoxin leads to increased concentration of digoxin causes increased risk of adverse effects related to digoxin.
Interaction of Lenangio 10mg with Erythropoietic agents, cause to produced rises in risk of thrombosis. Discuss with the patients prior to starting this combination treatment.
Interaction of Lenangio 10mg with warfarin, will produce increased exposure of hemorrhage disorders. check the INR value & prothrombin time.

CONTRAINDICATION

When pregnancy period the drug is contraindicated The patients are contraindicated to hypersensitivity reaction and the Lenangio 10mg component.

OVER DOSAGE

Over dosage of Lenangio 10mg will cause neutropenia & thrombocytopenia as mainly common side effects. Give the patient general supportive treatment. check the blood cells counts regularly during the treatment.

MISSED DOSE

The missed dose of Lenangio 10mg should be avoided. If missed dose founded, then patients should be consulting with doctor specialized in oncologist Regulate the usual dosing schedule.

SIDE EFFECTS

Second primary malignancies Hepatotoxicity , Hypersensitivity reactions, Thyroid dysfunction, Fetal toxicity, Hematological toxicity, Tumor lysis syndrome, Tumor flare reactions, Increase of mortality rate.
Common side effects;
Diabetes mellitus, Rash, Insomnia, Depression, Deep vein thrombosis, Myocardial infraction, Renal failure, Squamous cell carcinoma, Basal cell carcinoma, Fatigue, Asthenia, Pyrexia, Pain, Diarrhea, Dyspepsia, Bone pain, Neck pain, Respiratory infections, UTI, Influenza, Sepsis, Headache, Anemia, Loss of appetite, Hypokalemia, Hyperglycemia, Hypocalcaemia, Dehydration, Gout.

WARNING

The some of the common life-threatening condition like :
Venous & arterial thromboembolism
Blood clotting effects
Embryo fetal damage
Hypersensitivity reactions
Hematological disorders
For all these conditions, some supportive measures should be used and provide safety measures.

Lenalidomide - Lenangio 5mg tablet online | Myapplepharma

Lenangio 5mg is belongs to anticancer medication which contains Lenalidomide as an active substance which belongs to thalidomide analogue.
Lenangio 5mg is used to the disease condition by combining with dexamethasone.
Lenangio 5mg consist of some other pharmacological activities like immuno modulatory & anti-angiogenesis.
Lenangio 5mg is a prescription drug that can only use under the supervision of medical oncologist.

INDICATION

The indications of Lenangio 5mg are;
Lenangio combination with dexamethasone is indicated to treat the patients suffered from multiple myeloma
Lenangio  is indicated for the patients having transfusion-dependent anemia because of intermediate 1 risk myelodysplastic syndrome along with deletion 5q cytogenetic abnormality without or without addition cytogenetic abnormalities
Lenangio is used to treat the patients with mantle cell lymphoma in which its used whose the disease was relapsed or progressed after two before treatment, especially the disease not response with the bortezomib therapy.

The adult usual dose of Lenangio 5mg capsule in myelodysplastic syndromes is 10mg and administrated once a day.
For renal damaged patients;
CrCl >60ml/min In Patients should not needed dosage adjustment of Lenangio
CrCl 30 to 60ml/min In Patients, 5mg of Lenangio should administer orally as once daily
CrCl <30ml/min In Patient, 2.5mg of Lenangio should be given orally as a once daily.
Dosage variation;

Thrombocytopenia:

Drops to <50000/mcL, treatment should be interrupted. Back to > or equal to 50000/mcL, follow the Lenangio of 5mg per day.
Neutropenia;
Drops to <500/mcL, treatment should be delayed. Back to > or equal to 500/mcL, treatment should be follow to 5mg per day.
Multiple myeloma;
In this disease, concomitant use of dexamethasone with Lenangio. The regular dose of Lenangio is 25mg should be given as once in a day on day 1 to 21.
The dose of dexamethasone;
Dexamethasone 40mg should be continued on day 1 to 4, 9 to 12 & 17 to 20 of each period of 28-day cycles. Patient with greater than 75 years, dexamethasone 20mg should be prescribed on day 1, 8, 15, & 22.
Mantle cell lymphoma;
The usual dose of Lenangio for this disease is 25mg should be given orally as once daily.
For renal damaged patients;
CrCl 30 to 60ml/min in patient, Lenangio 10mg should be given as once daily. CrCl <30ml/min in patients, Lenangio 15mg should be used for q48hr.
Pediatrics;
The safety & efficiency of Lenalidomide has not been described in pediatric patients with age of <18 years.

MECHANISM

Lenangio 5mg involves in the prudence of tumor and factor alpha arrangement, that reinforcement the T-cells and leads to lessening plasma levels of cytokines vascular endothelial growth factor and fundamental fibroblast growth factor.
Lenangio 5mg is moreover engaged with the stave off angiogenesis.
Lenalidomide is furthermore authorized G1 cell cycle capture and apoptosis of ruinous cells.

PHARMACOKINETICS

Absorption:

Absorbed rapidly with peak plasma concentration is between 0.625 and 1.5 hrs. combining with food will not change the prolong of absorption but dose decrease in Cmax.

