Monday, July 8, 2019

Jakavi 25mg 


Jakavi 25mg belongs to the type of targeted therapy. It is an oral receptor tyrosine kinase inhibitor. It acts by inhibiting certain enzymes in the body which affect blood cell production.
Jakavi 25mg is prescription drug provided under supervision of doctors or pharmacists

INDICATION


Jakavi 25mg is indicated for the treatment in patients with intermediate and high-risk myelofibrosis.

DOSAGE


Myelofibrosis :

Kinase inhibitor uses for treatment of patients with intermediate or high-risk myelofibrosis, involving mainly myelofibrosis, post-PolycythemiaVera myelofibrosis and post-essential thrombocythemia myelofibrosis
Starting recommended doses for myelofibrosis
If Platelet count >200 x10^9/L the dose given is 20 mg PO BID
If Platelet count 100-200 x10^9/L the dose given is 15 mg PO BID
If Platelet count 50 to <100 x10^9/L the dose given is 5 mg PO BID
Titrate dose based on response; not to exceed 25 mg PO BID
Polycythemia Vera
The recommended dose is 10mg PO BID
Undergo CBC and platelet count prior starting and q2-4wk until doses are stabilized, and then as clinically used.

MECHANISM


Ruxolitinib is also knowns kinase inhibitor which is discriminating for the Janus analogue Kinases (JAK) 1 and 2. These kinases are required for the mediation of cytokine and growth factor signalling which in turn effect immune function and hematopoiesis.
The communicate process involves signal transducers and transcription activators (STAT) that modulate gene expression. Patients having myelofibrosis consist of abnormal JAK1 and JAK2 activity, Therefore Ruxolitinib function to regulate this.

PHARMACOKINETICS


Fast absorption and not affected by food maximum plasma level is 1.5 hours.
volume of distribution is 76.6 L plasma protein binding
Jakavi capsule  metabolized by CYP3A4
Jakavi eliminated via urine 74% and unchanged drug is <1% and through urine 22%,<1 % as unchanged drug

PRECAUTION


Treatment with Jakavi 25mg can resultedin thrombocytopenia, Anemia and neutropenia. Control thrombocytopenia by decreasing the dose or temporarily interfere with Jakavi 25mg. Platelet transfusions may be necessary.
Risk of infection occurs by delay initiate treatment with Jakavi 25mg capsule until active severe infection have resolved. Tuberculosis infection has been reported in patients receiving Jakavi 25mg. Observe patients receiving Jakavi 25mg capsule  for signs and symptoms of active tuberculosis and manage promptly.
Progressive multifocal leukoencephalopathy (PML) has occurred with Jakavi 25mg capsule treatment. If PML is suspected, stop Jakavi 25mg and evaluate
Non-melanoma skin cancers including basal cell, squamous cell, and Merkel cell carcinoma have occurred in patients treated with Jakavi 25mg. Perform periodic skin examinations.

DRUG INTERACTION


Concomitant use with fluconazole doses greater than 200mg daily may increase Ruxolitinib exposure leads to increase the risks of exposure related adverse reaction.
Interaction of Jakavi 25mg capsule with strong CYP3A4 inhibitors will increases Ruxolitinib exposure.
Interaction of Jakavi 25mg with strong CYP3A4 inducers will decreases Ruxolitinib exposure.

CONTRAINDICATION


Hypersensitivity

MISSED DOSE


If dose is missed the have the dose immediately before next dose timing reaches or skip the missed dose and continue the regular schedule. Consult doctors regarding missed dose. Avoid taking double the dose.

SIDE EFFECTS


• Bruising
• Swelling
• Neutropenia
• Dizziness
• Increased cholesterol
• Shortness of breath
• Nasopharyngitis
• Anemia
• Thrombocytopenia
• Increased liver enzymes
• Diarrhea
• Headache
• Constipation
• Nausea & Vomiting
• Insomnia.

Friday, July 5, 2019


Jakavi 10mg


Jakavi 10mg belongs to the type of targeted therapy. It is an oral receptor tyrosine kinase inhibitor. It acts by inhibiting certain enzymes in the body which affect blood cell production.
Jakavi 10mg is prescription drug provided under supervision of doctors or pharmacists


INDICATION


Jakavi 10mg is indicated for the treatment in patients with intermediate and high-risk myelofibrosis.


