Anticancer

Product Details:

Indications:

• Metastatic carcinoma of the ovary after failure of initial or subsequent chemo therapy. 
• Small cell lung cancer disease after failure of first line chemotherapy.

Dosage:

• The recommended starting dose is 1.5mg/m2 body surface area by IV infusion over 30 minutes daily for 5 consecutive days.
• In absence of tumor progression, a minimum of four courses are recommended, as tumour response may be delayed.

Product Details:

Indications:

• Multiple myeloma: As monotherapy is indicated for the maintenance treatment of adult patients with newly diagnosed multiple myeloma who have undergone autologous stem cell transplantation.
• As combination therapy is indicated for the treatment of adult patients with previously untreated multiple myeloma who are not eligible for transplant.
• Myelodysplastic syndromes (MDS):- As monotherapy is indicated for the treatment of adult patients with transfusion-dependent anemia due to low- or intermediate-1-risk myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality when other therapeutic options are insufficient or inadequate.

Dosage:

• MDS: PO 10mg OD
• Multiple Myeloma: PO 25mg once daily on days 1 to 21 of repeated 28 day cycles.
• Note – Dosage adjustment is required in case of thrombocytopenia and neutropenia.

Product Details:

Indications:

• Leucovorin is used to reduce toxicity following high-dose methotrexate therapy in a process known as “folinic acid rescue”. It can also be used in accidental methotrexate overdose or in cases where excretion of methotrexate from the body is impaired.
• In advanced bowel cancer, Leucovorin can be used in combination with fluorouracil, as a mediator of cytotoxicity.

Leucovorin has also been shown to be useful in the treatment of megaloblastic anaemias caused by folic acid deficiency. These are known to occur in:

• Infants
• Pregnancy
• Malabsorption syndromes
• Liver diseases
• Malnutrition

Dosage:
Duration of calcium folinate rescue primarily depend on the type and dosage of methotrexate therapy, the occurrence of toxicity symptoms, and the individual excretion capacity for methotrexate. As a rule, the first dose of calcium folinate is 15 mg (6-12 mg/m²) to be given 12-24 hours (24 hours at the latest) after the beginning of methotrexate infusion. The same dose is given every 6 hours throughout a period of 72 hours. After several parenteral doses treatment can be switched over to the oral form.
Trimetrexate toxicity:

• Prevention: Calcium folinate should be administered every day during treatment with trimetrexate and for 72 hours after the last dose of trimetrexate. Calcium folinate can be administered either by the intravenous route at a dose of 20 mg/m² for 5 to 10 minutes every 6 hours for a total daily dose of 80 mg/m², or by oral route with four doses of 20 mg/m2 administered at equal time intervals. Daily doses of calcium folinate should be adjusted depending on the haematological toxicity of trimetrexate.
• Overdosage (possibly occurring with trimetrexate doses above 90 mg/m2 without concomitant administration of calcium folinate): after stopping trimetrexate, calcium folinate 40 mg/m2 IV every 6 hours for 3 days.

Trimethoprim toxicity:

• After stopping trimethoprim, 3-10 mg/day calcium folinate until recovery of a normal blood count.

Product Details:

Indications:

• Ifosfamide and mesna is indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis.

Dosage:

• injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage weight by weight (w/w) at the time of ifosfamide administration and 4 and 8 hours after each dose of ifosfamide.

Product Details:

Indications:

• Bortezomib is used for the treatment of people with multiple myeloma (a cancer of the plasma cells) and mantle cell lymphoma (a cancer of the lymph nodes).

Dosage:

Monotherapy:

• 3.5 mg powder for solution for injection is administered via intravenous or subcutaneous injection at the recommended dose of 1.3 mg/m2 body surface area twice weekly for two weeks on days 1, 4, 8, and 11 in a 21-day treatment cycle.
• This 3-week period is considered a treatment cycle. It is recommended that patients receive 2 cycles following a confirmation of a complete response.
• It is also recommended that responding patients who do not achieve a complete remission receive a total of 8 cycles.
• At least 72 hours should elapse between consecutive doses.

Dose adjustments during treatment and re-initiation of treatment for monotherapy:

• Treatment must be withheld at the onset of any Grade 3 non-haematological or any Grade 4 haematological toxicities, excluding neuropathy as discussed below.
• Once the symptoms of the toxicity have resolved, treatment may be re-initiated at a 25% reduced dose (1.3 mg/m2 reduced to 1.0 mg/m2; 1.0 mg/m2 reduced to 0.7 mg/m2).
• If the toxicity is not resolved or if it recurs at the lowest dose, discontinuation of must be considered unless the benefit of treatment clearly outweighs the risk.