Distribution:

Bounding of plasma protein is 30%

Metabolism:

Mainly metabolized in two metabolites is hydroxy-lenalidomide and N-acetyl-lenalidomide.

Excretion:

Primarily eliminated in renal route and the dose excreted via urine 90% and feces 4% and half-life is 3hrs

DRUG INTERACTION

Interaction of Lenangio 5mg with digoxin leads to increased concentration of digoxin causes increased risk of adverse effects related to digoxin.
Interaction of Lenangio 5mg with Erythropoietic agents, cause to produced rises in risk of thrombosis. Discuss with the patients prior to starting this combination treatment.
Interaction of Lenangio 5mg with warfarin, will produce increased exposure of hemorrhage disorders. check the INR value & prothrombin time.

CONTRAINDICATION

When pregnancy period the drug is contraindicated The patients are contraindicated to hypersensitivity reaction and the Lenangio 5mg component.

OVER DOSAGE

Over dosage of Lenangio 5mg will cause neutropenia & thrombocytopenia as mainly common side effects. Give the patient general supportive treatment. check the blood cells counts regularly during the treatment.

MISSED DOSE

The missed dose of Lenangio 5mg should be avoided. If missed dose founded, then patients should be consulting with doctor specialized in oncologist Regulate the usual dosing schedule.

SIDE EFFECTS

Second primary malignancies Hepatotoxicity , Hypersensitivity reactions, Thyroid dysfunction, Fetal toxicity, Hematological toxicity, Tumor lysis syndrome, Tumor flare reactions, Increase of mortality rate.
Common side effects;
Diabetes mellitus, Rash, Insomnia, Depression, Deep vein thrombosis, Myocardial infraction, Renal failure, Squamous cell carcinoma, Basal cell carcinoma, Fatigue, Asthenia, Pyrexia, Pain, Diarrhea, Dyspepsia, Bone pain, Neck pain, Respiratory infections, UTI, Influenza, Sepsis, Headache, Anemia, Loss of appetite, Hypokalemia, Hyperglycemia, Hypocalcaemia, Dehydration, Gout.

WARNING

The some of the common life-threatening condition like :
Venous & arterial thromboembolism
Blood clotting effects
Embryo fetal damage
Hypersensitivity reactions
Hematological disorders
For all these conditions, some supportive measures should be used and provide safety measures.

POMALID 4mg  

Pomalid (pomalidomide)4mg is a Natco pharma product which is endorsed by FDA, containing an active anti-cancer drug called pomalidomide. Pomalid(pomalyst) 4mg is available as orally bioavailable thalidomide derivative with various therapeutic activities such as; Immuno modulatory Anti-angiogenesis Anti-neoplastic Pomalid(pomalidomide) 4mg is similar to thalidomide & Lenalidomide with related to decreased rate of serum aminotransferase elevations during treatment. This may leads to severe liver injury.Pomalid 4mg is involved in the treatment for regression & unmanageable multiple myeloma.Pomalid(pomalidomide) 4mg is used in the patients who are failing to response for Lenalidomide treatment.Pomalid(pomalyst) 4mg is used in combination with dexamethasone.

INDICATION

The major therapeutic indication of Pomalid(pomalidomide) 4mg is involved in the treatment of multiple myeloma. This treatment is occurred by combining with dexamethasone for reducing the side effect associated with Pomalid 4mgomide. Pomalid 4mg capsule is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.
During hematological toxicities

Neutropenia :

ANC (absolute neutrophils count) <500/mcl: Postpone the Pomalid therapy and provide CBC weekly ANC more than or equal to 500/mcl: Continue the Pomalid 3mg capsule  daily.

Thrombocytopenia :

Platelets count <25,000/mcL: postpone the Pomalid treatment & follow the CBC >50,000/mcL: continue 3mg of Pomalid
Pomalid(pomalidomide) 4mg with potent CYP1A2 inhibitor :
During this combination reduce the dose of Pomalid by 50%

In renal impairment :

Initial dose of Pomalid(pomalyst) is 3mg

In hepatic impairment :

Mild to moderate condition, an initial dose of Pomalid is 3mg; in severe condition, the initial dose of Pomalid is 2mg.
Pomalid(pomalidomide) 4mg WORKS

Pomalid 4mg exhibits various activities like;
Anti-neoplastic activity

Prohibits proliferation Promote apoptosis of hematopoietic cancer cells Co adjuvant with dexamethasone in both Lenalidomide sensitive & resistant myeloma cells to activate the tumor cell apoptosis
Immuno modulatory

Boosted the T-cells & natural killer cell mediate immunity. The drug is prohibited the formation of pro-inflammatory cytokines by monocytes.
Anti-angiogenesis

Interfere with formation of new vessels and leads to inhibit the cell division.

