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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 tablet 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 25mg tablet 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 25mg 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 tablet 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 25mg 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 25mg tablet. 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 25mg 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 tablet 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 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 tablet 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 tablet 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.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
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 tablet is a prescription drug that can only use under the supervision of medical oncologist.
INDICATION
The indications of Lenangio 10mg are;
- Lenangio 10mg 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 10mg tablet 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 10mg
- 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 10mg . 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 tablet 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 tablet 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 tablet 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.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
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 tablet is a prescription drug that can only use under the supervision of medical oncologist.Lenangio 5mg , Lenangio 5mg tablet
INDICATION
The indications of Lenangio 5mg are;
- Lenangio combination with dexamethasone is indicated to treat the patients suffered from multiple myeloma
- Lenangio 5mg 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 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 5mg should administer orally as once daily
- CrCl <30ml/min In Patient, 2.5mg of Lenangio 5mg tablet 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 5mg . 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 5mg 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 tablet 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 tablet 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 tablet 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.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
Crizalk 200mg : View Uses, Price & side effects|Apple pharmaceuticals
- Crizalk 200mg belongs to type of tyrosine kinase inhibitor. Kinases are enzymes which are included in many functions, involving cell development and reproduction.
- Crizalk 200mg is made specifically for the treatment of a type of lung cancer in which ALK is overactive due to an abnormality in the ALK gene.
- Crizalk 200mg capsule is a prescription drug which is used under the supervision of medical practioner
INDICATION
- Crizalk 200mg capsule is indicated for the therapy of patients having metastatic non-small cell lung cancer.
DOSAGE MODIFICATION
- Crizalk 200mg capsule taken orally twice daily for First dose reduction
- Crizalk 200mg taken orally once daily for Second dose reduction
- Permanently discontinue if unable to tolerate Crizalk 200mg taken orally once daily.
MECHANISM
- Particularly, Crizotinib prevents anaplastic lymphoma kinase (ALK), hepatocyte growth factor receptor (HGFR, c-MET), and Recepteurd’OrigineNantais (RON).
- Malformations in the ALK gene result by mutations or translocations may leads expression of oncogenic fusion proteins. somepatients with NSCLC, they have the EML4-ALK gene.
- Crizotinib inhibits ALK tyrosine kinase which essentially results in decreasedproliferation of cells which carry the genetic mutation and tumour survivability.
ADME
- Maximum serum concentration is 4 to 6 hours and bioavailability were 43%.
- Volume of distribution is 1772L and plasma protein bounding is 91%
- Crizalk metabolised by CYP3A4 and CYP3A5
- Crizalk 200mg is eliminated via feces 63% and 22% via urine and half -life is 42 hours
Dosage and administration :
- Select patients for the treatment with Crizalk based on ALK or ROS1 presences in tumor specimens
- The usual dosage of Crizalk is 250mg orally twice in a day
- Administer the Crizalk dose with or without food, until disease progression.
PRECAUTION
- Before using Crizalk 200mg in some condition, consult with doctor.
- Hepatotoxicity causes while treatment with Crizalk 200mg capsule
- while treatment with Crizalk will causes Interstitial lung disease/pneumonitis.
- QT interval prolongation
- Bradycardia
- Severe visual loss
Embryo-fetal toxicity:
- based on mechanism action the drug will cause risk to foetus
DRUG INTERACTION
- Crizalk 200mg Combination with strong or moderate CYP3A4 inhibitors will increase Crizalk plasma concentration
- Crizalk 200mg capsule concomitant use with strong CYP3A inducers will decrease Crizalk plasma concentration
- Crizalk 200mg Interaction with CYP3A substrates will increase plasma concentration of CYP3A substrates
- Do not use combination with bradycardia causing drugs
CONTRAINDICATION
- None
MISSED DOSE
- If the patient vomits after taking a dose of Crizalk 200mg capsule or missed to take a dose, then should not to take an extra dose, but to take the next dose at the regular time, skip the missed dose.
STORAGE
- Store at 20℃ to 25℃
SIDE EFFECTS
Crizalk is caused some side effects as follows :
- Infection increased
- Breathlessness
- Eyesight changes
- Bowel changes
- Feeling sick
- Swelling of hands and feet’s
- Decreased appetite
- Fatigue
- Liver changes
- Skin rash
- bradycardia.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
Crizalk (Crizotinib) 250mg Capsule: View Uses, Price & side effects|Apple pharmaceuticals
- Crizalk 250mg belongs to type of tyrosine kinase inhibitor. Kinases are enzymes which are included in many functions, involving cell development and reproduction.
- Crizalk 250mg is made specifically for the treatment of a type of lung cancer in which ALK is overactive due to an abnormality in the ALK gene.
- Crizalk 250mg capsule is a prescription drug which is used under the supervision of medical practioner.
INDICATION
- Crizalk 250mg capsule is indicated for the therapy of patients having metastatic non-small cell lung cancer.
DOSAGE MODIFICATION
- Crizalk 250mg taken orally twice daily for First dose reduction
- Crizalk 250mg taken orally once daily for Second dose reduction
- Permanently discontinue if unable to tolerate Crizalk 250 mg taken orally once daily.
MECHANISM
- Particularly, crizotinibprevents anaplastic lymphoma kinase (ALK), hepatocyte growth factor receptor (HGFR, c-MET), and Recepteurd’OrigineNantais (RON).
- Malformations in the ALK gene result by mutations or translocations may leads expression of oncogenic fusion proteins. somepatients with NSCLC, they have the EML4-ALK gene.
- Crizotinib inhibits ALK tyrosine kinase which essentially results in decreased proliferation of cells which carry the genetic mutation and tumour survivability.
ADME
- Maximum serum concentration is 4 to 6 hours and bioavailability were 43%.
