The proper utilization of Lenalidomide is to treat myelodysplastic clutter and Multiple myelomas. Lenalidomide has a place with a class of prescriptions known as immunomodulatory specialists. It works by helping the bone marrow convey normally dynamic platelets and by executing atypical platelets inside the bone marrow.
The Lenangio 25mg capsules are containing an active substance known as Lenalidomide which an analogue of thalidomide with potent anti-neoplastic activity is.
The primary uses of Lenangio 25mg capsules are;
* Multiple myeloma :
Lenangio 25mg is involved in the therapy of multiple myeloma by combining with dexamethasone.
Lenangio 25mg is shown as upkeep treatment in patients with MM following autologous hematopoietic immature microorganism transplantation (auto-HSCT).
Myelodysplastic syndromes :
* Mantle cell lymphoma:
Lenangio 25mg is used for this condition in patients who are already receiving Bortezomib therapy priory.
Lenangio 25mg consisting Lenalidomide has various activities :
* Immuno modulatory agent
* Anti-angiogenesis agent
* Anti-neoplastic agent
The absorption of Lenalidomide is occurs very quickly and reaches maximum plasma concentration with the range of 0.5 to 6 hours.
The human plasma protein binding capacity of Lenalidomide is occurs by 30%.
The metabolism of Lenalidomide is undergoes in limited events.
In humans, the unchanged form of Lenalidomide is the most dominant circulating component.
Two major metabolites of Lenangio 5mg:
5 hydroxy Lenalidomide
Nearly 90% & 4% of dose should be eliminated via urine & feces. This may occur within 10 days.
82% of radioactive dose of Lenalidomide should be eliminated via urine within 24 hours.
The mean half-life period of Lenangio 25mg is 3 to 5 hours in multiple myeloma patients.
Lenangio 25mg involves in the inhibition of tumor necrosis factor alpha formation, which encourage the T-cells and causes diminishing serum levels of cytokines vascular endothelial growth factor & basic fibroblast growth factor.
Lenangio 25mg is also involved in the prohibition of angiogenesis.
Lenalidomide is also encouraged G1 cell cycle arrest & apoptosis of destructive cells.
The usual dose of Lenangio in myelodysplastic syndromes is 10mg should be administered as once a day.
For renal damaged patients;
Patients with CrCl >60ml/min should not require dosage adjustment.
Patients with CrCl 30 to 60ml/min, 5mg of Lenangio should be administered as once a day.
Patient with CrCl <30ml/min, 2.5mg of Lenangio should be given orally as a once a day.
Drops to <50000/mcL, therapy should be postponed.
Back to > or equal to 50000/mcL, continue the Lenangio with 5mg/day.
Drops to <500/mcL, therapy should be postponed.
Back to > or equal to 500/mcL, treatment should be continuing to 5mg/day.
In this condition, Lenangio is combined with dexamethasone.
The prescribed dose of Lenangio is 25mg should be administered as once daily on day 1 to 21.
The dose of dexamethasone;
40mg of dexamethasone should be followed on day 1 to 4, 9 to 12 & 17 to 20 of each 28-day cycles.
Patient with >75 years, 20mg of dexamethasone should be recommended on day 1, 8, 15, & 22.
Mantle cell lymphoma;
The advised dose of Lenangio for this condition is 25mg should be administered orally as once daily.
For renal damaged patients;
CrCl 30 to 60ml/min, 10mg of Lenangio should be administered as once daily.
CrCl <30ml/min, 15mg of Lenangio should be used for q48hr.
The potency & effectiveness of Lenalidomide has not been evaluated in pediatric patients with age of <18 years.
Lenangio 25mg with digoxin causes elevation of both Cmax&AUCinf of digoxin. Avoid this concomitant use. Patients should be monitored with digoxin plasma levels.
Lenangio 25mg with Erythropoietic agents causes increased exposure of thrombosis. Patient should be counseled before starting the treatment about the risk benefit of these combinations.
In multiple myeloma condition, Lenangio 25mg is combining with warfarin. In this condition both prothrombin time & INR value should be monitored periodically.
Lenangio 25mg capsules container should be stored at temperature of 20oC to 25oC.
Keep the container away from heat, moisture, & light.
In case of missed dose occurs, patient must be consult with medical oncologist and follow the regular schedule.
The over dosage of Lenangio 25mg is treated by providing some general supportive measures.
The manifestation due to over dosage of Lenangio 25mg should be monitored frequently
The over dosage of Lenangio 25mg caused neutropenia & thrombocytopenia
Monitor the blood counts periodically.
Adverse effects :
Fetal toxicity, Hematological toxicity, Elevation of mortality rate, Second primary malignancies, Liver toxicity, Hypersensitivity reactions, Tumor lysis syndrome, Tumor flare reactions, Thyroid disorders.
Common side effects :
Fatigue, Asthenia, Pyrexia, Pain, Diarrhea, Dyspepsia, Bone pain, Neck pain, Muscle weakness, pain, Respiratory infections, UTI, Influenza, Sepsis, Headache, Anemia, Loss of appetite, Hypokalemia, Hyperglycemia, Hypocalcaemia, Dehydration, Gout, Diabetes mellitus, Rash, Insomnia, Depression, Deep vein thrombosis, Myocardial infraction, Renal failure, Squamous cell carcinoma, Basal cell carcinoma.
Lenangio 25mg should not be used in pregnancy period
Lenangio 25mg causes fetal damage and finally leads to death
Breast feeding should not be suggested.
Lenangio 25mg is contraindicated to pregnancy & lactating period.
Anaphylactic reactions are produced because patients are contraindicated to the component of Lenangio 5mg.
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