WARNING

There are two major worsening condition may occur during the treatment using with Pomalid(pomalidomide) 4mg.
Embryo fetal damage

Pomalid(pomalyst) 4mg capsules are contraindicated to pregnancy period. During the treatment, patients avoid to becoming pregnant. Use effective contraceptives for preventing pregnancy during therapy.
Venous & arterial thromboembolism

Patient who are receiving Pomalid(pomalidomide) 4mg capsules have chance of getting deep vein thrombosis, pulmonary embolism, myocardial infarction & stroke. This type of condition should be treated by initiating prophylactic anti-thrombotic drugs. The patients who are acquiring this condition then thromboprophylaxis should be provided

CONTRAINDICATION

Pomalid(pomalidomide) 4mg should be contraindicated to pregnancy & lactating women. The pregnancy category of Pomalid 4mg is X.

DRUG INTERACTION

Pomalidomide metabolism is mediated by CYP1A2 & CYP3A4. The concomitant use of Pomalid 4mg with CYP1A2 drugs like Fluoxamine causes elevation of Cmax & AUC of Pomalidomide and concludes as increased concentration of Pomalid leads to higher extent of adverse effects associated with Pomalid In this condition, reduce the dose of Pomalid(pomalidomide) 4mg and recommended.

Pomalid 2mg 

Pomalid(pomalidomide) 2mg is a Natco pharma product which is endorsed by FDA, containing an active anti-cancer drug called pomalidomide. Pomalid(pomalyst) 2mg is available as orally bioavailable thalidomide derivative with various therapeutic activities such as; Immuno modulatory Anti-angiogenesis Anti-neoplastic Pomalid(pomalidomide) 2mg is similar to thalidomide & Lenalidomide with related to decreased rate of serum aminotransferase elevations during treatment. This may leads to severe liver injury.Pomalid(pomalyst) 2mg is involved in the treatment for regression & unmanageable multiple myeloma.Pomalid(pomalidomide) 2mg is used in the patients who are failing to response for Lenalidomide treatment.Pomalid(pomalyst) 2mg is used in combination with dexamethasone.

INDICATION

The major therapeutic indication of Pomalid 2mg is involved in the treatment of multiple myeloma. This treatment is occurred by combining with dexamethasone for reducing the side effect associated with Pomalid(pomalyst) 2mg pomalidomide. Pomalid(pomalidomide) 2mg is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.
During hematological toxicities

Neutropenia :

ANC (absolute neutrophils count) <500/mcl: Postpone the Pomalid therapy and provide CBC weekly ANC more than or equal to 500/mcl: Continue the Pomalid 3mg daily.

Thrombocytopenia :

Platelets count <25,000/mcL: postpone the Pomalid treatment & follow the CBC >50,000/mcL: continue 3mg of Pomalid
Pomalid(pomalidomide) 2mg with potent CYP1A2 inhibitor :
During this combination reduce the dose of Pomalid(pomalyst) by 50%

In renal impairment :

Initial dose of Pomalid is 3mg

In hepatic impairment :

Mild to moderate condition, an initial dose of Pomalid(pomalyst) is 3mg; in severe condition, the initial dose of Pomalid(pomalidomide) is 2mg.
Pomalid(pomalidomide) 2mg WORKS

Pomalid(pomalyst) 2mg exhibits various activities like;
Anti-neoplastic activity

Prohibits proliferation Promote apoptosis of hematopoietic cancer cells Co adjuvant with dexamethasone in both Lenalidomide sensitive & resistant myeloma cells to activate the tumor cell apoptosis
Immuno modulatory

Prohibits proliferation Boosted the T-cells & natural killer cell mediate immunity. The drug is prohibited the formation of pro-inflammatory cytokines by monocytes.
Anti-angiogenesis

Prohibits proliferation Interfere with formation of new vessels and leads to inhibit the cell division.

WARNING

There are two major worsening condition may occur during the treatment using with Pomalid 2mg.
Embryo fetal damage

Pomalid(pomalidomide) 2mg capsules are contraindicated to pregnancy period. During the treatment, patients avoid to becoming pregnant. Use effective contraceptives for preventing pregnancy during therapy.
Venous & arterial thromboembolism

Patient who are receiving Pomalid(pomalidomide) 2mg capsules have chance of getting deep vein thrombosis, pulmonary embolism, myocardial infarction & stroke. This type of condition should be treated by initiating prophylactic anti-thrombotic drugs. The patients who are acquiring this condition then thromboprophylaxis should be provided

DRUG INTERACTION

Pomalidomide? metabolism is mediated by CYP1A2 & CYP3A4. The concomitant use of Pomalid(pomalidomide) 2mg with CYP1A2 drugs like Fluoxamine causes elevation of Cmax & AUC of Pomalidomide and concludes as increased concentration of Pomalid leads to higher extent of adverse effects associated with Pomalid In this condition, reduce the dose of Pomalid 2mg and recommended.

CONTRAINDICATION

Pomalid 2mg capsuel should be contraindicated to pregnancy & lactating women. The pregnancy category of Pomalid(pomalyst) 2mg is X.

POMALID 1mg

Pomalid (pomalidomide) 1mg is a Natco pharma product which is endorsed by FDA, containing an active anti-cancer drug called pomalidomide. Pomalid(pomalyst) 1mg is available as orally bioavailable thalidomide derivative with various therapeutic activities such as; Immuno modulatory Anti-angiogenesis Anti-neoplastic Pomalid(pomalidomide) 1mg is similar to thalidomide & Lenalidomide with related to decreased rate of serum aminotransferase elevations during treatment. This may leads to severe liver injury. Pomalid(pomalyst) 1mg is involved in the treatment for regression & unmanageable multiple myeloma. Pomalid(pomalidomide) 1mg is used in the patients who are failing to response for Lenalidomide treatment.Pomalid(pomalyst) 1mg is used in combination with dexamethasone.

