Mycophenolate mofetil (MMF) Medication Guide

 What is Mycophenolate Mofetil? 

Mycophenolate (Cellcept) is recommended in order to prevent rejection in patients with heart, kidney, or liver transplant. The mycophenolate mofetil uses are recommended with other cyclosporine and corticosteroids. It is also recommended for autoimmune conditions such as lupus and Crohn's disease. 

How does Mycophenolate Mofetil work? 

Mycophenolate falls under the class of a drug named immunosuppressive, that works by weakening the patient's immune system so it helps stop the rejection of transplanted organs. 

How should I take Mycophenolate Mofetil? 

• Mofetil should be consumed exactly as prescribed. 
• In case of missed mycophenolate mofetil dose, consume the regular prescribed dose of mycophenolate mofetil as soon as you remember. If it is almost time for your next dose, you need to skip your missed dose and consume your next dose at normal scheduled time. Do not consume two doses at about the same time.
• Consume mycophenolate 500 mg tablet on an empty stomach, either 1 hour before or a couple of hours following a meal, unless your healthcare practitioner instructs you otherwise. 

Possible Side Effects: Commonly occurred side effects due to mycophenolate are as follows: 

• Diarrhea
• Vomiting 
• Pain 
• Stomach area pain 
• Swelling of the ankles and feet 
• High blood pressure 

More often side effects that occurs in children than in adults taking mycophenolate mofetil 500 mg include: 

• Stomach area pain
• Sore throat 
• Fever
• Colds (respiratory tract infections) 
• Infection
• High blood pressure 
• Pain
• Low white blood cell count 
• Blood infection (sepsis)
• Low red blood cell count 
• Diarrhea 
• Vomiting

Above listed are not all the possible mycophenolate mofetil 500 mg side effects. Inform your healthcare practitioner about any side effect that bothers you or that does not go away.

What should I avoid while on Mycophenolate Mofetil? 

• Pregnancy should be avoided. 
• Amount of time you spend in sunlight should be limited. 
• Use of tanning beds/sunlamps needs to be avoided. 
• Protective clothes should be preferred when individuals are in the sun and use sunscreen with SPF factor. 

How should I store Mycophenolate Mofetil? 

Store cellcept 500 mg tablets/capsules at 20°C to 25°C (68° to 77°F). Container should be kept closed tightly. 

Store the prepared oral suspension at room temperature, 59°F-86°F (15°C-30°C), for up to about 2 months. Oral suspension can be stored in the refrigerator at 36°F - 46°F (2°C - 8°C). Never freeze the oral suspension. 

NOTE: The piece of information provided in this article is just for informational purposes and is not served as a substitute for the medical treatment, consultation, diagnosis, of a qualified healthcare practitioner.

FAQ's

What is mycophenolate mofetil used for?

As an immunosuppressive agent, the drug mycophenolate is used with other medicines to help prevent the body from rejecting kidney transplants. 

Who should not take MMF?

The drug mycophenolate 500 mg must be avoided by women who are pregnant or who want to become pregnant.

How is it given?

The mycophenolate mofetil is recommended to be consumed by mouth in the form of tablets, capsules or an oral suspension.

What are the side effects of mycophenolate mofetil?

The common side effects of cellcept 250 mg include infections, nausea, and diarrhea. Although serious side effects may include progressive multifocal leukoencephalopathy, gastrointestinal bleeding and anemia. 

When should I take mycophenolate mofetil?

Mycophenolate is taken twice in a day on an empty stomach, one hour prior to 2 hours after eating/drinking. It must be taken at about the same times each day, and doses should be spaced about 12 hours apart.

Is Mycophenolate mofetil a steroid?

Mycophenolate is a non-steroid drug, being considered as an alternative to prednisone in order to treat sarcoidosis. 

How much does mycophenolate mofetil cost? 

The mycophenolate mofetil cost is reasonable. Prices may vary from branded to non-branded drugs. Price of a single strip containing 10 tablets of cellcept 500 mg is around 665 INR. Any pharmaceutical firm that is certified can offer the best mycophenolate mofetil price. 

