Opsan Healthtech Private Limited

Tab Lenalidomide 10mg (sold in packs of 10 tablets) is an immunomodulatory agent that is primarily used in the treatment of certain types of cancers and disorders related to the immune system
 Active Ingredient: Lenalidomide (10 mg per tablet): Lenalidomide is a derivative of thalidomide and acts through multiple mechanisms, including immune modulation, antiinflammatory effects, and direct antitumor activity 
 Mechanism of Action:Lenalidomide works by modifying the immune response and inhibiting the growth of tumor cells It enhances the activity of natural killer cells and Tcells and increases the production of cytokines that help in immune responses Additionally, it has direct anticancer effects by inhibiting tumor cell proliferation and inducing apoptosis (programmed cell death) in malignant cells
 Indications: Multiple Myeloma: Lenalidomide is used in combination with dexamethasone or other agents to treat multiple myeloma, a cancer of plasma cells in the bone marrow Myelodysplastic Syndromes (MDS): Specifically used for MDS with deletion of chromosome 5q, a specific genetic abnormality Mantle Cell Lymphoma: Lenalidomide can be used in combination with other therapies for relapsed or refractory mantle cell lymphoma Follicular Lymphoma: Used in cases where the disease is relapsed or refractory to previous treatments   Dosage and Administration: The dose of Lenalidomide varies depending on the specific condition being treated, but for multiple myeloma, a typical dose is 10 mg once daily for the first cycle, with the dose adjusted based on patient response and tolerability For Myelodysplastic Syndromes (MDS) with a 5q deletion, the usual starting dose is 10 mg per day  Lenalidomide is typically taken orally, once a day, with or without food It is important to follow the prescribed regimen and not to stop the medication without consulting the healthcare provider
 Contraindications: Pregnancy: Lenalidomide is contraindicated during pregnancy due to its teratogenic effects (ability to cause birth defects) Women of childbearing age must use effective contraception during treatment and for some time after treatment ends Severe renal or hepatic impairment: Caution is required in patients with significant renal or liver dysfunction Hypersensitivity: It should not be used in patients who have shown hypersensitivity reactions to lenalidomide or thalidomide
 Precautions: Regular blood tests to monitor blood cell counts, liver function, and renal function are necessary It can cause blood clots (deep vein thrombosis or pulmonary embolism), so patients may need anticoagulation therapy or close monitoring It should be used with caution in elderly patients or those with preexisting heart conditions

Tab Pazopanib 400mg is an oral medication that contains Pazopanib, a multikinase inhibitor used primarily in the treatment of advanced or metastatic cancers It targets several key signaling pathways involved in tumor growth, angiogenesis (formation of new blood vessels), and cancer cell survival
 Active Ingredient: Pazopanib (400 mg per tablet): Pazopanib is a targeted therapy that inhibits multiple receptors involved in the regulation of tumor growth, particularly vascular endothelial growth factor receptors (VEGFR), plateletderived growth factor receptors (PDGFR), and ckit By blocking these receptors, Pazopanib prevents tumor cells from receiving the signals they need to grow and proliferate
 Mechanism of Action:Pazopanib works by inhibiting VEGFRs, PDGFRs, and ckit, which are receptors involved in blood vessel formation (angiogenesis) and cell survival Blocking these pathways prevents the formation of new blood vessels that tumors require to grow and spread Pazopanib also directly targets cancer cell signaling pathways, slowing down the growth and spread of tumors
 Indications: Advanced Renal Cell Carcinoma (RCC): Pazopanib is used to treat advanced or metastatic renal cell carcinoma (kidney cancer) Soft Tissue Sarcoma: Pazopanib is indicated for the treatment of advanced soft tissue sarcoma in patients who have received prior chemotherapy   Dosage and Administration: Starting Dose: The recommended dose of Pazopanib for both advanced renal cell carcinoma and soft tissue sarcoma is typically 800 mg once daily However, the prescribed dose can be adjusted depending on the patient's health and tolerance Dosage Adjustments: In some cases, the dose may be reduced to 400 mg per day or further adjusted based on adverse effects, including liver function tests and blood pressure monitoring Administration: Pazopanib should be taken orally once daily, preferably at the same time each day, and on an empty stomach (at least 1 hour before or 2 hours after a meal)
 Contraindications: Hypersensitivity: Pazopanib should not be used in patients who have shown hypersensitivity or allergic reactions to Pazopanib or any of its components Severe Liver Impairment: Pazopanib is contraindicated in patients with severe hepatic (liver) dysfunction due to the risk of further liver damage
 Precautions: Hypertension (High Blood Pressure): Pazopanib can increase blood pressure, so blood pressure should be monitored regularly Antihypertensive therapy may be required Liver Function: Pazopanib can affect liver function, so liver enzymes should be monitored during treatment Proteinuria: Pazopanib can cause protein in the urine, and kidney function should be monitored regularly Gastrointestinal Perforation: There is an increased risk of gastrointestinal perforation in patients treated with Pazopanib, so caution is necessary for those with a history of gastrointestinal issues QT Prolongation: Pazopanib can cause QT interval prolongation, which may lead to heart arrhythmias Electrocardiograms (ECGs) may be recommended for certain patients, especially those with underlying heart conditions