INDICATION

The major therapeutic indication of Pomalid(pomalidomide) 1mg is involved in the treatment of multiple myeloma.
This treatment is occurred by combining with dexamethasone for reducing the side effect associated with Pomalid(pomalyst) 1mg
Pomalid(pomalidomide) 1mg is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.

DOSAGE & ADMINISTRATION

During hematological toxicities;

Neutropenia :

ANC (absolute neutrophils count) <500/mcl: Postpone the Pomalid therapy and provide CBC weekly ANC more than or equal to 500/mcl: Continue the Pomalid 3mg daily.

Thrombocytopenia :

Platelets count <25,000/mcL: postpone the Pomalid treatment & follow the CBC >50,000/mcL: continue 3mg of Pomalid
Pomalid(pomalidomide) 1mg with potent CYP1A2 inhibitor :
During this combination reduce the dose of Pomalid by 50%

In renal impairment :

Initial dose of Pomalid(pomalidomide) is 3mg

In hepatic impairment :

Mild to moderate condition, an initial dose of Pomalid(pomalyst) is 3mg; in severe condition, the initial dose of Pomalid(pomalidomide) is 2mg.

POMALID 1MG WORKS

Pomalid(pomalyst) 1mg exhibits various activities like;
Anti-neoplastic activity

Prohibits proliferation Promote apoptosis of hematopoietic cancer cells Co adjuvant with dexamethasone in both Lenalidomide sensitive & resistant myeloma cells to activate the tumor cell apoptosis
Immuno modulatory

Boosted the T-cells & natural killer cell mediate immunity. The drug is prohibited the formation of pro-inflammatory cytokines by monocytes.
Anti-angiogenesis

Interfere with formation of new vessels and leads to inhibit the cell division.

WARNING

There are two major worsening condition may occur during the treatment using with Pomalid(pomalidomide) 1mg.
Embryo fetal damage

Pomalid(pomalyst) 1mg capsules are contraindicated to pregnancy period. During the treatment, patients avoid to becoming pregnant. Use effective contraceptives for preventing pregnancy during therapy.
Venous & arterial thromboembolism

Patient who are receiving Pomalid(pomalidomide)1mg capsules have chance of getting deep vein thrombosis, pulmonary embolism, myocardial infarction & stroke. This type of condition should be treated by initiating prophylactic anti-thrombotic drugs. The patients who are acquiring this condition then thromboprophylaxis should be provided

DRUG INTERACTION

Pomalidomide(pomalyst) metabolism is mediated by CYP1A2 & CYP3A4. The concomitant use of Pomalid 1mg with CYP1A2 drugs like Fluoxamine causes elevation of Cmax & AUC of Pomalidomide and concludes as increased concentration of Pomalid leads to higher extent of adverse effects associated with Pomalid In this condition, reduce the dose of Pomalid(pomalidomide) 1mg and recommended.

Lenalid 15mg 

Lenalid is belongs to anticancer medication which contains Lenalidomide as an active substance which belongs to thalidomide analogue, the main ingredient which is used as lenalidomide . Lenalid 15mg is used to the disease condition by combining with dexamethasone. Lenalid 15mg consist of some other pharmacological activities like immuno modulatory & anti-angiogenesis. Lenalid 15mg is a prescription drug that can only use under the supervision of medical oncologist.

INDICATION

The indications of Lenalid 15mg are; Lenalid (Lenalidomide) combination with dexamethasone is indicated to treat the patients suffered from multiple myeloma Lenalid is indicated for the patients having transfusion-dependent anemia because of intermediate 1 risk myelodysplastic syndrome along with deletion 5q cytogenetic abnormality without or without addition cytogenetic abnormalities Lenalid (Lenalidomide) is used to treat the patients with mantle cell lymphoma in which its used whose the disease was relapsed or progressed after two before treatment, especially the disease not response with the bortezomib therapy.

MECHANISM

Lenalid 15mg involves in the prudence of tumor and factor alpha arrangement, that reinforcement the T-cells and leads to lessening plasma levels of cytokines vascular endothelial growth factor and fundamental fibroblast growth factor. Lenalid (Lenalidomide) 15mg is moreover engaged with the stave off angiogenesis. Lenalidomide is furthermore authorize G1 cell cycle capture and apoptosis of ruinous cells.