- Volume of distribution is 1772L and plasma protein bounding is 91%
- Crizalk metabolised by CYP3A4 and CYP3A5
- Crizalk is eliminated via feces 63% and 22% via urine and half -life is 42 hours
Dosage and administration :
- Select patients for the treatment with Crizalk 250mg based on ALK or ROS1 presences in tumor specimens
- The usual dosage of Crizalk is 250mg orally twice in a day
- Administer the Crizalk dose with or without food, until disease progression.
PRECAUTION
- Before using Crizalk in some condition, consult with doctor.
- Hepatotoxicity causes while treatment with Crizalk 250mg.
- while treatment with Crizalk will causes Interstitial lung disease/pneumonitis.
- QT interval prolongation
- Bradycardia
- Severe visual loss
Embryo-fetal toxicity:
- based on mechanism action the drug will cause risk to foetus
DRUG INTERACTION
- Crizalk 250mg Combination with strong or moderate CYP3A4 inhibitors will increase Crizalk plasma concentration
- Crizalk 250mg concomitant use with strong CYP3A inducers will decrease Crizotinib plasma concentration
- Crizalk 250mg capsule Interaction with CYP3A substrates will increase plasma concentration of CYP3A substrates
- Do not use combination with bradycardia causing drugs
CONTRAINDICATION
- None
MISSED DOSE
- If the patient vomits after taking a dose of Crizalk 250mg or missed to take a dose, then should not to take an extra dose, but to take the next dose at the regular time, skip the missed dose.
STORAGE
- Store at 20℃ to 25℃
SIDE EFFECTS
Crizalk is caused some side effects as follows :
- Infection increased
- Breathlessness
- Eyesight changes
- Bowel changes
- Feeling sick
- Swelling of hands and feet’s
- Decreased appetite
- Fatigue
- Liver changes
- Skin rash
- bradycardia.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
Resof 400 & Hepcfix 60 mg | Daclatasvir and Sofosbuvir | Anti viral drugs
- Resof Hepcfix tablet are hostile to viral medicine Resof Hepcfix tablet are single measurements treatment, it is a doctor prescribed medication utilized by the patients just under the information of restorative expert who are all around rehearsed Daclatasvir isn’t utilized alone, for better activity it ought to be joined with Sofosbuvir tablet. In some condition Resof Hepcfix is joined with ribavirin, a hostile to viral pharmaceutical utilized as a part of decompensated (Child Pugh B or C) cirrhosis
PRESCRIBED FOR
- The primary sign of Resof Hepcfix is; This mix tablets are utilized to treat the constant hepatitis C viral disease caused by genotype I or III The significant restriction happened while utilizing Resof Hepcfix are lessening of steady virological reaction rate in hepatitis C genotype I or III contaminated patients.
PHARMACOLOGY
- The activity of Resof Hepcfix tablet are occurred by involving in some mechanism;
SOFOSBUVIR
- Sofosbuvir containing sofosbuvir has hostile to hepaciviral movement, which is specifically acting medication displays its activity by disallowing NS5B RNA dependent RNA polymerase protein; fundamental for hepatitis viral duplication. Sofosbuvir is processed to frame uridine triphosphate, a fundamental dynamic metabolite which uncovered a hostile to viral action. The mixture of this dynamic metabolite into hepatitis viral RNA with the assistance of NS5B polymerase and causes viral chain cessation
DACLATASVIR
- Daclatasvir containing Daclatasvir removes hostile to viral action by restricting NS5A protein which is needful in viral generation and virion collection
DOSAGE
- Resof Hepcfix tablet are given with or without food, in the condition of chronic hepatitis C viral infection originated by genotype I or III Resof Hepcfix is single dose therapy
Dosage regimens
- Daclatasvir normally is not used alone treatment, it is combined with Sofosbuvir The suggested dosage of Resof Hepcfix is one tablet should be taken as a single dose If Sofosbuvir is discontinued, Daclatasvir also get stopped Genotype I Patient suffered without cirrhosis or with compensated cirrhosis: The recommended usual dosage of Resof Hepcfix is one tablet should be taken as a single dose with or without food In decompensated cirrhosis patients: Resof+Hepcfix should be altogether with ribavirin as a single dose
Genotype III
- Patient suffered without cirrhosis or with compensated cirrhosis: The recommended usual dosage of Resof Hepcfix is one tablet should be administered as a single dose with or without food In decompensated cirrhosis patients: Resof Hepcfix should be concomitant with ribavirin as a once a day The dosage of ribavirin; The hemoglobin level of patients, dose can be calculated on basis of body weight. Below 75kg: The dosage is 1000mg of ribavirin; suggested for genotype I or III 600mg of ribavirin as an primary dose and followed as 1000mg/per Slightly 75 kg: The dose of 1200mg of ribavirin administrated In decompensated cirrhosis given as twice daily. The safety and efficacy of Daclatasvir has not been established <18 years Sofosbuvir used in ≥12 years or weight of ≥35kg
PHARMACOKINETICS
Absorption :