Product Details:

Indications:

• Acute myeloblastic Leukemia
• Neuroblastoma
• Acute Lymphoblastic Leukemia
• Rhabdomyosarcoma
• Acute Non-Lymphatic Leukemia of adults
• Remission induction in acute Lymphatic Leukemia of children and adults

Dosage:
Starting Doses:

• The recommended dosage in each individual may vary from 0.5 to 3 mg/ kg.

Acute non-lymphoytic leukemia

• Patients <60 yrs. of age: 45mg/m2/day.
• Patients >60 yrs. of age: 30mg/m2/day.

Acute Lymphocytic Leukemia (ALL)

• Paediatric: 25mg/m2
• Adult: 45mg/m2

Product Details:

Indications:

• Doxorubicin hydrochloride liposomal Injection is indicated for the treatment of metastatic carcinoma of the ovary in patients with disease that is refractory to both paclitaxel and platinum based chemotherapy regimens. Refractory disease is defined as disease that has progressed while on treatment or within 6 months of completing treatment.
• Doxorubicin hydrochloride liposomal Injection is indicated as monotherapy for the treatment of metastatic breast cancer, where there is an increased cardiac risk.????
• Doxorubicin hydrochloride liposomal Injection is also indicated for the treatment of AIDS related Kaposi''s Sarcoma in patients with extensive mucocutaneous or visceral disease that has progressed on prior combination therapy (consisting of two of the following agents: a vinca alkaloid, bleomycin and standard doxorubicin or another anthracycline) or in patients who are intolerant to such therapy.

Dose Adjustment:

• Hepatic Impairment: the dose should be reduced if the bilirubin level is 1.2 mg/dL or greater.
• Serum bilirubin 1.2 to 3 mg/dL: give 1/2 the normal dose
• Serum bilirubin greater than 3 mg/dL: give 1/4 the normal dose.
• Toxicity: adverse reactions, such as hand-foot syndrome, hematologic toxicities, and stomatitis may be managed by dose delay and adjustments.
• Drug Availability: doxorubicin liposomal injection is supplied as a 20 mg/10mL and 50 mg/25 mL single-use vial.

Dosage:

• AIDS-related Kaposi''s sarcoma
• Multiple Myeloma
• Ovarian Cancer
• IV, intravenous

Dose:

• 20 mg/m2 IV every 3 weeks until disease progression or unacceptable toxicity.
• Following bortezomib administration, 30 mg/m2 IV on day 4 every 3 weeks for eight cycles or until disease progression or unacceptable toxicity.
• (bortezomib: 1.3 mg/m2 bolus on days 1, 4, 8 and 11)
• 50 mg/m2 every 4 weeks until disease progression or unacceptable toxicity.

Product Details:

Indications:

• Treatment of adenocarcinoma of the stomach or pancreas.
• Also used in treatment of, bladder, breast, cervical, colorectal, head and neck, and non-small cell lung cancer.

Dosage:

• As Single Therapy: 12 - 14 mg/m² once a month or every 35 days by intravenous infusion.
• The crystals are dissolved in 200 mL of a 5% glucose solution which is then administered over a period of 30 minutes, preferably with Vitamin B Compound.
• As Combination Therapy: 10 mg/m² every 6 - 9 weeks. Higher doses have also been given.
• Mitomycin-C is usually administered along with other agents (e.g. FOAM –5 FU plus vincristine plus doxorubicin plus mitomycin; SMF –streptozotocin plus mitomycin plus 5 FU; AM – doxorubicin plus mitomycin; FAM –5 FU plus doxorubicin plus mitomycin).

Product Details:

Indications:

• Leukaemias, including acute lymphocytic leukaemia, chronic lymphocytic leukaemia, acute myelogenous leukaemia and blastic crisis of chronic myelogenous leukaemia
• Malignant lymphomas, including Hodgkin's disease and non-Hodgkin's lymphomas.
• Solid tumours, including breast carcinoma, small cell bronchogenic carcinoma, head and neck carcinoma and soft tissue sarcomas.
• Paediatric solid tumours, including Ewing's sarcoma, embryonal rhabdomyosarcoma, neuroblastoma, Wilms' tumour, retinoblastoma and medulloblastoma

Dosage:

• Adults: 1.4 mg/m2 IV once weekly (typical dose 2 mg)
• Children: 1.4 to 2 mg/m2 given on a weekly basis with a maximum weekly dose of 2 mg.        
• Elderly: l Body weight more than 10 kg or body surface area of 1 m2 or more - 1 to 2 mg/m2 IV once weekly.
• l Body weight less than or equal to 10 kg or Body surface area less than 1 m2 or more - 0.05 mg/kg IV once weekly initially. Titrate dose as tolerated up to 2 mg/dose.
• Hepatic Impairment: A 50 per cent reduction in the dose of vincristine sulphate is recommended for patients having a direct serum bilirubin value above 3 mg/100 ml (51 micromol/l).