The adult usual dose of Lenalid 15mg capsule  in myelodysplastic syndromes is 10mg and adminisrated once a day. For renal damaged patients; CrCl>60ml/min In Patients should not needed dosage adjustment of Lenalid(Lenalidomide) CrCl 30 to 60ml/min In Patients, 5mg of Lenalid should administre orally as once daily CrCl<30ml/min In Patient, 2.5mg of Lenalid(Lenalidomide) should be given orally as a once daily. Dosage variation;

Thrombocytopenia:

Drops to <50000/mcL, treatment should be interrupted. Back to > or equal to 50000/mcL, follow the Lenalid(Lenalidomide) of 5mg per day.
Neutropenia;
Drops to <500/mcL, treatment should be delayed. Back to > or equal to 500/mcL, treatment should be follow to 5mg per day.
Multiple myeloma;
In this disease, concomitant use of dexamethasone with Lenalid(Lenalidomide). The regular dose of Lenalid(Lenalidomide) is 25mg should be given as once in a day on day 1 to 21. The dose of dexamethasone; Dexamethasone 40mg should be continued on day 1 to 4, 9 to 12 & 17 to 20 of each period of 28-day cycles. Patient with greater than 75 years, dexamethasone 20mg should be prescribed on day 1, 8, 15, & 22.

PHARMACOKINETICS

Absorption:

absorbed rapidly withpeak plasma concentration is between 0.625 and 1.5 hrs. combining with food will not change the prolong of absorption but dose decrease in Cmax.

Distribution:

bounding of plasma protein is 30%

Metabolism:

mainly metabolized in two metabolites is hydroxy-lenalidomide and N-acetyl-lenalidomide.

Elimination:

primarily eliminated in renal route and the dose excreted via urine 90% and feces 4% and half-life is 3hrs

MANTLE CELL LYMPHOMA

The usual dose of Lenalid(Lenalidomide) for this disease is 25mg should be given orally as once daily. For renal damaged patients; CrCl 30 to 60ml/min in patient, Lenalid 10mg should be given as once daily. CrCl<30ml/min in patients, Lenalid(Lenalidomide) 15mg should be used for q48hr. Pediatrics; The safety & efficiency of Lenalidomide has not been decribed in pediatric patients with age of <18 years.

DRUG INTERACTIONS

Interaction of Lenalid(Lenalidomide) 15mg with digoxin leads to increased concentration of digoxin causes increased risk of adverse effects related to digoxin. Interaction of Lenalid 15mg with Erythropoietic agents, cause to produced rises in risk of thrombosis. Discuss with the patients prior to starting this combination treatment. Interaction of Lenalid(Lenalidomide) 15mg with warfarin, will produce increased exposure of hemorrhage disorders. check the INR value & prothrombin time.

CONTRAINDICATION

When pregnancy period the drug is contraindicated The patients are contraindicated to hypersensitivity reaction and the Lenalid 15mg component.

MISSED DOSE

The missed dose of Lenalid(Lenalidomide) 15mg should be avoided. If missed dose founded, then patients should be consulting with doctor specialized in oncologist Regulate the usual dosing schedule.

OVER DOSAGE

Over dosage of Lenalid(Lenalidomide) 15mg will cause neutropenia & thrombocytopenia as mainly common side effects. Give the patient general supportive treatment. check the blood cells counts regularily during the treatment.

SIDE EFFECTS

Second primary malignancies :

Hepatotoxicity , Hypersensitivity reactions, Thyroid dysfunction, Fetal toxicity, Hematological toxicity, Tumor lysis syndrome, Tumor flare reactions, Increase of mortality rate.
Common side effects;
Diabetes mellitus, Rash, Insomnia, Depression, Deep vein thrombosis, Myocardial infraction, Renal failure, Squamous cell carcinoma, Basal cell carcinoma, Fatigue, Asthenia, Pyrexia, Pain, Diarrhea, Dyspepsia, Bone pain, Neck pain, Respiratory infections, UTI, Influenza, Sepsis, Headache, Anemia, Loss of appetite, Hypokalemia, Hyperglycemia, Hypocalcaemia, Dehydration, Gout.

WARNING

The some of the common life-threatening condition like :
Venous & arterial thromboembolism
Blood clotting effects
Embryo fetal damage
Hypersensitivity reactions
Hematological disorders
For all these conditions, some supportive measures should be used and provide safety measures.

Lenalid 10mg 

Lenalid(lenalidomide ) is belongs to anticancer medication which contains Lenalidomide as an active substance which belongs to thalidomide analogue, the main ingredient which is used as lenalidomide .Lenalid 10mg is used to the disease condition by combining with dexamethasone. Lenalid 10mg(lenalidomide ) consist of some other pharmacological activities like immuno modulatory & anti-angiogenesis. Lenalid 10mg is a prescription drug that can only use under the supervision of medical oncologist.

lenalid 10mg

INDICATION

The indications of Lenalid 10mg capsule are; Lenalid(lenalidomide ) combination with dexamethasone is indicated to treat the patients suffered from multiple myeloma Lenalid  is indicated for the patients having transfusion-dependent anemia because of intermediate 1 risk myelodysplastic syndrome along with deletion 5q cytogenetic abnormality without or without addition cytogenetic abnormalities Lenalid(lenalidomide ) is used to treat the patients with mantle cell lymphoma in which its used whose the disease was relapsed or progressed after two before treatment, especially the disease not response with the bortezomib therapy.