- The maximum plasma concentration of Daclatasvir tablets occurs within 2 hours The mean bioavailability of Daclatasvir is 67% The maximum plasma concentration of Sofosbuvir tablets occurs within the range of 0.5 to 2 hours relatively. The nourishment won’t makes any variety in retention of Resof+Hepcfix tablets, might be taken with or without sustenance
Distribution :
- Volume of distribution in Daclatasvir tablet is 47L Daclatasvir bounds to human plasma protein nearly 99% Blood to plasma ratio of Sofosbuvir is relatively 0.7 The Sofosbuvir bounds to human plasma protein nearly 61 to 65%
Metabolism :
- Sofosbuvir metabolized in liver and formed as dynamic metabolite uridine triphosphate, metabolism experienced with the assistance of cathepsin A or carboxylesterase 1 Daclatasvir digestion happened with the assistance of CYP3A4
Elimination :
- Nearly 88% of Daclatasvir is eliminated via feces; 53% as parent form; 6.6% eliminated through urine. Sofosbuvir metabolites are excreted through 80% in urine, 14% in feces & 2.5% in exhaled air The terminal half life period of Sofosbuvir is reaches at 0.51 hours; Daclatasvir half life period is 12 to 15 hours
DRUG INTERACTION
- While consolidating Resof Hepcfix with solid CYP3A inducers causes loss of virological response rate of Daclatasvir CYP3A solid inducers like st Johns wort, rifampin, phenytoin or carbamazepine In the event that Sofosbuvir joins with P-gp or BCRP inhibitors prompts cause rise of Sofosbuvir plasma focus. Resof Hepcfix tablet attendant with amiodarone causes genuine symptomatic bradycardia. Resof Hepcfix tablet attendant with hostile to convulsants, against mycobacterials or natural items like st Johns wort causes diminish as a result of fixation Resof Hepcfix with HMG CoA reductase inhibitors, this mix prompts because expanding the presentation of these medications (statins)
Dosage adjustment in drug interaction
- If concurrent use with strong CYP3A inhibitors, the dosage of Daclatasvir is reduced to 30mg while co administration Concurrent use with moderate CYP3A inducers, the dosage of Daclatasvir increased to 90mg Concomitant use of Daclatasvir with CYP3A strong inducers should be avoided, it is contraindicated
CONTRAINDICATION
- A few contraindications happens while utilizing Resof Hepcfix tablet In decompensated cirrhosis, joins with ribavirin contraindicated in pregnancy condition Some anaphylactic response happens if patients are contraindicated to the segments show in Resof Hepcfix
MISSED DOSE
- Both Resof Hepcfix tablet are single dosage treatment, if tolerant neglects to take the measurement of these tablets, must counsel the doctor and take the measurement inside the time according to the direction given by therapeutic expert Generally the missed measurement ought to be skipped and take after the standard dosing plan
PRECAUTIONS
- While taking Resof Hepcfix tablet , with CYP3A solid inducers causes loss of remedial reaction of Resof Hepcfix tablet . Stay away from this accompanying to diminish the unfriendly impacts Resof Hepcfix causes genuine bradycardia while simultaneous use with amiodarone, to keep this condition some elective solution is given or ends the amiodarone if conceivable. Insight the patients about the introduction of bradycardia amid the treatment Utilizing Resof Hepcfix with ribavirin, ought not be prescribed in pregnancy condition as a result of creating fetal harm because of ribavirin
SIDE EFFECTS
The most common side effects occurred during the therapy;
- Headache, Loss of appetite, Irritability, Neutropenia, Anemia, Chills, Influenza like symptoms, Pyrexia, Myalgia, Pancytopenia, Fatigue, Nausea, Diarrhea, Elevation of lipase, Cardiac problems like symptomatic bradycardia , Insomnia, Pruritus, Asthenia, Rashes, on the grounds that almost 99% of medication limited to human plasma protein .
OVERDOSAGE
- The over dose of Resof Hepcfix tablet are happened because of missed measurement , if once finished dose happens the patients must be observed oftentimes for support of harmfulness and give wellbeing measures Hemodialysis is a technique used to take out the part from body, sofosbuvir evacuates with partition coefficient of 54% though Daclatasvir is hazardous
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
Sofovir 400 & Daclahep 60 mg | Daclatasvir and Sofosbuvir | Anti viral drugs
- Sofovir Daclahep tablet are hostile to viral medicine Sofovir Daclahep tablet are single measurements treatment, it is a doctor prescribed medication utilized by the patients just under the information of restorative expert who are all around rehearsed Daclatasvir isn’t utilized alone, for better activity it ought to be joined with Sofosbuvir tablet. In some condition Sofovir Daclahep is joined with ribavirin, a hostile to viral pharmaceutical utilized as a part of decompensated (Child Pugh B or C) cirrhosis.
PRESCRIBED FOR
- The primary sign of Sofovir Daclahep is; This mix tablets are utilized to treat the constant hepatitis C viral disease caused by genotype I or III The significant restriction happened while utilizing Sofovir+Daclahep tablets are lessening of steady virological reaction rate in hepatitis C genotype I or III contaminated patients.