Product Details:

Indications:

• Trophoblastic neoplasms (chorioadenoma destruens, choriocarcinoma, and hydatidiform mole).
• Acute lymphocytic leukemia (ALL)
• Meningeal leukemia or meningeal leukemia
• Breast cancer
• Head and neck cancer
• Cutaneous T-cell lymphoma (mycosis fungoides)
• Lung cancer
• Non-Hodgkin's lymphoma (NHL)
• Burkitt's Lymphoma
• Osteogenic sarcoma

Dosage:

• Trophoblastic Neoplasms Adults: 15-30mg peroral (PO)/ intramuscular (IM) once daily, given for 5 days.
• Acute Lymphocyic Leukemia Adults & children: 3.3mg/m2 IV daily for 4-6 weeks or followed by maintenance therapy with 20-30mg/m2/PO/IM given twice weekly.
• Breast Cancer Adults & Children: 40-60mg/m2 IV given on day 1 of every 21-28 days along with cyclophosphamide & fluorouracil.
• Head & Neck Cancer Adults & Children: 40mg/m2 IV on days 1 & 15 of every 21 days alone or with bleomycin & cisplatin.
• Cutaneous T-cell Lymphoma Adults: 50mg IM once weekly or 25mg twice weekly.
• Lung Cancer: Methotrexate 20mg/m2 IV as a single dose along with cisplatin, doxorubicin & cyclophosphamide repeated every 28 days.

Product Details:

Indications:

• Is used in combination with other anti-neoplastic agents to treat acute lymphoblastic leukaemia.
• It may also be used in other neoplastic conditions where depletion of asparagine might be expected to have a useful effect.
• Patients receiving treatment with L-asparaginase from Escherichia coli, and who develop hypersensitivity to that enzyme may be able to continue treatment with as the enzymes are immunologically distinct.

Dosage:

• The usual dosage range for L-Asparaginase is 50 to 200 KU/kg bodyweight daily or every alternate day, given intravenously or intramuscularly.
• Test Dose: Before treatment is started a test dose of 1 to 10 KU of L-Asparaginase in 0.1 ml of distilled water should be injected subcutaneously and the injection site observed for several hours of evidence of primary hypersensitivity.

Product Details:

Indications:

• Carcinoma of the Colon or Rectum.
• Metastatic carcinoma of the colon or rectum whose disease has recurred or progressed following initial fluorouracil-based therapy.

Dosage:

• Colorectal cancer single agent regimen 1: Irinotecan Hydrochloride Injection, 125 mg/m2 intravenous infusion over 90 minutes on days 1, 8, 15, 22 then 2-week rest. (2.1)
• Colorectal cancer single agent regimen 2: Irinotecan Hydrochloride Injection, 350 mg/m2 intravenous infusion over 90 minutes on day 1 every 3 weeks. (2.1)

Product Details:

Indications:

• Cytarabine may be used alone or in combination with other antineoplastic agents.
• It is indicated alone or in combination for induction of remission and/or maintenance in patients with acute myeloid leukemia, acute non-lymphoblastic leukaemias, acute lymphoblastic leukaemias, acute lymphocytic leukaemia, erythroleukaemia, blast crises of chronic myeloid leukaemia, diffuse histiocytic lymphomas (non-Hodgkin's lymphomas of high malignancy), meningeal leukaemia and meningeal neoplasms.
• Clinicians should refer to the current literature on combination therapy before initiating treatment.

Dosage:

• Remission Induction: Adults
• Continuous Dosing: The usual dose in leukaemia is 2 mg/kg by rapid intravenous injection daily for ten days. If after ten days neither therapeutic response nor toxicity has been observed, the dose may be increased to 4 mg/kg until a therapeutic response or toxicity is evident.
• Intermittent dosing: 3-5 mg/kg daily, for five consecutive days. This course of treatment can be repeated after an interval of 2 to 9 days.

Product Details:

Indication:

• Is indicated as monotherapy for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating mutations of EGFR-TK.

Dosage:

• Adult: 250 mg tablet once a day, taken with or without food.

Product Details:

Indications:

• To be used as mono-therapy, or as part of an existing chemotherapy for advanced or metastatic tumours: testicular carcinoma (palliative and curative poly-chemotherapy) and ovary carcinoma (stages III and IV), and head and neck squamous-cell epithelioma (palliative therapy).
• In the treatment of small cell lung carcinoma.
• In the treatment of advanced non-small cell lung carcinoma.