DOSAGE

Myelofibrosis :

Kinase inhibitor uses for treatment of patients with intermediate or high-risk myelofibrosis, involving mainly myelofibrosis, post-PolycythemiaVera myelofibrosis and post-essential thrombocythemia myelofibrosis
Starting recommended doses for myelofibrosis
If Platelet count >200 x10^9/L the dose given is 20 mg PO BID
If Platelet count 100-200 x10^9/L the dose given is 15 mg PO BID
If Platelet count 50 to <100 x10^9/L the dose given is 5 mg PO BID
Titrate dose based on response; not to exceed 25 mg PO BID
Polycythemia Vera
The recommended dose is 10mg PO BID
Undergo CBC and platelet count prior starting and q2-4wk until doses are stabilized, and then as clinically used.


MECHANISM


Ruxolitinib is also knowns kinase inhibitor which is discriminating for the Janus analogue Kinases (JAK) 1 and 2. These kinases are required for the mediation of cytokine and growth factor signalling which in turn effect immune function and hematopoiesis.
The communicate process involves signal transducers and transcription activators (STAT) that modulate gene expression. Patients having myelofibrosis consist of abnormal JAK1 and JAK2 activity, Therefore Ruxolitinib function to regulate this.


PHARMACOKINETICS


Fast absorption and not affected by food maximum plasma level is 1.5 hours.
volume of distribution is 76.6 L plasma protein binding
Jakavi metabolized by CYP3A4
Jakavi eliminated via urine 74% and unchanged drug is <1% and through urine 22%,<1 % as unchanged drug


PRECAUTION

Treatment with Jakavi 10mg can resultedin thrombocytopenia, Anemia and neutropenia. Control thrombocytopenia by decreasing the dose or temporarily interfere with Jakavi 10mg. Platelet transfusions may be necessary.
Risk of infection occurs by delay initiate treatment with Jakavi 10mg until active severe infection have resolved. Tuberculosis infection has been reported in patients receiving Jakavi 10mg. Observe patients receiving Jakavi 10mg for signs and symptoms of active tuberculosis and manage promptly.
Progressive multifocal leukoencephalopathy (PML) has occurred with Jakavi 10mg treatment. If PML is suspected, stop Jakavi 10mg and evaluate
Non-melanoma skin cancers including basal cell, squamous cell, and Merkel cell carcinoma have occurred in patients treated with Jakavi 10mg. Perform periodic skin examinations.


DRUG INTERACTION


Concomitant use with fluconazole doses greater than 200mg daily may increase Ruxolitinib exposure leads to increase the risks of exposure related adverse reaction.
Interaction of Jakavi 10mg with strong CYP3A4 inhibitors will increases Ruxolitinib exposure.
Interaction of Jakavi 10mg with strong CYP3A4 inducers will decreases Ruxolitinib exposure.


CONTRAINDICATION


Hypersensitivity


MISSED DOSE


If dose is missed the have the dose immediately before next dose timing reaches or skip the missed dose and continue the regular schedule. Consult doctors regarding missed dose. Avoid taking double the dose.


SIDE EFFECTS


• Bruising
• Swelling
• Neutropenia
• Dizziness
• Increased cholesterol
• Shortness of breath
• Nasopharyngitis
• Anemia
• Thrombocytopenia
• Increased liver enzymes
• Diarrhea
• Headache
• Constipation
• Nausea & Vomiting
• Insomnia.

ADDRESS


No. 24, K. M. A. Garden,
Industrial Estate Chinandimadam Kodungaiyur,
Chennai- 600118, Tamil Nadu, India.


CONTACT

Mail:info@beemainfratech.com

Phone:+91 9381028255, +91 9489004466, +91 9489004433, 044-25267437 / 42064966.

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ADDRESS

No. 24, K. M. A. Garden,
Industrial Estate Chinandimadam Kodungaiyur, 
Chennai- 600118, Tamil Nadu, India.

CONTACT

Mail:info@beemainfratech.com

Phone:+91 9381028255, +91 9489004466, +91 9489004433, 044-25267437 / 42064966.