PHARMACOLOGY
- The activity of Sofovir Daclahep tablet are occurred by involving in some mechanism;
SOFOSBUVIR
- Sofosbuvir containing sofosbuvir has hostile to hepaciviral movement, which is specifically acting medication displays its activity by disallowing NS5B RNA dependent RNA polymerase protein; fundamental for hepatitis viral duplication. Sofosbuvir is processed to frame uridine triphosphate, a fundamental dynamic metabolite which uncovered a hostile to viral action. The mixture of this dynamic metabolite into hepatitis viral RNA with the assistance of NS5B polymerase and causes viral chain cessation
DACLATASVIR
- Daclatasvir containing Daclatasvir removes hostile to viral action by restricting NS5A protein which is needful in viral generation and virion collection
DOSAGE
- Sofovir Daclahep tablet are given with or without food, in the condition of chronic hepatitis C viral infection originated by genotype I or III Sofovir+Daclahep is single dose therapy
Dosage regimens
- Daclatasvir normally is not used alone treatment, it is combined with Sofosbuvir The suggested dosage of Sofovir Daclahep is one tablet should be taken as a single dose If Sofosbuvir is discontinued, Daclatasvir also get stopped Genotype I Patient suffered without cirrhosis or with compensated cirrhosis: The recommended usual dosage of Sofovir Daclahep is one tablet should be taken as a single dose with or without food In decompensated cirrhosis patients: Sofovir Daclahep should be altogether with ribavirin as a single dose
Genotype III
- Patient suffered without cirrhosis or with compensated cirrhosis: The recommended usual dosage of Sofovir Daclahep is one tablet should be administered as a single dose with or without food In decompensated cirrhosis patients: Sofovir Daclahep should be concomitant with ribavirin as a once a day The dosage of ribavirin; The hemoglobin level of patients, dose can be calculated on basis of body weight. Below 75kg: The dosage is 1000mg of ribavirin; suggested for genotype I or III 600mg of ribavirin as an primary dose and followed as 1000mg/per Slightly 75 kg: The dose of 1200mg of ribavirin administrated In decompensated cirrhosis given as twice daily. The safety and efficacy of Daclatasvir has not been established <18 years Sofosbuvir used in ≥12 years or weight of ≥35kg
PHARMACOKINETICS
Absorption :
- The maximum plasma concentration of Daclatasvir tablets occurs within 2 hours The mean bioavailability of Daclatasvir is 67% The maximum plasma concentration of Sofosbuvir tablets occurs within the range of 0.5 to 2 hours relatively. The nourishment won’t makes any variety in retention of Sofovir+Daclahep tablets, might be taken with or without sustenance
Distribution :
- Volume of distribution in Daclatasvir tablet is 47L Daclatasvir bounds to human plasma protein nearly 99% Blood to plasma ratio of Sofosbuvir is relatively 0.7 The Sofosbuvir bounds to human plasma protein nearly 61 to 65%
Metabolism :
- Sofosbuvir metabolized in liver and formed as dynamic metabolite uridine triphosphate, metabolism experienced with the assistance of cathepsin A or carboxylesterase 1 Daclatasvir digestion happened with the assistance of CYP3A4
Eliminaton :
- Nearly 88% of Daclatasvir is eliminated via feces; 53% as parent form; 6.6% eliminated through urine. Sofosbuvir metabolites are excreted through 80% in urine, 14% in feces & 2.5% in exhaled air The terminal half life period of Sofosbuvir is reaches at 0.51 hours; Daclatasvir half life period is 12 to 15 hours
DRUG INTERACTION
- While consolidating Sofovir Daclahep with solid CYP3A inducers causes loss of virological response rate of Daclatasvir CYP3A solid inducers like st Johns wort, rifampin, phenytoin or carbamazepine In the event that Sofosbuvir joins with P-gp or BCRP inhibitors prompts cause rise of Sofosbuvir plasma focus. Sofovir Daclahep tablet attendant with amiodarone causes genuine symptomatic bradycardia. Sofovir+Daclahep tablets attendant with hostile to convulsants, against mycobacterials or natural items like st Johns wort causes diminish as a result of fixation Sofovir Daclahep with HMG CoA reductase inhibitors, this mix prompts because expanding the presentation of these medications (statins)
Dosage adjustment in drug interaction
- If concurrent use with strong CYP3A inhibitors, the dosage of Daclatasvir is reduced to 30mg while co administration Concurrent use with moderate CYP3A inducers, the dosage of Daclatasvir increased to 90mg Concomitant use of Daclatasvir with CYP3A strong inducers should be avoided, it is contraindicated
MISSED DOSE
- Both Sofovir Daclahep tablet are single dosage treatment, if tolerant neglects to take the measurement of these tablets, must counsel the doctor and take the measurement inside the time according to the direction given by therapeutic expert Generally the missed measurement ought to be skipped and take after the standard dosing plan
PRECAUTIONS
- While taking Sofovir Daclahep tablet , with CYP3A solid inducers causes loss of remedial reaction of Sofovir+Daclahep tablets. Stay away from this accompanying to diminish the unfriendly impacts Sofovir Daclahep causes genuine bradycardia while simultaneous use with amiodarone, to keep this condition some elective solution is given or ends the amiodarone if conceivable. Insight the patients about the introduction of bradycardia amid the treatment Utilizing Sofovir Daclahep with ribavirin, ought not be prescribed in pregnancy condition as a result of creating fetal harm because of ribavirin
CONTRAINDICATION
- A few contraindications happens while utilizing Sofovir Daclahep tablet In decompensated cirrhosis, joins with ribavirin contraindicated in pregnancy condition Some anaphylactic response happens if patients are contraindicated to the segments show in Sofovir Daclahep .
SIDE EFFECTS
The most common side effects occurred during the therapy;
- Headache, Loss of appetite, Irritability, Neutropenia, Anemia, Chills, Influenza like symptoms, Pyrexia, Myalgia, Pancytopenia, Fatigue, Nausea, Diarrhea, Elevation of lipase, Cardiac problems like symptomatic bradycardia , Insomnia, Pruritus, Asthenia, Rashes, on the grounds that almost 99% of medication limited to human plasma protein .
OVERDOSAGE
- The over dose of Sofovir Daclahep tablet are happened because of missed measurement , if once finished dose happens the patients must be observed oftentimes for support of harmfulness and give wellbeing measures Hemodialysis is a technique used to take out the part from body, sofosbuvir evacuates with partition coefficient of 54% though Daclatasvir is hazardous
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
Resof L 400 & 90 mg | Ledipasvir/Sofosbuvir | Anti viral drugs
- Resof L tablet should be used for both adults & pediatric patients with the age of 12 years or older or weight of at least 35kg. Used for; Genotype I, 4, 5, or 6 with compensated cirrhosis or without cirrhosis Genotype 1 infection with compensated cirrhosis or without cirrhosis Liver transplantation condition, genotype 1 with decompensated cirrhosis by use of ribavirin Genotype 1 or 4 without cirrhosis or with compensated cirrhosis by use of ribavirin Pediatric patients, HCV infection related to genotype 1, 4, 5, or 6 without cirrhosis or with compensated cirrhosis.
