Afatinib: Precautions and Warnings

Afatinib is specifically indicated for treating certain sorts of non-small cell lung cancer that has developed to the nearby tissues or to other organs of the body. It belongs to the class of medicines known as kinase inhibitors and acts by blocking the action of a certain naturally occurring substance that helps cancer cells to multiply.

The pills of afatinib should be taken by mouth on an empty stomach at least 1 hour prior to or 2 hours following a meal.

Consume afatinib exactly as instructed. Gulped the afatinib tablets whole with the help of water. Neither crushed nor dissolved the tablets.

Precautions:

• You must ensure that the wholesaler or pharmacy you are purchasing from is genuine & licensed.
• Always choose wholesalers or pharmacies that need a genuine prescription letter. 
• It is always a good idea to check online reviews, prior to making the purchase of afatinib. 
• You should always choose an online pharmacy/wholesaler that has an experienced pharmacist.
• Do not choose a pharmacy/wholesaler that offers afatinib at cheap prices. It may be a trick to attract customers.
• Always go with the reputable pharmacies/wholesalers that hold the certification of WHO-GDP & ISO. 
• You must not provide your personal information such as credit card numbers unless you are sure the site/pharmacy/wholesaler can protect them.
• Never accept afatinib if the packaging seems damaged or puffed up.
• Never accept afatinib if it doesn't look authentic.

Warnings:

• This drug must be administered under the supervision of an experienced health professional.
• The afatinib 40 mg should be discontinued in patients who develop life-threatening bullous, exfoliating lesions or blistering.
• This medicine may be responsible for causing fetal harm if given to a pregnant woman.
• Diarrhea, including severe diarrhea, may occur during treatment with this medicine.
• Patients need to avoid products that contain lactose or any foods known to aggravate diarrhea.
• Hepatic failure has been reported while on treatment with this medicinal product.
• This medicine is used with caution in patients with a history of keratitis, ulcerative keratitis or severe dry eye.

All you need to know about Carmustine Injection

What is Carmustine:

It belongs to a group of anticancer substances known as nitrosourea that act by resisting the growth of cancer cells.

Indication: Carmustine is prescribed as a single agent or in combination therapy with other anticancer medications in certain sorts of cancers, like:

• Multiple myeloma
• Hodgkin’s disease
• Non-Hodgkin’s lymphomas
• Malignant melanoma
• Tumours of digestive system tract or gastrointestinal tract
• Brain tumours; medulloblastoma, glioblastoma, astrocytoma and metastatic brain tumours. 

Dosage: Dosage directly depends on the body size, medical condition and response to treatment. It is usually recommended at least every 6 weeks. As a single agent, the recommended dose in previously untreated patients is carmustine 150 - 200 mg/m2, should be given intravenously every 6 weeks.

Dosage may also depend on whether carmustine is given together with other anti-cancer drugs. Doses can be adjusted according to how you respond to the treatment.

Administration of Carmustine: 

The carmustine 100 mg should always be given to you by a healthcare provider with experience in the use of anticancer medications.

It is given into a vein by a drip over a 1 to 2 hour period. The duration of infusion should not be less than 1  hour in order to avoid the burning and pain at the injected area. The injected area needs to be monitored while administration.

The treatment duration is specified by the healthcare provider and may vary for every patient.

Avoid the use of Carmustine: Do not use this medication:

• in case of the allergic to carmustine or any of the other ingredients of this drug. 
• if you have decreased blood platelets, white blood cells or red blood cells, either as a result of chemo or from other causes.
• in patients with severe kidney function impairment. 
• in patients with less than 18 years. 
• if you are breast-feeding. 

Possible side effects: Like all drugs, carmustine injection may cause side effects, although not everybody gets them.

Inform your healthcare provider immediately if you notice any of the following:

Very common: The most common carmustine side effects are following:

• Ataxia
• Dizziness
• Headache
• Blurred vision
• Retinal bleeding
• Fall in blood pressure
• Inflammation of the veins
• Shortness of breath
• Persistent cough, 
• Chest pain
• Persistent tiredness
• Delayed myelosuppression
• Severe nausea and vomiting
• Inflammation of the iris and optic nerve

Common: Some commonly reported side effects include;

• Acute leukemias
• Bone marrow dysplasias
• Anaemia 
• Anorexia
• Constipation
• Diarrhoea
• Inflammation of the mouth and lips
• Loss of hair
• Flushing of the skin
• Reactions on the injection site

Warnings & Precautions:

1. Interact with your doctor, pharmacist or nurse prior to using carmustine 100 mg injection.
2. Since the major adverse reactions of this medication is delayed bone marrow suppression, your doctor will monitor blood counts weekly for at least 6 weeks following a dose.
3. Notify your doctor if you have symptoms; unusual tiredness, fever, persistent sore throat, enhanced tendency to bruising, throbbing heartbeat. 
4. Prior to and during treatment, your liver as well as kidney function should be tested and observed regularly.
5. Use of carmustine 100 mg may lead to lung damage, an X-ray of the chest region and the lung function tests should be conducted prior to initiating treatment.
6. Your healthcare provider will talk to you about the possibility of lung damage and allergic reactions and their signs. If such signs appear, call your doctor right away.
7. Women, as well as male of childbearing potential, must use effective contraception while on treatment and for at least 6 months after treatment. 
8. Avoid breast-feeding while taking this medicine and up to 7 days after completion of treatment. A risk to the infant/newborn cannot be excluded.