Dosage:

• Single dose of 50 to 120 mg/m2 body surface every 3 to 4 weeks.
• 15 to 20 mg/m2/day for five days, every 3 to 4 weeks.
• If cisplatin is used in combination chemotherapy, the dose of cisplatin must be reduced.
• A typical dose is 20 mg/m2 or more once every 3 to 4 weeks unless in the combination therapy of small-cell and non-small-cell lung carcinoma, in which a typical dose of 80 mg/m2 is administered.

Product Details:

Indications:

• Non small cell lung carcinoma, breast carcinoma, Hodgkin's disease, ovarian carcinoma, squamous cell carcinoma of the head and neck, cervical, SCLC, renal cell cancer and kaposi's sarcoma.

Dosage:

• Initial dose of 30mg/m² weekly over a period of 6-10 min.
• No dose adjustment is required for renal insufficiancy

Product Details:

Indications

• Bicalutamide 150 mg tablets are indicated either alone or as adjuvant to radical prostatectomy or radiotherapy in patients with locally advanced prostate cancer at high risk for disease progression.
• Bicalutamide 150 mg tablets are also indicated for the management of patients with locally advanced.
• Non-metastatic prostate cancer for whom surgical castration or other medical intervention is not considered appropriate or acceptable.

Dosage

• Adult males including the elderly- One 150 mg tablet once a day.
• Bicalutamide 150 mg tablets should be taken continuously for at least 2 years or until disease progression.
• Children and adolescents- Bicalutamide is contraindicated in children and adolescents.
• Renal impairment- No dose adjustment is necessary for patients with renal impairment
• Hepatic impairment- No dose adjustment is necessary for patients with mild hepatic impairment.
• Increased accumulation may occur in patients with moderate to severe hepatic impairment.

Product Details:

Indication:

• Squamous cell carcinoma affecting the mouth, nasopharynx and paranasal sinuses, larynx, oesophagus, external, cervix or skin. Well differentiated tumours usually respond better than anaplastic ones.
• Hodgkin's disease and other malignant lymphomas, including mycosis fungoides.
• Testicular teratoma
• Malignant effusions of serous cavities.
• Secondary indications in which bleomycin has been shown to be of some value (alone or in combination with other drugs) include metastatic malignant melanoma, carcinoma of the thyroid, lung and bladder.

Dosage:

• Used alone the normal dosage is 15 x 103 IU (1 vial) three times a week or 30 x 103 IU (2 vials) twice a week, either intramuscularly or intravenously.

Product Details:

Indications

• Hypercalcemia of Malignancy (Moderate to Severe)
• Paget's Disease
• Osteolytic Bone Metastases of Breast Cancer
• Osteolytic Lesions of Multiple Myeloma

Dosage

• Moderate Hypercalcemia (serum calcium 12-13.5 mg/dL) 60 to 90 mg given as a single-dose, intravenous infusion over 2 to 24 hours.
• Severe Hypercalcemia (serum calcium >13.5 mg/dL) 90 mg given as a single-dose, intravenous infusion over 2 to 24 hours.
• Paget's Disease (Moderate to Severe) 30 mg daily, administered as a 4-hour infusion on 3 consecutive days for a total dose of 90 mg.
• Osteolytic Lesions of Multiple Myeloma 90 mg administered as a 4-hour infusion given on a monthly basis.
• Osteolytic Bone Metastases of Breast Cancer 90 mg administered over a 2-hour infusion given every 3-4 weeks.

Product Details:

Epirubicin Hydrochloride use to treat adjuvant primary breast cancer inhibition of topoisomerase 2high affinity binding to dna  through intercalationbinding to cell membrane and effect the fluidity of the membrane generation of free radicals

Product Details:

Indications:

• Advanced ovarian carcinoma of epithelial origin in:
• First line therapy
• Second line therapy, after other treatments have failed.
• Small cell carcinoma of the lung.

Dosage:

• Carboplatin should be used by the intravenous route only.
• The recommended dosage of Carboplatin in previously untreated adult patients with normal kidney function, i.e. creatinine clearance > 60 ml/min is 400 mg/m2 as a single short term IV dose administered by a 15 to 60 minutes infusion

Product Details:

Indications:

• Rituximab is used to treat non-Hodgkin's lymphoma or chronic lymphocytic leukemia. This medicine is also used in combination with another drug called methotrexate to treat symptoms of adult rheumatoid arthritis. It is also used in combination with steroid medicines to treat certain rare disorders that cause inflammation of blood vessels and other tissues in the body.