DOSAGE
- The usual advised dose of Resof L is one tablet should be administered as once a day. In HIV-1 co infected patients, Resof L dosage consideration is; Patient without cirrhosis: (adult or pediatric of 12 years of age or older with genotype I, IV, V or VI Chronic HCV) The prescribed dose of Resof L is one tablet should be taken orally as a single dose for 12 weeks
Genotype I
- Without cirrhosis or compensated cirrhosis: Resof L should be taken alone as a single dose followed for 12 weeks
- Therapy experienced without cirrhosis:Resof L tablet should be taken as a single agent for once a day for 12 weeks
- Therapy experienced with compensated cirrhosis: Resof L tablet should be used for 24 weeks
- In decompensated cirrhosis: Resof L should be combined with ribavirin to be used, followed for 12 weeks
Genotype I to IV
- In liver transplantation patients with compensated cirrhosis or without cirrhosis: Resof L tablet should be combined with ribavirin for 12 weeks.
Genotype IV, V or VI :
- Resof L tablet should be administered alone for 12 weeks for without cirrhosis or with compensated cirrhosis patients: On the basis of body weight the dose of ribavirin should be calculated <75kg: 1000mg; ≥75kg: 1200mg Ribavirin should be administered with food. Resof L should be administered with or without food.
PHARMACOKINETICS
Peak plasma concentration of Resof L :
- Sofosbuvir: 0.8 to 1 hour & GS331007: 3.5 to 4 hours; ledipasvir: 4 to 4.5 hours No effect produced, while Resof L should be administered with or without food.
Plasma protein binding capacity of Resof L :
- Sofosbuvir: 61 to 65% & GS-331007: minimal binding effect, ledipasvir: >99.8%
Metabolism of Resof L :
- Sofosbuvir: hepatic metabolism with cathepsin A, or carboxyl esterase 1 & ledipasvir: mediated by CYP1A2, 2C8, 2C9, 2C19, 2D6 & 3A4.
Elimination of Resof L :
- Major route of elimination is through urine & feces. Ledipasvir through urine by 87%; Sofosbuvir through urine by 80%, feces by 14% & exhaled air by 3.5%
Half life period of Resof L :
- Sofosbuvir 0.4%, GS-331007: 27 hours & Ledipasvir: 47 hours.
WORK AS
- Ledipasvir is a solid prohibitor of perpetual hepatitis C viral relating non structural 5A protein which is a viral phosphoprotein. The essential part of Ledipasvir in hostile to viral action instrument; Restraint of; Replication Virion assembly Secretion The mechanism of Sofosbuvir associated with against viral movement is; Sofosbuvir is prohibitor of nucleotide analogue of hepatitis C viral disease identified with non basic 5B polymerase. This catalyst is in charge of interceding the HCV RNA duplication. The dynamic type of Sofosbuvir is in triphosphate shape, which included diminishing the common cell uridine nucleotide and is coordinated by HCV RNA polymerase into the broadened RNA preliminary strand, which is closed in viral chain end.
SAFETY MEASURES
Hepatitis B reoccurrence :
- This condition is mostly occurs in patients who are undergoing anti-viral therapy & fail to receive the anti-hepatitis B viral treatment. Monitor the HBsAg & anti-HBc counts before the therapy Hepatic function test should be performed Start the anti-hepatitis B treatment.
Bradycardia :
- This severity is due to combination of amiodarone with Resof L treatment. To avoid the problem patient ECG should be monitored. Patient should be counseled before initiate the treatment about the exposure of risk due to amiodarone. Provide supportive management.
Drug interactions :
- The combination of Resof L with P-gp inducers (potent), causes decreasing the plasma concentration of component of Resof L tablet .
Risk due to ribavirin :
- Ribavirin causes fetal damage and leads to death. Contraindicated to pregnancy
IN PEDIATRIC
Genotype I
- Without cirrhosis or with compensated cirrhosis: Resof L should be administered orally for 12 weeks. Therapy experienced without cirrhosis: Resof L should be administered orally for 12 weeks. Therapy experienced compensated cirrhosis: Resof L tablet should be administered orally for 12 weeks.
Genotype IV, V or VI
- Therapy naïve or experienced without cirrhosis or with compensated cirrhosis: Resof L tablet should be administered orally for 12 weeks. Renal impairment patients; Resof L dosage adjustment should not be allowed in severe renal damaged condition. Due to greater exposure of Sofosbuvir metabolite causes final stage of renal disease (ERSD).
DRUG INTERACTION
- Resof L an inhibition of P-gp or BCRP drug transporters, this concomitant use causes increase intestinal absorption of these substrates.
- Resof L+ P-gp strong inducers lead to diminish the Resof L plasma concentration causes loss of therapeutic efficacy of Resof L Resof L+ warfarin causes alteration in INR values, monitor the prothrombin time during this combination.
- Resof L+ gastric regulators, causes diminishing Ledipasvir plasma concentration, do not administer Resof L tablet concurrently with gastric regulators. Resof L+ anti-arrhythmic agents lead to produce plasma concentration elevation of these drugs.
- Resof L+ anti-convulsants or anti-mycobacterials may cause depletion of plasma concentration of Resof L Resof L+ anti-retroviral drugs, increases the plasma concentration of these drugs. Resof L+ st Johns wort causes decreasing the plasma concentration of Resof L Resof L+ HMG CoA reductase inhibitors cause elevation of plasma concentration of these drugs.
OVERDOSAGE
- The over dosage condition should be overcome by; Provide supportive management. Monitor the manifestations. Treated by Hemodialysis Ledipasvir does not eliminate by hemodialysis process, because of Ledipasvir has large protein binding capacity. The circulating metabolite of Sofosbuvir is eliminated from the body by processing with hemodialysis with the range of 54%.