MECHANISM

Lenalid 10mg involves in the prudence of tumor and factor alpha arrangement, that reinforcement the T-cells and leads to lessening plasma levels of cytokines vascular endothelial growth factor and fundamental fibroblast growth factor. Lenalid 10mg(lenalidomide ) is moreover engaged with the stave off angiogenesis. Lenalidomide is furthermore authorize G1 cell cycle capture and apoptosis of ruinous cells.

The adult usual dose of Lenalid 10mg in myelodysplastic syndromes is 10mg and adminisrated once a day. For renal damaged patients; CrCl>60ml/min In Patients should not needed dosage adjustment of Lenalid(lenalidomide ) CrCl 30 to 60ml/min In Patients, 10mg of Lenalid should administre orally as once daily CrCl<30ml/min In Patient, 2.10mg of Lenalid(lenalidomide ) should be given orally as a once daily. Dosage variation;

Thrombocytopenia:

Drops to <50000/mcL, treatment should be interrupted. Back to > or equal to 50000/mcL, follow the Lenalid of 10mg per day.
Neutropenia;
Drops to <500/mcL, treatment should be delayed. Back to > or equal to 500/mcL, treatment should be follow to 10mg per day.
Multiple myeloma;
In this disease, concomitant use of dexamethasone with lenalid(lenalidomide ). The regular dose of Lenalidis 210mg should be given as once in a day on day 1 to 21. The dose of dexamethasone; Dexamethasone 40mg should be continued on day 1 to 4, 9 to 12 & 17 to 20 of each period of 28-day cycles. Patient with greater than 75 years, dexamethasone 20mg should be prescribed on day 1, 8, 15, & 22.

PHARMACOKINETICS

Absorption:

absorbed rapidly withpeak plasma concentration is between 0.625 and 1.5 hrs. combining with food will not change the prolong of absorption but dose decrease in Cmax.

Distribution:

bounding of plasma protein is 30%

Metabolism:

mainly metabolized in two metabolites is hydroxy-lenalidomide and N-acetyl-lenalidomide.

Excretion:

primarily eliminated in renal route and the dose excreted via urine 90% and feces 4% and half-life is 3hrs

MANTLE CELL LYMPHOMA

The usual dose of Lenalid for this disease is 210mg should be given orally as once daily. For renal damaged patients; CrCl 30 to 60ml/min in patient, Lenalid 10mg(lenalidomide ) should be given as once daily. CrCl<30ml/min in patients, Lenalid 10mg should be used for q48hr. Pediatrics; The safety & efficiency of Lenalidomide has not been decribed in pediatric patients with age of <18 years.

WARNING

Venous & arterial thromboembolism
Blood clotting effects
Embryo fetal damage
Hypersensitivity reactions
Hematological disorders
For all these conditions, some supportive measures should be used and provide safety measures.

CONTRAINDICATION

When pregnancy period the drug is contraindicated The patients are contraindicated to hypersensitivity reaction and the Lenalid 10mg(lenalidomide ) component.

MISSED DOSE

The missed dose of Lenalid 10mg(lenalidomide ) should be avoided. If missed dose founded, then patients should be consulting with doctor specialized in oncologist Regulate the usual dosing schedule.

OVER DOSAGE

Over dosage of Lenalid 10mg(lenalidomide ) will cause neutropenia & thrombocytopenia as mainly common side effects. Give the patient general supportive treatment. check the blood cells counts regularily during the treatment.

SIDE EFFECTS

Second primary malignancies :

Hepatotoxicity , Hypersensitivity reactions, Thyroid dysfunction, Fetal toxicity, Hematological toxicity, Tumor lysis syndrome, Tumor flare reactions, Increase of mortality rate.
Common side effects;
Diabetes mellitus, Rash, Insomnia, Depression, Deep vein thrombosis, Myocardial infraction, Renal failure, Squamous cell carcinoma, Basal cell carcinoma, Fatigue, Asthenia, Pyrexia, Pain, Diarrhea, Dyspepsia, Bone pain, Neck pain, Respiratory infections, UTI, Influenza, Sepsis, Headache, Anemia, Loss of appetite, Hypokalemia, Hyperglycemia, Hypocalcaemia, Dehydration, Gout.

 Lenalid 5mg

The indications of Lenalid 5mg are; Lenalid ( lenalidomide) combination with dexamethasone is indicated to treat the patients suffered from multiple myeloma, the main ingredient which is used as lenalidomide .Lenalid is indicated for the patients having transfusion-dependent anemia because of intermediate 1 risk myelodysplastic syndrome along with deletion 5q cytogenetic abnormality without or without addition cytogenetic abnormalities Lenalid( lenalidomide) is used to treat the patients with mantle cell lymphoma in which its used whose the disease was relapsed or progressed after two before treatment, especially the disease not response with the bortezomib therapy.

MECHANISM

Lenalid 5mg involves in the prudence of tumor and factor alpha arrangement, thatreinforcement the T-cells and leads to lessening plasma levels of cytokines vascular endothelial growth factor and fundamental fibroblast growth factor. Lenalid 5mg is moreover engaged with the stave off angiogenesis. Lenalidomide is furthermoreauthorize G1 cell cycle capture and apoptosis of ruinous cells.