Product Details:

Indications:

• Prevention of skeletal related events (pathological fractures, spinal compression, radiation or surgery to bone, or tumour-induced hypercalcaemia) in adult patients with advanced malignancies involving bone.
• Treatment of adult patients with tumour-induced hypercalcaemia (TIH).
• Patients with Multiple Myeloma (MM) and patients with documented bone metastases from solid tumors, in conjunction with standard anti-neoplastic therapy. Prostate cancer should have progressed after treatment with at least one hormonal therapy and Hypercalcemia of Malignancy (HCM).

Product Details:

FLOPLATIN USE TO TREAT Inhibition of Topoisomerase 2High affinity binding to DNA  through intercalation Binding top cell membrane and effect the fluidity of the membraneGeneration of free radicalsoxaliplatin forms both inter- and intra-strand cross links in DNA, which prevent DNA replication and transcription, causing cell death.

Product Details:

LENALIDOMIDE USE TO TREAT : Multiple myeloma (MM),

myelodysplastic syndromes (MDS)

Mantle cell lymphoma (MCL)

•      Lenalidomide, a thalidomide analogue, is an immunomodulator with multiple mechanisms of action.

•      Lenalidomide has immunomodulatory, tumoricidal, and antiangiogenic SAproperties, and synergizes with dexamethasone to enhance anti-myeloma activity

Product Details:

FRACZOL 4 mg injection is used in the treatment of Hypercalcemia of Malignancy Multiple Myeloma and Bone Metastases of Solid Tumors and post menopausal osteoporosis (porous bones), osteoporosis in men (porous bones) and steroid induced osteoporosis (porous bones).
How it worksZoledronic acid belongs to a class of drugs known as bisphosphonates. It works by slowing bone breakdown, increasing bone density (thickness), and decreasing the amount of calcium released from the bones into the blood.

Product Details:

Indications:

• Flutamide is indicated for the treatment of advanced prostatic carcinoma in which suppression of effects is indicated.
• Flutamide may be used in combination with an LHRH agonist, both on commencement of treatment or as an adjunctive therapy in patients already receiving an LHRH agonist.
• Flutamide may also be used in surgically castrated patients.

Dosage:

• Adults and older people: One tablet three times daily at 8 hour intervals.

Dosage Adjustment:

• Renal Impairment: Dosing adjustments for renal impairment are not indicated for flutamide.
• Hepatic Impairment: Discontinue Flutamide if AST ≥ 2 x ULN or bilirubin is > ULN.

Product Details:

Indications:

• Temozolomide Capsules is an alkylating drug indicated for the treatment of adult patients with:
• Newly diagnosed glioblastoma multiforme (GBM) concomitantly with radiotherapy and then as maintenance treatment.
• Refractory anaplastic astrocytoma patients who have experienced disease progression on a drug regimen containing nitrosourea and procarbazine.

Dosage:

• Newly Diagnosed GBM: 75 mg/m2 for 42 days concomitant with focal radiotherapy followed by initial maintenance dose of 150 mg/m2 once daily for Days 1-5 of a 28-day cycle of Temozolomide Capsules for 6 cycles.
• Refractory Anaplastic Astrocytoma: Initial dose 150 mg/m2 once daily for 5 consecutive days per 28-day treatment cycle.
• Temozolomide Capsules can be administered under both fasting and non-fasting conditions; however, absorption is affected by food and consistency of administration with respect to food is recommended. There are no dietary restrictions with Temozolomide Capsules. To reduce nausea and vomiting, Temozolomide Capsules should be taken on an empty stomach. Bedtime administration may be advised. Antiemetic therapy may be administered prior to and/or following administration of Temozolomide Capsules.

Product Details:

Indications:

• As an orally active anti-oestrogen in the treatment of breast cancer. Also used to stimulate ovulation in anovulatory infertility.

Dosage:

• Breast Cancer: Adults (including the elderly): The dosage range is 20 to 40 mg daily, given either in divided doses twice daily or as a single dose once daily.
• In early disease, it is currently recommended that treatment is given for not less than 5 years. The optimal duration of tamoxifen therapy remains to be determined.
• Anovulatory Infertility: In women with regular menstruation but with anovular cycles treatment should commence with 20 mg daily in either one or two doses administered on the second, third, fourth and fifth days of the menstrual cycle. In unsuccessful cases further courses may be given during subsequent menstrual periods, increasing the dosage to 20 mg then 40 mg twice daily.

Product Details:

Indications:

• Thalidomide in combination with melphalan and prednisone as first line treatment of patients with untreated multiple myeloma, aged ≥ 65 years or ineligible for high dose chemotherapy.
• Thalidomide is prescribed and dispensed according to the Thalidomide Pregnancy Prevention Programme.