Thursday, July 4, 2019

                                       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 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) 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.

                                        Pomalong 1mg


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


INDICATION


The major therapeutic indication of Pomalong 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 Pomalong 1mg omide.
Pomalong 1mg is majorly indicated in patients who are not reacts for prior two therapies like Lenalidomide & proteasome inhibitor.

DOSAGE & ADMINISTRATION


The prescribed dose of Pomalong in multiple myeloma is 4mg should be administered orally as once a day on day 1 to 21 of reciprocated 28-day cycles.
Pomalong 1mg should be concomitant with dexamethasone.
Pomalong 1mg Capsules should be taken with or without food.
During hematological toxicities:

Neutropenia:

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

Thrombocytopenia:

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

In renal impairment:

Initial dose of Pomalong is 3mg

In hepatic impairment:

Mild to moderate condition, an initial dose of Pomalong is 3mg; in severe condition, the initial dose of Pomalong is 2mg.

WORK AS


Pomalong 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 Pomalong 1mg.

Embryo fetal damage :

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

CONTRAINDICATION


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

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
Diarrhea
Shortness of breath
Upper respiratory infections
Back pain
Fever.
Less common effects :
Neuropathy
Dizziness
Confusion.

Wednesday, July 3, 2019

ABEVMY - 400MG / 16ML


Category: Monoclonal antibody or Anti-angiogenesis drug
Bevacizumab is sold under the brand name Abevmy 400mg which belongs to vascular endothelial growth factor directed antibody.
Abevmy 400mg consist of human framework regions and murine complementarity-determining regions.
Abevmy 400mg is a combined human monoclonal antibody IgG1, that predicament to and prohibits the biological activity of human vascular endothelial growth factor (VEGF)


INDICATION


Abevmy 400mg 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


DOSAGE


Key point:
Avoid administrating Abevmy before at least 28 days following surgery and the wound is completely cured
Metastatic colorectal carcinoma:
The Abevmy usual dosage by concomitant with 5-fluorouracil based chemotherapy.
Abevmy 5mg/kg for every 2 weeks IV in concomitant with bolus IFL
Abevmy 10mg/kg for every 2 weeks IV in combination with FOLFOX4
Abevmy 5mg/kg IV for every 2 weeks or Abevmy 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 patient’s regular dosage of Abevmy is 15mg/kg IV for every 3 weeks by interacting with carboplatin and paclitaxel

Glioblastoma:

Abevmy 10mg/kg administered IV for every 2 weeks
Metastatic renal cell cancer:
Concurrent use with interferon alfa.: The usual dose of Abevmy is 10mg/kg IV for every 2 weeks
Metastatic cervical cancer:
The usual dose of Abevmy; Abevmy 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 Abevmy for Platinum opposing: 10mg/kg of Abevmy for every 2 weeks by concurrent use with paclitaxel, pegylated liposomal doxorubicin or topotecan
Or The regular dosage of Abevmy; 15mg/kg of Abevmy given through IV for every 3 weeks by combining with topotecan
The usual dose of Abevmy 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 Abevmy; 15mg/kg of Abevmy given IV for 3 weeks by combining with gemcitabine & carboplatin for 6 to 10 cycles.

Preparation & administration:

Abevmy 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
Abevmy IV infusion is prepared in aseptic condition
Abevmy 400mg containing 16ml solution whereas 100mg containing 4ml
Abevmy 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.


MECHANISM OF ACTION


Abevmy 400mg 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


PHARMACOKINETICS


The pharmacokinetic form of Abevmy 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)


PRECAUTIONS

Caution with use in the conditions like;
Previously If you have taking or ever had DPD (dihydropyridine dehydrogenase) deficiency of enzyme.Inform the doctor about this then your doctor may preferably inform you avoid taking Abevmy 400mg.
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 Abevmy 100mg. You should use an essential method of conceiving to prevent pregnancy in yourself or your partner during your treatment with Abevmy 400mg. The drug will harm the fetus.
Avoid breast feeding while on treatment with Abevmy 400mg
While using Abevmy 400mg 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.