READ - All you need to know about Eltrombopag

All you need to know about Eltrombopag

 What is eltrombopag? 

Eltrombopag specifically is an oral thrombopoietin-receptor (TPO-R) agonist, used for the treatment of chronic immune (idiopathic) thrombocytopenic purpura (ITP) patients aged one year and older, who are refractory to certain treatments such as corticosteroids, immunoglobulins.

How does eltrombopag work?

The revolade eltrombopag acts in order to boost the platelet production for managing the levels of haemostatic platelets by binding to the transmembrane domain of the thrombopoietin-receptor. This helps for stimulating the differentiation as well as proliferation of cells in the megakaryocyte lineage.

Dosing: Eltrombopag is a once-daily oral therapy, and should be taken at the same time every day. The recommended starting eltrombopag dose is 50 mg in most patients.

For paediatric patients aged 1 to 5 years, eltrombopag comes as a 25 mg sachet of powder for the oral suspension.

Possible Side Effects: Patients should be informed about the most commonly observed eltrombopag side effects, such as: 

• Chills
• Headache 
• Nausea
• Diarrhoea
• Anaemia
• Insomnia
• Cough
• Alopecia
• Pruritus
• Myalgia
• Pyrexia
• Fatigue
• Asthenia
• Influenza like illness
• Peripheral oedema
• Decreased appetite

In paediatric patients with revolade, some most commonly observed side effects may include:

• Rash
• Cough
• Pyrexia
• Rhinitis
• Diarrhea
• Toothache
• Rhinorrhoea
• Abdominal pain 
• Nasopharyngitis
• Oropharyngeal pain
• Abnormal liver values
• Upper respiratory tract infection

Warnings and Precautions: Inform your doctor in case:

• you have liver problems. You will be monitored closely while you are taking eltrombopag 25 mg.
• you're at risk of having a blood clot in the veins or arteries, or any member in your family has had a blood clot, or if you have chronic liver disease. 
• you have a bone marrow problem, including a blood cancer such as myelodysplastic syndrome (MDS) or myelofibrosis. 
• you're pregnant, think you may be pregnant or plan to get pregnant
• you're breast-feeding or planning to breast-feed. 
• you're taking or planning to take any other medicine with eltrombopag tablets. This includes antacids, statins, lopinavir or ritonavir, topotecan or methotrexate, anticoagulants or antiplatelet therapy, corticosteroids, danazol, and azathioprine. 

Who should not take Eltrombopag? 

• The eltrombopag uses is not recommended:
• In infants less than aged one year. 
• In female patients of childbearing potential and during pregnancy. 
• In ITP patients who are with hepatic impairment. 
• In those patients who are allergic to this drug or any of its ingredients. 

Things to know when taking Eltrombopag Tablets:

• Do not take eltrombopag with foods, drinks, or other medicines containing high concentrations of iron, calcium, magnesium, selenium, aluminium.
• You must consume eltrombopag 50 mg at least a couple hours prior to or 4 hours following certain foods, drinks or drugs. 
• Your healthcare practitioner will inform you what is the appropriate dose for you. On behalf of how you respond to treatment.
• In case you need to consume more than 1 tablet, consume them at the same time orally with water. 

How to store Eltrombopag? 

For storing eltrombopag, does not require any specific conditions, but it should be placed out of the reach of children. Do not use this medicine following the expiry date mentioned on the pack.

How much does eltrombopag cost?

In India, the eltrombopag price is quite reasonable. Price of revolade 50 mg and 25 mg for a single strip of 7 tablets is around 14434 INR & 6837 INR respectively. 

NOTE: The piece of information provided in this article is just for informational purposes and is not served as a substitute for the medical treatment, consultation, diagnosis, of a qualified healthcare practitioner.

Procarbazine: Information for Patients, Parents and Carers

 What is procarbazine?

Procarbazine is a chemotherapy medicine commonly used in the treatment of Hodgkin's lymphoma and brain cancers. 