Dosage:

Multiple Myeloma:

• Thalidomide is administered in combination with dexamethasone in 28-day treatment cycles. The dose of thalidomide is 200 mg administered orally once daily with water, preferably at bedtime and at least 1 hour after the evening meal. The dose of dexamethasone is 40 mg daily administered orally on days 1-4, 9-12, and 17-20 every 28 days. Patients who develop adverse reactions such as constipation, somnolence, or peripheralneuropathy may benefit by either temporarily discontinuing the drug or continuing at a lower dose. With the abatement of these adverse reactions, the drug may be started at a lower dose or at the previous dose based on clinical judgment.

Cardiac Transplantation:

• 1.5 g intravenously twice a day administered over no less than 2 hours or 1.5 g orally twice a day.

Product Details:

Indications:

• Imatinib is indicated for the treatment of
• Acute lymphoblastic leukemia
• Aggressive systemic mastocytosis
• Chronic myeloid leukemia (CMC)
• Myelodysplastic disease
• Gastrointestinal stromal tumor (GIST)

Dosage:

• 400 mg/day for adult patients in chronic phase, 600 mg/day for adult patients in accelerated phase.
• The dose of 340 mg/m2 daily is recommended for children with chronic phase.

Product Details:

Indications:

• Myeloma.
• Resistant chronic myelotic leukemia.
• Recurrent, Metastatic or inoperable carcinoma of the ovary.
• Primary squamous cell (epidermal) carcinomas of the head and the neck cancer, excluding the lip.
• Melanoma

Dosage:

• Adults:- FLOXEA should be started 7 days before concurrent irradiation therapy.
• Continuous therapy:- FLOXEA 20-30 mg/kg should be given daily in single doses.
• Intermittent therapy:- FLOXEA 80 mg/kg in single doses should be given every third day.

Product Details:

Indications:

• Dacarbazine is indicated for the treatment of patients with metastasised malignant melanoma.

Further indications for dacarbazine as part of a combination chemotherapy are:

• Advanced Hodgkin's disease,
• Advanced adult soft tissue sarcomas (except mesothelioma, Kaposi sarcoma).

Dosage:

Malignant melanoma:

• Dacarbazine can be administered as single agent in doses of 200 to 250 mg/m2 body surface area/day as an i.v. injection for 5 days every 3 weeks.
• As an alternative to an intravenous bolus injection dacarbazine can be administered as a short-term infusion (over 15 - 30 minutes).
• It is also possible to give 850 mg/m2 body surface area on day 1 and then once every 3 weeks as intravenous infusion.

Product Details:

Indications

• Uterine cancer
• Malignant melanoma
• Testicular cancer
• Acute lymphocytic leukemia
• Wilms' tumor
• Advanced tumors of breast or ovary
• Rhabdomyosarcoma
• Paget's disease of bone
• Ewing's sarcoma Kaposi's sarcoma
• Sarcoma botryoides
• Acute organ (kidney or heart) rejection

Dosage

• Adults 500 mcg (0.5 mg) I.V. daily for a maximum of 5 days. Maximum dose is 15 mcg/kg/day or 400 to 600 mcg/m2/day for 5 days. After bone marrow recovery, course may be repeated.
• Dose should be based on body surface area in obese or edematous patients.
• Children 15 mcg/kg (0.015 mg/kg) I.V. daily for a maximum of 5 days. Or, give a total dosage of 2,500 mcg/m2 I.V. over a 1-week period. Maximum dose is 15mcg/kg/day or 400 to 600 mcg/m2/day. After bone marrow recovery, course may be repeated.
• For isolation-perfusion, use 50 mcg/kg for leg or pelvis; 35 mcg/kg for arm. For second course, wait at least 3 weeks, provided all signs of toxicity have subsided.

Product Details:

Indications:

• Symptomatic control and reduction of growth hormone (GH) and IGF-1 plasma levels in patients with acromegaly who are inadequately controlled by surgery or radiotherapy.
• Is also indicated for acromegalic patients unfit or unwilling to undergo surgery, or in the interim period until radiotherapy becomes fully effective.
• Relief of symptoms associated with functional gastro-entero-pancreatic (GEP) endocrine tumours, e.g. carcinoid tumours with features of the carcinoid syndrome
• Itis not an anti-tumour therapy and is not curative in these patients.
• Prevention of complications following pancreatic surgery.
• Emergency management to stop bleeding and to protect from re-bleeding owing to gastro-oesophageal varices in patients with cirrhosis. It is to be used in association with specific treatment such as endoscopic sclerotherapy.

Treatment of TSH-secreting pituitary adenomas:

• When secretion has not normalised after surgery and/or radiotherapy;
• In patients in whom surgery is inappropriate;
• In irradiated patients, until radiotherapy is effective.