The adult usual dose of Lenalid( lenalidomide) 5mg in myelodysplastic syndromes is 10mg and adminisrated once a day. For renal damaged patients; CrCl>60ml/minIn Patients should not needed dosage adjustment of Lenalid CrCl 30 to 60ml/minIn Patients, 5mg of Lenalid( lenalidomide) should administre orally as once daily CrCl<30ml/minIn Patient, 2.5mg of Lenalid should be given orally as a once daily. Dosage variation;

Thrombocytopenia:

Drops to <50000/mcL, treatment should be interrupted. Back to > or equal to 50000/mcL, follow the Lenalid( lenalidomide) of 5mg per day.
Neutropenia;
Drops to <500/mcL, treatment should be delayed. Back to > or equal to 500/mcL, treatment should be follow to 5mg per day.
Multiple myeloma
In this disease, concomitant use of dexamethasone with Lenalid. The regular dose of Lenalid( lenalidomide)is 25mg should be given as once in a day on day 1 to 21. The dose of dexamethasone; Dexamethasone 40mg should be continued on day 1 to 4, 9 to 12 & 17 to 20 of each period of28-day cycles. Patient with greater than 75 years, dexamethasone20mg should be prescribed on day 1, 8, 15, & 22.

PHARMACOKINETICS

Absorption:

absorbed rapidly withpeak plasma concentration is between 0.625 and 1.5 hrs. combining with food will not change the prolong of absorption but dose decrease in Cmax.

Distribution:

bounding of plasma protein is 30%

Metabolism:

mainly metabolized in two metabolites is hydroxy-lenalidomide and N-acetyl-lenalidomide.

Excretion:

primarily eliminated in renal route and the dose excreted via urine 90% and feces 4% and half-life is 3hrs

MANTLE CELL LYMPHOMA

Mantle cell lymphoma
The usual dose of Lenalid( lenalidomide) for this disease is 25mg should be given orally as once daily. For renal damaged patients; CrCl 30 to 60ml/min in patient, Lenalid 10mg should be given as once daily. CrCl<30ml/min in patients, Lenalid capsule ( lenalidomide) 15mg should be used for q48hr. Pediatrics; The safety&efficiency of Lenalidomide has not been decribed in pediatric patients with age of <18 years.

DRUG INTERACTION

Interaction of Lenalid( lenalidomide) 5mg with digoxin leads to increased concentration of digoxin causes increased risk of adverse effects related to digoxin. Interaction of Lenalid 5mg with Erythropoietic agents, cause to produced rises in risk of thrombosis. Discuss with the patients prior to starting this combination treatment. Interaction of Lenalid 5mg capsule ( lenalidomide) 5mgwith warfarin, will produce increased exposure of hemorrhage disorders. check the INR value & prothrombin time.

OVER DOSAGE

Over dosage of Lenalid( lenalidomide) 5mgwill cause neutropenia& thrombocytopenia as mainly common side effects. Give the patient general supportive treatment. check the blood cells counts regularily during the treatment.

MISSED DOSE

The missed dose of Lenalid( lenalidomide) 5mg should be avoided. If missed dose founded, then patients should be consulting with doctor specialized in oncologist Regulate theusual dosing schedule.

CONTRAINDICATION

When pregnancy period the drug is contraindicated The patients are contraindicated to hypersensitivity reaction and the Lenalid ( lenalidomide) 5mg component.

SIDE EFFECTS

Second primary malignancies Hepatotoxicity , Hypersensitivity reactions, Thyroid dysfunction, Fetal toxicity, Hematological toxicity, Tumor lysis syndrome, Tumor flare reactions, Increase of mortality rate.
Common side effects;
Diabetes mellitus, Rash, Insomnia, Depression, Deep vein thrombosis, Myocardial infraction, Renal failure, Squamous cell carcinoma, Basal cell carcinoma, Fatigue, Asthenia, Pyrexia, Pain, Diarrhea, Dyspepsia, Bone pain, Neck pain, Respiratory infections, UTI, Influenza, Sepsis, Headache, Anemia, Loss of appetite, Hypokalemia, Hyperglycemia, Hypocalcaemia, Dehydration, Gout.

WARNING

The some of the common life-threatening condition like
Venous & arterial thromboembolism
Blood clotting effects
Embryo fetal damage
Hypersensitivity reactions
Hematological disorders
For all these conditions, some supportive measures should be used and provide safety measures.

Cizumab  

Category: Monoclonal antibody or Anti-angiogenesis drug Bevacizumab is sold under the brand name Cizumab which belongs to vascular endothelial growth factor directed antibody, the main ingredient which is used as bevacizumab. Cizumab consist of human framework regions and murine complementarity-determining regions. Cizumab is a combined human monoclonal antibody IgG1, that predicament to and prohibits the biological activity of human vascular endothelial growth factor (VEGF)

INDICATION

Cizumab is indicated for the treatment :
• In combination with 5-fluorouracil chemotherapy administered intravenously, first or second line drug of choice for Metastatic colon or rectal cancer
• Concurrent use with carboplatin and paclitaxel as first line therapy for Non-squamous, non-small cell lung cancer
• Used in the treatment of recurrent Glioblastoma in adults
• Concurrent use with interferon alfa for Metastatic renal cell cancer
• Concurrent use with paclitaxel & cisplatin or paclitaxel & topotecan for Metastatic cervical cancer
• In combination with paclitaxel, pegylated liposomal doxorubicin or topotecan for Epithelial ovarian, fallopian tube or peritoneal cancer.