What preparations of procarbazine 

are available?

Procarbazine is available as 50mg capsules. At some hospitals, a liquid can be made in pharmacies which contains 10mg/ml. Apart from this, the procarbazine tablet form is not available. 

How does Procarbazine work?

Procarbazine specifically kills cancer cells in the different phases of cell life.

How is Procarbazine given?

Procarbazine is given by mouth. The procarbazine 50mg comes as capsules, and consumed with food in order to reduce the risk of nausea as well as vomiting.

Are there any precautions regarding food or other drugs?

There are certain foods that should be avoided while taking procarbazine and also for at least 4 weeks following stop taking procarbazine. 

• Avoid Marmite, Bovril, Vegemite and vitamin products.
• Fermented or ‘aged’ food, e.g. salami should be avoided. 
• Eat certain foods in small amounts, e.g. bananas (but not overripe) and avocado.
• Avoid eating any leftover food. Prefer food as fresh as possible.
• Do not take cough/cold medication containing pseudoephedrine, dextromethorphan and ephedrine.
• Do not use any nasal sprays/drops containing phenylephrine/ephedrine.
• Must take procarbazine at the same time every day.
• Check with the healthcare practitioner prior to giving any other prescription or non-prescription drugs, herbs, or vitamins.

What should I do in case of missed dose?

If a procarbazine dose is missed, give it as quickly as you remember that particular day. Avoid giving a double dose.

If your child pukes within 30 minutes following a dose, give it again. If your child pukes following 30 minutes, avoid repeating the dose. Contact your healthcare practitioner if more than 1 dose is missed/vomited.

What are the side effects of Procarbazine?

The commonly observed procarbazine side effects may include:

• Nausea
• Vomiting
• Headaches
• Dizziness
• Hallucinations
• Diarrhoea
• Low blood counts
• Sleep disturbances

Occasional side effects due to procarbazine hydrochloride capsules may include:

• Mouth sores
• Skin rash
• Emotional changes

When should I call the doctor?

Call your healthcare practitioner if your child experiences:

• Skin rash
• Tight chest
• Skin rash
• Wheezing
• Dizziness
• Fever or chills
• Mouth sores
• Hallucinations
• Bleeding or unusual bruising
• Continued vomiting or diarrhoea

What other information do I need to know?

• Gloves should be weared when handling urine, stool, and vomit while on chemotherapy and for 48 hours afterward. Urine, stool, and vomit should be safely disposed of in the toilet.
•  Contaminated bed linens and clothes with urine, stool, or vomit must be washed separately with hot water as well as detergent.
•  Individuals handling the contaminated laundry must wear gloves.
•  In order to watch the effects of the medicine, blood samples will be required. 
•  Extra mouth care is required, so that it will help prevent the mouth sores.
•  Outdated or extra drugs should be returned to the pharmacy for disposal. Avoid flushing them down the toilet or throw them in the bin.
•  In case excess or the inappropriate chemotherapy drug is taken, call your healthcare practitioner immediately.

How should the procarbazine be handled and stored? 

• Always should be placed safe out of the reach and sight of children. 
• Capsules should be stored at room temperature. 
• Should be Kept out of direct sunlight. 
• Procarbazine should always be handled with care. While handling this drug, always wear gloves.
• In case you are pregnant or think you could be conceiving a child, please talk about handling of procarbazine with your healthcare practitioner.

NOTE: The piece of information provided in this article is just for informational purposes and is not served as a substitute for the medical treatment, consultation, diagnosis, of a qualified healthcare practitioner.

FAQ's

What is procarbazine hydrochloride used for? 

Together with other drugs, procarbazine uses are as follows:

• Hodgkin's disease
• Brain cancers

How does procarbazine work? 

As an alkylating agent, procarbazine works in order to slow or stop the growth of cancer cells.

What kind of drug procarbazine is?

The procarbazine hydrochloride specifically is a group of drugs named alkylating agents.

How long are most chemo treatments?