Dosage:

• Acromegaly: Initially 0.05 to 0.1 mg by subcutaneous (s.c.) injection every 8 or 12 hours. Dosage adjustment should be based on monthly assessment of GH and IGF-1 levels (target: GH <2.5 ng/mL); IGF-1 within normal range) and clinical symptoms, and on tolerability. In most patients, the optimal daily dose will be 0.3 mg. A maximum dose of 1.5 mg per day should not be exceeded. For patients on a stable dose of Octreotide assessment of GH should be made every 6 months.
• If no relevant reduction in GH levels and no improvement in clinical symptoms have been achieved within 3 months of starting treatment with Octreotide therapy should be discontinued.
• Gastro-entero-pancreatic endocrine tumours: Initially 0.05 mg once or twice daily by s.c. injection. Depending on clinical response, effect on levels of tumour-produced hormones (in cases of carcinoid tumours, on the urinary excretion of 5-hydroxyindole acetic acid), and on tolerability, dosage can be gradually increased to 0.1 to 0.2 mg 3 times daily. Under exceptional circumstances, higher doses may be required. Maintenance doses have to be adjusted individually.
• In carcinoid tumours, if there is no beneficial response within 1 week of treatment with Octreotide at the maximum tolerated dose, therapy should not be continued.
• Complications following pancreatic surgery: 0.1 mg 3 times daily by s.c. injection for 7 consecutive days, starting on the day of surgery at least 1 hour before laparotomy.
• Bleeding gastro-oesophageal varices: 25 micrograms/hour for 5 days by continuous intravenous (i.v.) infusion, Octreotide can be used in dilution with physiological saline.
• In cirrhotic patients with bleeding gastro-oesophageal varices. Octreotide has been well tolerated at continuous i.v. doses of up to 50 micrograms/hour for 5 days.

Product Details:

Indications:

• Frequently Responsive Malignancies
• Generalized Hodgkin's disease (Stages III & IV).
• Lymphocytic lymphoma (nodular and diffuse, poorly and well differentiated).
• Histiocytic lymphoma.
• Mycosis fungoides (advanced stages).
• Advanced carcinoma of the testis (embryonal carcinoma, teratocarcinoma & choriocarcinoma).
• Kaposi's sarcoma.
• Less Frequently Responsive Malignancies
• Choriocarcinoma resistant to other chemotherapeutic agents.
• Carcinoma of the breast, unresponsive to appropriate endocrine surgery & hormonal therapy.

Dosage:

• Adults: A single IV dose of 3.7 mg/m2 of body surface area for 4-6 weeks.
• Children: 6 mg/m2 of body surface area with other chemotherapeutic agents.

Product Details:

Indications:

• The primary treatment and re-treatment of tuberculosis and for prophylaxis in cases of inactive tuberculosis or large-tuberculin-positive reaction.
• Ethambutol should only be used in conjunction with other anti-tuberculous drugs to which the patients organisms are susceptible.??????????????

Dosage:

• The dosage of Ethambutol must be adjusted according to the body weight of the patient.

Adults:

• For primary treatment and prophylaxis: Ethambutol should be administered in a single daily oral dose of 15mg/kg, concomitant drugs being maintained at their recommended dosage levels.
• For re-treatment: For the first 60 days of treatment, Ethambutol should be administered in a single daily oral dose of 25mg/kg. Thereafter the dosage should be reduced to 15mg/kg, concomitant drugs being maintained at their recommended dosage levels.

Children:

• For primary treatment and re-treatment: For the first 60 days of treatment, a single daily oral dose of 25mg/kg. Thereafter the dosage should be reduced to 15mg/kg, concomitant drugs being maintained at their recommended dosage levels.
• For prophylaxis: A single daily oral dose of 15mg/kg, concomitant drugs being used at their recommended dosage levels.

Elderly:

• As for adults: However, patients with decreased renal function may need to have the dosage adjusted as determined by blood levels of Ethambutol.
• In order to obtain maximum effect due to high serum levels, drug administration should be once daily.

Renal Impairment:

• Renal function should be checked before treatment with antituberculous drugs and appropriate dosage adjustments made. Ethambutol should preferably be avoided in patients with renal impairment
• If used, where creatinine clearance is less than 30mL/minute, use 15-25 mg/kg (max. 2.5 g) 3 times a week and plasma ethambutol concentration should be monitored.

Product Details:

Indications:

• Indicated for the treatment of tuberculosis in combination with other active agents. It is most commonly used in patients with Multi-drug Resistant TB (MDR-TB) or in situations when therapy with isoniazid and rifampin is not possible due to a combination of resistance and/or intolerance.
• When tablet added to the treatment regimen in patients proven or suspected drug resistance, it should be accompanied by at least one and preferably two other new agents to which the patient''s organism is known or expected to be susceptible.