Key point :

Avoid administrating Cizumab before at least 28 days following surgery and the wound is completely cured

Metastatic colorectal carcinoma :

The Cizumab usual dosage by concomitant with 5-fluorouracil based chemotherapy. Cizumab 5mg/kg for every 2 weeks IV in concomitant with bolus IFL Cizumab 10mg/kg for every 2 weeks IV in combination with FOLFOX4 Cizumab 5mg/kg IV for every 2 weeks or Cizumab 7.5 mg/kg as IV every 3 weeks by concurrently take with fluoropyrimidine Irinotecan or fluoropyrimidine oxaliplatin based therapy

Non-small cell lung cancer :

The patients regular dosage of Cizumab is 15mg/kg IV for every 3 weeks by interacting with carboplatin and paclitaxel

Glioblastoma :

Cizumab 10mg/kg administered IV for every 2 weeks

Metastatic renal cell cancer :

Concurrent use with interferon alfa.: The usual dose of Cizumab is 10mg/kg IV for every 2 weeks

Metastatic cervical cancer :

The usual dose of Cizumab; Cizumab 15mg/kg given intravenously for every 3 weeks by combining with paclitaxel and cisplatin or with paclitaxel and topotecan

Epithelial ovarian, fallopian tube or peritoneal cancer :

The usual dose of Cizumab for Platinum opposing:; 10mg/kg of Cizumab for every 2 weeks by concurrent use with paclitaxel, pegylated liposomal doxorubicin or topotecan Or The regular dosage of Cizumab; 15mg/kg of Cizumab given through IV for every 3 weeks by combining with topotecan The usual dose of Cizumab for Platinum responsive; 15mg/kg given IV for 3 weeks in concomitant with carboplatin and paclitaxel for 6 to 8 cycles The recommended dosage of Cizumab; 15mg/kg of Cizumab given IV for 3 weeks by combining with gemcitabine & carboplatin for 6 to 10 cycles.

PHARMACOKINETICS

The pharmacokinetic form of Cizumab is assayed by measuring total serum Bevacizumab concentration.

Distribution :

The volume of distribution is 2.9 (22%) L

Elimination :

The terminal half life period of Bevacizumab is 20days (11 to 50days)

MECHANISM OF ACTION

Cizumab constitute an active ingredient like Bevacizumab which joined to VEGF and will not have communication of VEGF to its receptors like Flt-1 & KDR that present on the surface of the cells. While this interaction inhibits endothelial cell proliferation and new blood vessel production occurs Hence in counts discontinuation of metastatic tumor cells growth happens

PREPARATION & ADMINISTRATION

Cizumab is intravenous solution At initial infusion: given IV infusion over 90 minutes Following infusions: give second infusion over 60 minutes, if tolerated Administer all following infusion over 30minutes Cizumab IV infusion is prepared in aseptic condition Cizumab 400mg containing 16ml solution whereas 100mg containing 4ml Cizumab dilute into 100ml of 0.9% NS Do not dilute with dextrose solution Dispose the remaining drug which is left in a vial under guidance of pharmacist.

PRECAUTION

Caution with use in the conditions like ;
Previously If you have taking or ever had DPD (dihydropyrimidine dehydrogenase) deficiency of enzyme . Inform the doctor about this then your doctor may preferably inform you avoid taking Cizumab. Discuss with the doctor that you have or have ever had renal, hepatic, or cardiac problem Discuss with the doctor that are you pregnant or plan to become pregnant. Avoid planning to have children while on treatment with Cizumab. You should use a essential method of conceiving to prevent pregnancy in yourself or your partner during your treatment with Cizumab. The drug will harm the fetus. Avoid breast feeding while on treatment with Cizumab While using Cizumab these are some other complications occurred during therapy, care should be taken Hypertension Posterior reversible encephalopathy syndrome Gastrointestinal perforations Wound healing complications Hemorrhage Arterial thromboembolic events Venous thromboembolic events Embryo fetal toxicity occurs

MISSED DOSE

If patient fail to take the dose or missed the cycle means must consult with oncologist and follow the regular dosing schedule Do not take overdose

STORAGE

Cizumab vial should be stored at 2 to 8(36 to 46℃) Single use vial Discard the left out medicine under guidance of pharmacist

CONTRAINDICATION

No contraindication occurred

DRUG INTERACTION

While interaction of Cizumab with paclitaxel & Carboplatin, leads to lowering in exposure of paclitaxel after four cycles of therapy.

SIDE EFFECTS

Gastrointestinal perforation and fistulae
Surgery and wound healing complication
Hemorrhage
Arterial thromboembolic events
Venous thromboembolic events
Hypertension
Posterior reversible encephalopathy syndrome
Renal injury & Proteinuria
Infusion reactions
Ovarian failure
Congestive heart failure
Neutropenia, mucosal inflammation, infection, neuropathy, Epistaxis, erythrodysaesthesia.