Maximum chemotherapy treatments are given in repeating cycles. The length of a cycle usually depends on the treatment being given. Most treatment cycles may range from 2-6 weeks. 

What are the other medications for hodgkin's lymphoma? 

There are some other medication for hodgkin's lymphoma, which are as follows:

• Adcetris (Brentuximab Vedotin)
• BiCNU (Carmustine)
• Bleomycin Sulfate
• Cyclophosphamide
• Dacarbazine
• Dexamethasone
• Doxorubicin Hydrochloride
• Keytruda (Pembrolizumab)
• Leukeran (Chlorambucil)
• Opdivo (Nivolumab)
• Prednisone
• Vinblastine Sulfate
• Vincristine Sulfate

Where can I best procarbazine 50mg price? 

In India, procarbazine is available at the best price. Any pharmaceutical wholesaler firm which is certified by WHO-GDP and ISO can give the best procarbazine price. 

More- Hodgkin’s Lymphoma Alternative Treatment

Patient Information on Azathioprine

 Azathioprine ( Imuran) is given for kidney transplants in order to prevent rejection, ulcerative colitis, systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease and granulomatosis with polyangiitis.

How does Azathioprine work?

As an immunosuppressive drug, it works in order to reduce the activity of the immune system. in RA, this function is effective in order to reduce the inflammation as well as reduce the pain and swelling. It is also believed that this medicine limits damage to the joints and helps for preventing disability. Because this drug acts for reducing damage to the joints, instead of just relieving pain, it falls under the group of medications named DMARDs.

 How is azathioprine taken?

Azathioprine should be taken orally in 25mg or 

50mg tablets which need to be swallowed whole.

Dosage: The azathioprine dose mainly depends on the specific immune or inflammatory related conditions. The azathioprine dose is usually initiated at 50mg to 100mg per day. The azathioprine tablets can be consumed once or twice daily.

Possible Side Effects: Commonly reported azathioprine side effects may include:

• nausea
• signs of fever or infection
• unexpected bruising or bleeding 

Although, uncommon side effects of azathioprine 50 mg tablet may include:

• new marks on skin
• cough
• difficulty breathing
• tiredness
• dizziness 
• muscle or bone pain
• kidney problems
• feeling faint 
• diarrhea
• abdominal pain 
• serious skin reaction 

If you experience any side effects, not listed above, inform your healthcare professionals.

What precautions are necessary?

• Since the liver as well as blood cells may be affected by azathioprine 50 mg, you must go for regular blood tests while on treatment. 
• Consuming allopurinol together with azathioprine may be very hazardous. You should inform your healthcare practitioner if you are consuming allopurinol.
• The combined pain drugs such as Panadeine as well as Panadeine Forte should be used safely. 
• Because azathioprine 50 mg tablet uses may be responsible for affecting the liver, you must avoid heavy consumption of alcohol.
• In case you wish to become pregnant or you intend to breastfeed, you need to talk with your healthcare provider.
• When consuming imuran generic, it is necessary to apply sunscreen and the prolonged sun exposure should be avoided. 

Overdose: In case of overdose, call your healthcare practitioner or head to the hospital emergency department, even if there are no signs and symptoms.

Missed Dose: If you forget to consume a dose of azathioprine, avoid consuming extra tablets in order to make up for the forgotten dose. Talk to your healthcare provider immediately, about your missed doses.

How azathioprine should be stored?

Store azathioprine tablets ip 50 mg in a cool, dry place, away from the heat as well as light. You must keep your medicines out of reach of children.

How much does azathioprine cost? 

The cost of azathioprine may vary from generic to branded drugs. Any WHO-GDP & ISO certified pharmaceutical company can offer this drug at varying prices around 100 INR to 450 INR.

NOTE: Before starting azathioprine treatment, consult a physician. To know more about azathioprine read full prescribing information. 

FAQ's

What is azathioprine used for in humans?

This immunosuppressive drug is used for the treatment of following conditions:

• rheumatoid arthritis
• granulomatosis with polyangiitis
• Crohn's disease
• ulcerative colitis
• systemic lupus erythematosus
• in kidney transplants to prevent rejection

What are the side effects of azathioprine?