Dosage:

• Adults and Children
• PO 150 mg/kg (max, 12 g/day).

Product Details:

Indications:

• Primarily indicated for the treatment of active tuberculosis in patients with M. tuberculosisresistant to isoniazid or rifampin, or when there is intolerance on the part of the patient to other drugs.
• Its use alone in the treatment of tuberculosis results in the rapid development of resistance. It is essential, therefore, to give a suitable companion drug or drugs, the choice being based on the results of susceptibility tests.
• If the susceptibility tests indicate that the patient's organism is resistant to one of the first-line antituberculosis drugs (i.e., isoniazid or rifampin) yet susceptible to ethionamide, ethionamide should be accompanied by at least one drug to which the M. tuberculosis isolate is known to be susceptible. If the tuberculosis is resistant to both isoniazid and rifampin, yet susceptible to ethionamide, ethionamide should be accompanied by at least two other drugs to which the M. tuberculosis isolate is known to be susceptible.

Dosage:

Usual Adult Dose for Tuberculosis - Active:

• 500 mg to 1 g orally (15 to 20 mg/kg) in 1 or more divided doses per day
• Maximum dose: 1 g orally per day
• Duration: Treatment should continue until permanent bacteriological conversion and maximal clinical improvement have occurred, generally, 18 to 24 months.

Usual Pediatric Dose for Tuberculosis - Active:

• 10 to 20 mg/kg orally in 2 or 3 divided doses per day or 15 mg/kg orally once per day after meals.
• Maximum dose: 1 g orally per day
• Duration: Treatment should continue until permanent bacteriological conversion and maximal clinical improvement have occurred, generally, 18 to 24 months.

 
Renal Dose Adjustments

Adults:

• CrCl less than 30 mL/min: 250 to 500 mg/day.

Liver Dose Adjustments:

• Ethionamide is contraindicated in patients with severe hepatic impairment.

Product Details:

Indications:

• For all forms of pulmonary and extra-pulmonary tuberculosis.

Dosage:

• For Treatment of Tuberculosis
• Isoniazid is used in conjunction with other effective anti-tuberculous agents. Drug susceptibility testing should be performed on the organisms initially isolated from all patients with newly diagnosed tuberculosis. If the bacilli becomes resistant, therapy must be changed to agents to which the bacilli are susceptible.
• Usual Oral Dosage (depending on the regimen used):

Adults

• 5 mg/kg up to 300 mg daily in a single dose; or
• 15 mg/kg up to 900 mg/day, two or three times/week

Children

• 10 mg/kg to 15 mg/kg up to 300 mg daily in a single dose; or
• 20 mg/kg to 40 mg/kg up to 900 mg/day, two or three times/week

Product Details:

Indications

• Pyrazinamide' is indicated in patients with active tuberculosis caused by Mycobacterium tuberculosis.
• Pyrazinamide' is not active against the atypical mycobacteria.
• Pyrazinamide' should only be given in combination with other antituberculous agents.

Dosage

Recommended dosage for standard unsupervised 2-month treatment

• Adults Under 50kg bodyweight maximum of 3 tablets or 1.5g daily. 50kg and over bodyweight maximum of 4 tablets or 2g daily.
• Children 35mg/kg daily.

Recommended dosage for intermittent supervised 2-month treatment

• Adults Under 50kg bodyweight maximum of 4 tablets or 2g 3 times a week. 50kg and over bodyweight maximum of 5 tablets or 2.5g 3 times a week.
• Children 50mg/kg 3 times a week.
• Pyrazinamide' should be administered with at least one other effective antituberculous drug. The use of 'Pyrazinamide' in combination therapy does not modify the accepted dosages of other antituberculous agents.
• Use in the elderly The general considerations outlined above should also apply to elderly patients.
• Immunocompromised patients Multi-resistant M. tuberculosis may be present in immunocompromised patients. The organism should always be cultured to confirm its type and drug sensitivity. Confirmed M. Tuberculosis infection sensitive to first-line drugs should be treated with a standard 6 month regimen; after completing treatment, patients should be closely monitored. The regimen may need to be modified if infection is caused by resistant organisms and specialist advice is needed.
• In meningeal or pericardial tuberculosis, a corticosteroid should be started at the same time as antituberculosis therapy.

Product Details:

Indications:

• Treatment of hormone receptor-positive advanced breast cancer in postmenopausal women
• Adjuvant treatment of hormone receptor-positive early invasive breast cancer in postmenopausal women.
• Adjuvant treatment of hormone receptor-positive early invasive breast cancer in postmenopausal women who have received 2 to 3 years of adjuvant tamoxifen.

Dosage:

• The recommended dose of Anastrozole for adults including the elderly is one 1mg tablet once a day.