DRUG INTERACTION


While interaction of Abevmy 400mg with paclitaxel & Carboplatin, leads to lowering in exposure of paclitaxel after four cycles of therapy. Interaction of Abevmy 400mg with paclitaxel & Carboplatin leads to increase the paclitaxel exposure at day 6


CONTRAINDICATION


No contraindication occurred


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, erythrodysesthesia.


STORAGE


Abevmy 400mg vial should be stored at 2 to 8℃ (36 to 46℉)
Single use vial
Discard the left-out medicine under guidance of pharmacist


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

                                     Abevmy 100mg


Category: Monoclonal antibody or Anti-angiogenesis drug
Bevacizumab is sold under the brand name Abevmy 100mg which belongs to vascular endothelial growth factor directed antibody.
Abevmy 100mg consist of human framework regions and murine complementarity-determining regions.
Abevmy 100mg is a combined human monoclonal antibody IgG1, that predicament to and prohibits the biological activity of human vascular endothelial growth factor (VEGF)


INDICATION


Abevmy 100mg 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


DOSAGE


Key point:

Avoid administrating Abevmy before at least 28 days following surgery and the wound is completely cured
Metastatic colorectal carcinoma:
The Abevmy usual dosage by concomitant with 5-fluorouracil based chemotherapy.
Abevmy 5mg/kg for every 2 weeks IV in concomitant with bolus IFL
Abevmy 10mg/kg for every 2 weeks IV in combination with FOLFOX4
Abevmy 5mg/kg IV for every 2 weeks or Abevmy 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 patient’s regular dosage of Abevmy is 15mg/kg IV for every 3 weeks by interacting with carboplatin and paclitaxel

Glioblastoma:

Abevmy 10mg/kg administered IV for every 2 weeks

Metastatic renal cell cancer:

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

Metastatic cervical cancer:

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

Preparation & administration:

Abevmy 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
Abevmy IV infusion is prepared in aseptic condition
Abevmy 100mg containing 16ml solution whereas 100mg containing 4ml
Abevmy 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.


MECHANISM OF ACTION


Abevmy 100mg 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

PHARMACOKINETICS


The pharmacokinetic form of Abevmy 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)


PRECAUTIONS


Caution with use in the conditions like;
Previously If you have taking or ever had DPD (dihydropyridine dehydrogenase) deficiency of enzyme.Inform the doctor about this then your doctor may preferably inform you avoid taking Abevmy 100mg.
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 Abevmy 100mg. You should use an essential method of conceiving to prevent pregnancy in yourself or your partner during your treatment with Abevmy 100mg. The drug will harm the fetus.
Avoid breast feeding while on treatment with Abevmy 100mg
While using Abevmy 100mg 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.


DRUG INTERACTION


While interaction of Abevmy 100mg with paclitaxel & Carboplatin, leads to lowering in exposure of paclitaxel after four cycles of therapy. Interaction of Abevmy 100mg with paclitaxel & Carboplatin leads to increase the paclitaxel exposure at day 6


CONTRAINDICATION


No contraindication occurred


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, erythrodysesthesia.


STORAGE


Abevmy 100mg vial should be stored at 2 to 8℃ (36 to 46℉)
Single use vial
Discard the left-out medicine under guidance of pharmacist


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

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 injection  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 CizumabIV 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.https://myapplepharma.com/cizumab-100mg.php 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.https://myapplepharma.com/cizumab-100mg.php 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.

Tuesday, July 2, 2019

                              LENANGIO 10mg


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 tablets  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 tablets 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.

                                  LENANGIO 5mg


Lenangio 5mg is belongs to anticancer medication which contains Lenalidomide as an active substance which belongs to thalidomide analogue.
Lenangio 5mg tablets  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 tablets  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 tablets 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 tablets. 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 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 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.

Monday, July 1, 2019

LENALID - 5MG


The indications of Lenalid 5mg are; Lenalid capsules ( 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 capsules 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 indications of Lenalid 5mg capsules  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( 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 capsules( lenalidomide) 5mg with warfarin, will produce increased exposure of hemorrhage disorders. check the INR value & prothrombin time.


OVER DOSAGE


Over dosage of Lenalid( lenalidomide) 5mg will 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 capsules( 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.

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