CONTRAINDICATION
- Resof L with ribavirin is contraindicated to pregnancy condition Hypersensitivity reactions produces, if patients are contraindicated to the component present in the Resof L tablet
MISSED DOSE
- In case of missed dose occurrence during the therapy, patient must be consult with medical practitioner and follow the instructions. Maintain the regular dosing schedule.
SIDE EFFECTS
- Fatigue, Headache, Nausea, Diarrhea, Insomnia, Elevation of bilirubin, Elevation of lipase, Elevation of creatine kinase, Severe bradycardia, HBV reactivation, Chest pain, Dizziness, Trouble in breathing.
WARNING
- The regular antagonistic delivered amid or after finish of treatment are; Introduction of HBV restoration in HCV/HBV co contaminated patients. To avoid the problem by counting the patients HBsAg & anti-HBc values before initiate the treatment with Resof L. Monitor the hepatic function test periodically before, during & after completion of treatment. Patient should be provided with supportive management for preventing the hepatitis B viral infection reoccurrence.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
Myhep Lvir 400 & 90 mg | Ledipasvir/Sofosbuvir
- Myhep Lvir tablet should be used for both adults & pediatric patients with the age of 12 years or older or weight of at least 35kg.
- Used for; Genotype I, 4, 5, or 6 with compensated cirrhosis or without cirrhosis Genotype 1 infection with compensated cirrhosis or without cirrhosis Liver transplantation condition, genotype 1 with decompensated cirrhosis by use of ribavirin Genotype 1 or 4 without cirrhosis or with compensated cirrhosis by use of ribavirin Pediatric patients, HCV infection related to genotype 1, 4, 5, or 6 without cirrhosis or with compensated cirrhosis.
DOSAGE
- The usual advised dose of Myhep Lvir is one tablet should be administered as once a day. In HIV-1 co infected patients, Myhep Lvir dosage consideration is; Patient without cirrhosis: (adult or pediatric of 12 years of age or older with genotype I, IV, V or VI Chronic HCV) The prescribed dose of Myhep Lvir is one tablet should be taken orally as a single dose for 12 weeks
Genotype I
- Without cirrhosis or compensated cirrhosis: Myhep Lvir should be taken alone as a single dose followed for 12 weeks
- Therapy experienced without cirrhosis: Myhep Lvir should be taken as a single agent for once a day for 12 weeks
- Therapy experienced with compensated cirrhosis: Myhep Lvir tablet should be used for 24 weeks
- In decompensated cirrhosis: Myhep Lvir should be combined with ribavirin to be used, followed for 12 weeks
Genotype I to IV
- In liver transplantation patients with compensated cirrhosis or without cirrhosis: Myhep Lvir tablet should be combined with ribavirin for 12 weeks.
Genotype IV, V or VI :
- Myhep Lvir tablet should be administered alone for 12 weeks for Without cirrhosis or with compensated cirrhosis patients: On the basis of body weight the dose of ribavirin should be calculated <75kg: 1000mg; ≥75kg: 1200mg Ribavirin should be administered with food. Myhep Lvir should be administered with or without food.
PHARMACOKINETICS
Peak plasma concentration of Myhep Lvir :
- Sofosbuvir: 0.8 to 1 hour & GS331007: 3.5 to 4 hours; Ledipasvir: 4 to 4.5 hours No effect produced, while Myhep Lvirshould be administered with or without food.
Plasma protein binding capacity of Myhep Lvir :
- Sofosbuvir: 61 to 65% & GS-331007: minimal binding effect, Ledipasvir: >99.8%
Metabolism of Myhep Lvir :
- Sofosbuvir: hepatic metabolism with cathepsin A, or carboxyl esterase 1 & Ledipasvir: mediated by CYP1A2, 2C8, 2C9, 2C19, 2D6 & 3A4.
Elimination of Myhep Lvir :
- Major route of elimination is through urine & feces. Ledipasvir through urine by 87%; sofosbuvir through urine by 80%, feces by 14% & exhaled air by 3.5%
Half life period of Myhep Lvir :
- Sofosbuvir 0.4%, GS-331007: 27 hours & Ledipasvir: 47 hours.
WORK AS
- Ledipasviris a solid prohibitor of perpetual hepatitis C viral relating non structural 5A protein which is a viral phosphoprotein.
- The essential part of ledipasvir in hostile to viral action instrument; Restraint of; Replication Virion assembly Secretion The mechanism of sofosbuvir associated with against viral movement is; Sofosbuvir is prohibitor of nucleotide analogue of hepatitis C viral disease identified with non basic 5B polymerase. This catalyst is in charge of interceding the HCV RNA duplication.
- The dynamic type of sofosbuvir is in triphosphate shape, which included diminishing the common cell uridine nucleotide and is coordinated by HCV RNA polymerase into the broadened RNA preliminary strand, which is closed in viral chain end.
SAFETY MEASURES
Hepatitis B reoccurrence :
- This condition is mostly occurs in patients who are undergoing anti-viral therapy & fail to receive the anti-hepatitis B viral treatment. Monitor the HBsAg & anti-HBc counts before the therapy Hepatic function test should be performed Start the anti-hepatitis B treatment.
Bradycardia :
- This severity is due to combination of amiodarone with Myhep Lvir treatment. To avoid the problem patient ECG should be monitored. Patient should be counseled before initiate the treatment about the exposure of risk due to amiodarone. Provide supportive management.
Drug interactions :
- The combination of Myhep Lvir with P-gp inducers (potent), causes decreasing the plasma concentration of component of Myhep Lvir.
Risk due to ribavirin :
- Ribavirin causes fetal damage and leads to death. Contraindicated to pregnancy
IN PEDIATRIC
Genotype I
- Without cirrhosis or with compensated cirrhosis: Myhep Lvir should be administered orally afor 12 weeks. Therapy experienced without cirrhosis: Myhep Lvir should be administered orally for 12 weeks. Therapy experienced compensated cirrhosis: Myhep Lvir tablet should be administered orally for 12 weeks.