Overdose & Missed Dose: As a healthcare provider will be giving you this medicine, it is unlikely that you will be given an incorrect or missed dose. 

Tell your healthcare provider if you have any concerns about the missed dose and quantity of drug that you receive.

How to store Carmustine:

Keep carmustine injection out of the sight and reach of children.

Store and transport refrigerated (2°C – 8°C). Avoid using this medication after the expiry date. 

FAQ's

What is the best source to buy Carmustine? 

In India, the carmustine price is very reasonable. Buy this cost-effective medication from a WHO-GDP & ISO certified pharma wholesaler company. Prices may vary from branded to non-branded drugs. 

How is Carmustine (BiCNU) supplied? 

Each package mainly includes a vial containing 100mg carmustine and an ampule containing 3mL sterile diluent.

Is use of Carmustine safe?

Carmustine is completely safe in case taken at prescribed dose and duration as instructed by your healthcare practitioner.

Who should not take Carmustine? 

Carmustine should not be taken by individuals who have shown a previous hypersensitivity to this medicine.

Is Carmustine a vesicant?

Carmustine falls under irritants amongst chemo drugs. Although when administered at the high doses it may act as vesicant.

What need to avoid while taking carmustine treatment?

Follow your healthcare provider's instructions regarding any kind of restrictions on foods, beverages, or activity. 

Does Carmustine inhibit DNA replication?

Yes, Carmustine acts in order to prevent DNA replication.

What if I overdose?

You need to seek emergency medical attention or call your healthcare professionals promptly.

What if I miss a carmustine dose?

Call your healthcare practitioner promptly for instructions in case you miss an appointment for your carmustine injection.

NOTE: The piece of information mentioned about "All you need to know about Carmustine Injection" in this article is just for the informational purposes and is not served as a substitute for medical treatment, consultation, diagnosis of an experienced/qualified healthcare practitioner.

All you need to know Pazopanib

Pazopanib(votrient) is specifically a selective multi-targeted receptor TKI (tyrosine kinase inhibitor). This drug is marketed under the brand name Votrient. It prevents the activity of proteins, involved in the growth and spread of cancer cells. The pazopanib 400mg is prescribed for adults to treat:

• advance renal cell carcinoma
• certain forms of soft-tissue sarcoma

Most Common Side Effects of Pazopanib: 

• diarrhoea
• feeling or being sick
• stomach pain
• loss of appetite
• weight loss
• loss of taste
• sore mouth
• headache
• tumour pain
• skin rash
• high blood pressure
• feeling weak or tired
• loss of skin pigment
• changes in hair colour
• unusual hair loss or thinning

Tell your doctor or pharmacist if any of these pazopanib side effects becomes troublesome.

Warnings and Precautions:

• The votrient 400 mg can raise your blood pressure, and it should be checked prior to taking this drug and while you are taking it. 
• If you're scheduled for an operation, votrient 200 mg should be stopped at least 7 days prior to your operation as it may affect the wound healing.
• The pazopanib 400mg is not prescribed for people aged under 18 and children younger than 2 years of age because of safety concerns.
• Avoid taking pazopanib 200mg with food, as it affects the way the drug is absorbed. Consume it at least a couple of hours following a meal or 1 hour prior to a meal.
• Drinking grapefruit juice should be avoided while you are being treated with the pazopanib tablet as it may increase the chance of side effects.
• Do not take this medication during pregnancy. Notify your doctor if you want to get pregnant.
• Don’t breast-feed while on treatment with this medicine. 
• Avoid driving or using machines if you feel weak, dizzy, or tired, or if your energy levels are low. 
• Discuss with your doctor prior to taking pazopanib 200mg, if you have heart and liver disease.

How Does Pazopanib Works: This multiple kinase inhibitor mainly acts by limiting the growth of tumor by targeting angiogenesis via inhibition of the enzymes including VEGFR (vascular endothelial growth factor receptor), PDGFR (platelet derived growth factor receptor), c-KIT and FGFR. 

How to take Pazopanib: Always take this drug exactly as your doctor has told you. Check with your healthcare professionals if you are not sure.

How much to take: The usual recommended dose is two 400 mg tablets (800 mg pazopanib) consumed once a day. This is the maximum recommended dose per day. Your healthcare provider may need to reduce your dose if you get adverse reactions.

When to take: Don’t take pazopanib together with food. Consume it at least a couple of hours following your meal, or 1 hour prior to a meal.

For instance, you could consume it a couple of hours following breakfast or 1 hour prior to lunch. Consume your pills at about the same time every day.

Tablets should be swallowed whole with the help of water, one after the other. Do not crush or break the tablets as this affects the way the drug is absorbed and may increase the chance of adverse reactions.

If you take more Pazopanib than you should: If you take excess pills, contact a doctor or pharmacist in order to seek the appropriate medical advice. 

If you forget to take Pazopanib: Avoid the consumption of double dose in order to make up for a missed or forgotten dose. Just consume your very next dose at about the usual time.

What is the Best Price of Pazopanib: The pazopanib cost will be very reasonable if you choose to buy this medication from any WHO-GDP & ISO certified wholesaler company.