In patients with azathioprine, possible side effects may include vomiting, bone-marrow suppression, increased stomach irritation, abdominal pain, nausea, loss of appetite, hair loss, blood in the urine or stool, fatigue, unusual bruising and development of mouth sores/ulcers.

What is the alternative to azathioprine?

Some existing alternative are as follows:

Azoran 50mg Tablet: The azoran 50 mg is manufactured by Rpg Life Sciences Ltd. 

Imoprine 50mg Tablet: It is developed by the Canixa Life Sciences Pvt Ltd. 

Azapure 50mg Tablet: The apazure is manufactured by Intas Pharmaceuticals Ltd. 

Imuza 50mg Tablet: It is manufactured by the Panacea Biotec Ltd. 

Vaprin 50mg Tablet: Vapirn manufactured by the Cadila Healthcare Ltd (Zydus). 

Aparin 0.5mg Tablet: The aparin tablets are manufactured by Race Pharmaceuticals Pvt Ltd. 

Imurel 50 mg Tablet: The imurel 50 mg is manufactured by aspen. 

What are some other common medications for organ transplant? 

Mycophenolic acid (MPA): As an immunosuppressant, mycophenolate mofetil 500 mg is used for preventing the rejection following the organ transplantation. Specifically it is recommended after kidney, heart, and liver transplantation. This drug is available at reasonable cost. 

Sirolimus: It is a macrolide agent that is used to prevent organ transplant rejection. The sirolimus 1mg price is quite reasonable. 

Vincristine Fact Sheet

 In 1961,vincristine was isolated for the first time. It is specifically a vinca alkaloid, found from the Madagascar periwinkle Catharanthus roseus. 

Vincristine also can be addressed as leurocristine. It comes in the market under the brand name Oncovin, and falls under the chemotherapy medication. 

The vincristine injection is an important chemotherapeutic agent properly administered intravenously in the treatment of many patients with leukemia or lymphoma. However, improper administration of vincristine dose is fatal.

Vincristine is always administered intravenously. When it reaches to the blood, it is effective in order to block the growth of cancer by preventing cells from dividing. However, vincristine fda approved drug is a neurotoxin that may be responsible for causing peripheral neuropathy when administered intravenously and profound neurotoxicity if administered into the spinal fluid, which flows around the spinal cord and brain.

Many patients who receive vincristine 1 mg have a treatment regimen that includes other chemotherapy drugs that are administered intrathecally, or injected into the spinal fluid with a syringe. If this medication is by fault given into the spinal fluid, it is uniformly fatal, and may cause neurological defects, ascending paralysis, and death, usually within a week. 

If you are pregnant or become pregnant during vincristine uses, you should notify your doctor immediately.

This product should be refrigerated between 2°–8°C (36°–46°F). Discard unused solution. Protect from light. Store Upright.

The vincristine injection price may vary from branded to non-branded drugs. A WHO-GDP & ISO certified pharmaceutical wholesaler can provide you the best vincristine price around 50 INR to 250 INR. 

Note: Before starting treatment with vincristine, consult a physician. To know more about this product, please read full prescribing information. 

FAQ's

What is vincristine used for?

This chemotherapy drug is recommended to be used for the treatment of a number of types of cancer, includes:

• Acute lymphocytic leukemia
• Acute myeloid leukemia
• Hodgkin's disease
• Neuroblastoma
• Small cell lung cancer

What are the side effects of vincristine?

In patients with this medication some common side effects may occur, which may include change in sensation, constipation, hair loss, difficulty walking, and headaches. Although, some serious vincristine side effects may include lung damage and neuropathic pain. 

How long do side effects of vincristine last?

In case single, vincristine doses are given on the weekly basis, the side effects of leukopenia, constipation and neuritic pain may appear but are usually for short term (less than 1 week). In case of reduction in dosage, these side effects may be lessened or disappeared.

How do you inject vincristine?