Genotype IV, V or VI
- Therapy naïve or experienced without cirrhosis or with compensated cirrhosis: Myhep Lvir tablet should be administered orally for 12 weeks. Renal impairment patients; Myhep Lvir dosage adjustment should not be allowed in severe renal damaged condition. Due to greater exposure of sofosbuvir metabolite causes final stage of renal disease (ERSD).
DRUG INTERACTION
- Myhep Lvir an inhibition of P-gp or BCRP drug transporters, this concomitant use causes increase intestinal absorption of these substrates.
- Myhep Lvir+ P-gp strong inducers lead to diminish the Myhep Lvirplasma concentration causes loss of therapeutic efficacy of Myhep Lvir. Myhep Lvir+ warfarin causes alteration in INR values, monitor the prothrombin time during this combination.
- Myhep Lvir+ gastric regulators, causes diminishing ledipasvir plasma concentration, do not administer Myhep Lvir tablet concurrently with gastric regulators. Myhep Lvir+ anti-arrhythmic agents lead to produce plasma concentration elevation of these drugs. Myhep Lvir+ anti-convulsants or anti-mycobacterials may cause depletion of plasma concentration of Myhep Lvir. Myhep Lvir+ anti-retroviral drugs, increases the plasma concentration of these drugs.
- Myhep Lvir+ st Johns wort causes decreasing the plasma concentration of Myhep Lvir. Myhep Lvir+ HMG CoA reductase inhibitors cause elevation of plasma concentration of these drugs.
OVERDOSAGE
- The over dosage condition should be overcome by; Provide supportive management. Monitor the manifestations. Treated by Hemodialysis Ledipasvir does not eliminate by hemodialysis process, because of ledipasvir has large protein binding capacity. The circulating metabolite of sofosbuvir is eliminated from the body by processing with hemodialysis with the range of 54%.
CONTRAINDICATION
- Myhep Lvir with ribavirin is contraindicated to pregnancy condition Hypersensitivity reactions produces, if patients are contraindicated to the component present in the Myhep Lvir.
MISSED DOSE
- In case of missed dose occurrence during the therapy, patient must be consult with medical practitioner and follow the instructions. Maintain the regular dosing schedule.
SIDE EFFECTS
- Fatigue, Headache, Nausea, Diarrhea, Insomnia, Elevation of bilirubin, Elevation of lipase, Elevation of creatine kinase, Severe bradycardia, HBV reactivation, Chest pain, Dizziness, Trouble in breathing.
WARNING
- The regular antagonistic delivered amid or after finish of treatment are; Introduction of HBV restoration in HCV/HBV co contaminated patients.
- To avoid the problem by counting the patients HBsAg & anti-HBc values before initiate the treatment with Myhep Lvir.
- Monitor the hepatic function test periodically before, during & after completion of treatment. Patient should be provided with supportive management for preventing the hepatitis B viral infection reoccurrence.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
Entavir 1 mg | Anti viral drugs
- Entavir 1mg tablet are used as anti-viral medicine, the safety and effectiveness of the Entavir 1mg has been established against chronic hepatitis B viral infection. Entavir 1mg contains an active compound known as Entecavir.
- Entavir 1mg is a classified as prototype for cyclopentane class of nucleoside or nucleotide long lasting hepatitis B anti-viral drug.
- Entavir 1mg tablets are nor curable, may it used to reduce the amount of HBV virus in the body Entavir 1mg diminishing the capability of HBV for multiplication and infecting new liver cells Entavir 1mg enhance the condition of liver Entavir 1mg tablet used to reduce the chance of getting liver cancer & liver failure due to hepatitis B infection in chronic.
INDICATION
The major usage of Entavir 1mg tablets are :
- Entavir 1mg tablet are involved in the treatment of chronic hepatitis B viral infection in adults and pediatric patients with the age of 2 years and older with the sign of active viral production, either constant eminence of serum aminotransferase or histological effective disease.
- Before initiating the therapy with Entavir 1mg tablet, the crucial points should be considered; The evidence of Entavir 1mg in adult patients based on the clinical trial data in nucleoside inhibitor therapy for new patients and patient opposed to lamivudine treatment with HBeAg positive and HBeAg negative HBV infection and compensated liver cirrhosis & minor in decompensated cirrhosis. In children with the age of 2 years or older: Used for nucleoside inhibitor therapy naïve, lamivudine resistance patients with HBeAg positive chronic HBV infection and compensated cirrhosis patients.
DOSAGE
The dosage recommendation of Entavir tablets are given below as follows :
- In compensated liver disease : The usual dosage of Entavir for this condition in adults is 0.5mg should be recommended as a single dose.
- In decompensated cirrhosis: In chronic hepatitis B viral infected patients, the prescribed dosage of Entavir is 1mg should be given orally as a single dose.
In pediatric patients :
- For therapy naïve patients : The recommended dosage of Entavir tablet is 0.5mg should be given as a single dose.
- For lamivudine resistance : The prescribed dosage is 1mg of Entavir should be taken as a single dose.
- For renal impairment patients : CrCl 50ml/min or greater: The recommended dosage is 0.5mg of Entavir given as a single dose CrCl 30 to less than 50ml/min: The recommended dosage is 0.5mg of Entavir given for every 48 hours CrCl 10ml/min to less than 30ml/min: The prescribed dosage is 0.5mg of Entavir should be given for every 72 hours. CrCl less than 10ml/min & hemodialysis, CAPD: The suggested dosage is 0.5mg of Entavir given for every 7 days.