Vincristine is given intravenously. Patients have this treatment with the help of a drip into their arm or hand. Doctor puts a small tube (a cannula) into veins and connects the drip to it.

Patients might require a central line. This is a kind of long plastic tube that provides the medications into a large vein, either in the chest or through a vein in an arm. It stays in while patients are taking treatment, perhaps for some months.

How often is vincristine given?

Vincristine injection is given by several dosing schedules from weekly to bi-weekly to monthly. The most appropriate schedule and the total number of treatment cycles may vary and depend on patients clinical circumstances.

How does vincristine work in the body?

Vincristine is a chemotherapy drug, falls under the group of medicines named vinca alkaloids. It specifically acts by stopping the cancerous cells from integrating into new cells. So, it helps in stopping the growth of cancer.

Read  -  One cure for all diseases

Iclusig for Chronic Myeloid Leukaemia

 What is Iclusig used for?

As a kinase inhibitor Iclusig is recommended for the treatment of adults patients with:

• chronic phase chronic myeloid leukemia (CML) who didn't get benefit from treatment with at least 2 prior kinase inhibitor medications. 
• accelerated phase or blast phase CML, or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) who are not able to take any other kinase inhibitor drugs. 

What are the side effects of iclusig? 

The most common side effects of Iclusig may include:

• fever
• nausea
• skin rash 
• joint pain 
• abdomen pain
• headache 
• constipation
• dry skin
• high blood pressure 
• tiredness
• bleeding
• low hemoglobin in the blood 
• liver problems
• low blood platelet counts
• inflammation of the pancreas

Report to your healthcare practitioner in case you experience any side effect that is persistent and bothers you. 

What is the recommended dosage of iclusig? 

The starting dose of Iclusig is 45 mg, which should be given orally once in a day. Reducing the iclusig dosage is considered for patients with chronic phase CML and accelerated phase CML who have achieved a major cytogenetic response. Iclusig tablets should be consumed with or without food. Tablets required to be swallowed whole.

What dosage forms and strength iclusig comes? 

This medication is available in the form of tablets as following strength:

• iclusig 15 mg tablet
• iclusig 30 mg tablet
• iclusig 45 mg tablet

Is ponatinib a chemotherapy drug?

Ponatinib mainly is a type of targeted cancer drug. It is also known by its brand name Iclusig. It blocks as well as interferes with a number of protein kinases. 

What are the drug interactions with iclusig? This drug may interact when it is used with other drugs. Some possible iclusig drug interactions are as follows:

● Coadministration of carbamazepine, phenytoin, rifampin, and St. John’s Wort (strong CYP3A inducers) together with iclusig tablets must be avoided. 

● When using iclusig together with strong CYP3A inhibitors (e.g. ritonavir, indinavir, boceprevir, conivaptan, itraconazole, clarithromycin, nelfinavir, ketoconazole, lopinavir/ritonavir, posaconazole, saquinavir, telaprevir, telithromycin, nefazodone, voriconazole), the recommended initial dose needs to be reduced. 

How much does iclusig cost? 

In India, the cost of iclusig is quite reasonable. The iclusig 45 mg price is around $17,299 for a supply of 30 tablets. Prices may vary depending on branded to non-branded (generic) drugs. 

Where can I get Iclusig at a best price? 

In order to get the best iclusig price, always go with a pharmaceutical wholesaler company that holds the WHO-GDP & ISO certification. 

How should I store Iclusig?

Iclusig tablets should be placed at room temperature between 68°F - 77°F (20°C-25°C). Keep these tablets and all medicines out of the reach of children.

Below are some Medication List for Leukemia & Lymphoma Provide indian pharma at lowest cost.

Farabine (Clofarabine)

Arsenox (Arsenic Trioxide)

Reditux (Rituximab)

Clofarabine

Midostaurin

Trametinib

Bendit (Bendamustine)

Veenat (Imatinib)

Gleevec (Imatinib)

Isentress (Raltegravir)

Hamysl (Pegaspargase)

Read - Chronic Myeloid Leukemia Diagnosis and Treatment