- CrCl 50ml/min or greater: The recommended dosage is 1mg of Entavir given as a single dose CrCl 30 to less than 50ml/min: The recommended dosage is 0.5mg of Entavir as a single dose or 1mg for every 48 hours. CrCl 10ml/min to less than 30ml/min: The prescribed dosage is 1mg of Entavir should be given for every 72 hours. CrCl less than 10ml/min & hemodialysis, CAPD: The suggested dosage is 1mg of Entavir given for every 7 days.
- How to administer Entavir 1mg tablets : Entavir tablet should be given for chronic hepatitis B viral infected patients, taken in an empty stomach i.e., partially 2 hours after a meal and 2 hours earlier the next meal.
ADME
- Entavir enclose as Entecavir as an active component, a synthetic analogue of 2-deoxyguanosine has anti-viral activity against hepatitis B virus.
- Entecavir is triggers in-vivo into 5-triphosphate metabolite which is an active form of Entecavir. Successively, the active metabolite triphosphate form strike with natural substrate deoxyguanosine triphosphate dGTP for infusion into viral DNA.
- Hence infusion of the activated triphosphate metabolite of Entecavir leads to inhibition of reverse transcriptase enzyme. For viral production and transcription RT is required, thus inhibition results as cell lysis.
WORKS AS
- Entavir enclose as Entecavir as an active component, a synthetic analogue of 2-deoxyguanosine has anti-viral activity against hepatitis B virus. Entecavir is triggers in-vivo into 5-triphosphate metabolite which is an active form of Entecavir.
- Successively, the active metabolite triphosphate form strike with natural substrate deoxyguanosine triphosphate dGTP for infusion into viral DNA.
- Hence infusion of the activated triphosphate metabolite of Entecavir leads to inhibition of reverse transcriptase enzyme. For viral production and transcription RT is required, thus inhibition results as cell lysis.
PRECAUTIONS
- There are two major unfavorable conditions may occur during or after discontinuation of therapy with Entavir 1mg . It may include as; Hepatitis B aggravation occurs severely after therapy Lactic acidosis or hepatomegaly with steatosis
In lactic acidosis or hepatomegaly with steatosis :
- Nucleoside analogue inclusive of Entavir 1mg , using alone or combination with other anti-retroviral medicines, reported has fatal cases like lactic acidosis or hepatomegaly with steatosis. This condition is majorly occurs in women, causes obesity and extended nucleoside inhibitor risk. Discontinue the therapy If this adverse effect occurs or otherwise provide supportive measures.
- In hepatitis B reactivation : This side effect occurs mostly after the stopping of anti-hepatitis B viral therapy frequently. Hepatic or liver function test should be periodically taken for the patients To avoid this condition, The patients who are getting hepatitis B infection after the treatment, recurrently will get Anti-hepatitis B viral therapy
- In patients with HBV/HIV co infection : Entavir 1mg tablet usage is not assessed in HBV/HIV co infected patients who are not correspondingly getting anti-retroviral medication. Entavir 1mg tablets used to treat chronic hepatitis B infection in HIV infected patients that are not being used if there is a possible to get advancement of resistance to HIV nucleoside reverse transcriptase inhibitors. Patient must investigate by checking the HIV antibody before starting therapy with Entecavir
Entavir 1mg causes some effects due to interact with other drugs :
- Concurrent use of Entavir 1mg with lamivudine, Adefovir or tenofovir disoproxil fumarate cause no serious drug interactions Some drugs may cause some effects while concomitant with Entecavir, it may follow as; Chlorpheniramine Ginkgo Biloba Aspirin Lamivudine Metoprolol Valproate sodium Paracetamol, Sorafenib, KCl in sodium chloride Hence, Entavir 1mg is eliminated after metabolism through kidneys. If co administration of Entavir 1mg tablets with drugs reducing the renal function may leads to cause increasing the concentration of Entecavir and produces serious adverse effects.
STORAGE
Entavir 1mg tablet should be stored at 20℃ to 25℃ (68℉ to 77℉) Protected away from moisture, heat and light.
EFFECT OF FOOD
While taking Entavir 1mg tablet with high fat meal causes reduction of absorption of Entecavir. Entavir 1mg must be administered on an empty stomach.
CONTRAINDICATIONS
Entavir 1mg has no contraindications Some hypersensitivity reactions may occur, if patients are contraindicated to component of Entavir 1mg tablets.
MISSED DOSE
Entavir 0.5mg tablets are anti-hepaciviral drug, used only by getting advice from medical practitioner. If patient fail to take the dose of Entavir 1mg , should consult with physician and follow the instructions given by them or otherwise swap the missed dose and continue the regular dosing schedule.
OVERDOSAGE
Over dosage is not occurred during the therapy using with Entavir 1mg tablets. If over dosage occurs, the patients must be confirmed with toxicity and monitored the signs and symptoms. Patients should be provided with supportive measures For single dose of 1mg of Entecavir, after 4hours of hemodialysis clears 13% of Entecavir dose from the body.
SIDE EFFECTS
- Two major adverse effects occurred after completion of therapy, includes as Lactic acidosis or severe hepatomegaly with steatosis Aggravation of hepatitis B viral infection after anti-hepatitis B viral treatment discontinued. Most common side effects in compensated liver cirrhosis are : Headache, Fatigue, Dizziness, Hematuria, Abnormal lab test results may occur, Diarrhea, Dyspepsia, Vomiting, Insomnia, Hepatic encephalopathy, Creatinine value get elevated, Hyperglycemia, Respiratory tract infection, Depletion of blood bicarbonate, Renal failure, Hepatorenal syndrome, Gastrointestinal hemorrhage, Hepatocellular cancer, Immune system related effects like anaphylactic reaction, Skin: Alopecia, rash, Elevation of AST and ALT.
In decompensated cirrhosis :
- Peripheral edema, Ascites, Pyrexia, Glycosuria.
CONTACT DETAILS
Phone: + 91-9987711567
Email: applepharmaceutical@gmail.com
Email: info@myapplepharma.com
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