Epoetin Alfa Injection: Medical Overview

Epoetin alfa is a synthetic form of erythropoietin, a hormone naturally produced by the kidneys that stimulates red blood cell production in the bone marrow. It is used to treat anemia associated with chronic kidney disease (CKD), chemotherapy, and certain other conditions.

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Indications

Epoetin alfa is prescribed for:

Anemia due to Chronic Kidney Disease (CKD): In both dialysis and non-dialysis patients.

Anemia from Chemotherapy: In patients receiving myelosuppressive chemotherapy.
Anemia from HIV Treatment: In patients receiving zidovudine therapy.

Preoperative Anemia: To reduce the need for allogeneic red blood cell transfusions in patients undergoing elective, non-cardiac, non-vascular surgery.
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Mechanism of Action

Epoetin alfa stimulates erythropoiesis (red blood cell production) by binding to and activating erythropoietin receptors on erythroid progenitor cells in the bone marrow, promoting their proliferation and differentiation into mature red blood cells.

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Dosage and Administration

Route: Administered via subcutaneous (SC) injection or intravenous (IV) infusion.

Dosing: The dosage varies based on the patient's condition, response to treatment, and hemoglobin levels. Regular monitoring is essential to adjust dosing appropriately.

Administration: Typically administered by a healthcare professional. If self-administration is prescribed, proper training on injection techniques is required.

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Contraindications and Precautions

Epoetin alfa is contraindicated in:

Patients with uncontrolled hypertension.

Known hypersensitivity to epoetin alfa or any of its components.

Patients with pure red cell aplasia due to previous epoetin alfa therapy.([Practo][2])

Use with caution in:

Patients with a history of seizures.

Individuals with cardiovascular disease or risk factors.

Patients with iron deficiency, as adequate iron levels are necessary for optimal response.

Regular monitoring of blood pressure, hemoglobin levels, and iron status is recommended during therapy.

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Side Effects

Common side effects include:

Headache

Hypertension([Mayo Clinic][3])

Injection site reactions

Fatigue

Nausea

Serious adverse effects may include:

Severe allergic reactions (e.g., anaphylaxis)

Seizures([Cleveland Clinic][4])

Thromboembolic events (e.g., stroke, myocardial infarction)

Pure red cell aplasia

Discontinue therapy and seek immediate medical attention if any of these serious side effects occur.

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Pharmacokinetics

Absorption: Epoetin alfa is well absorbed following subcutaneous injection.

Distribution: Widely distributed in the body.

Metabolism: Metabolized primarily in the liver.

Elimination: Excreted via the urine.

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Price and Availability

The cost of epoetin alfa varies based on brand, dosage, and location. Common brands include Epogen® and Procrit®. Prices may differ between countries and healthcare providers. It's advisable to consult local pharmacies or healthcare providers for specific pricing information.

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IVIG – Intravenous Immunoglobulin
Strength: 5 grams per vial (typically in 100 mL solution)
Brands include:

• Privigen®

• Octagam®

• Gamunex-C®

• IVIGlob® (India)

• Globucel®, Venoglobulin®, etc.

📌 Drug Class:

Polyclonal human immunoglobulin (IgG) derived from pooled human plasma

⚙️ Mechanism of Action:

• Provides passive immunity by supplying IgG antibodies

• Neutralizes pathogens, modulates immune response

• Suppresses harmful autoantibodies in autoimmune conditions

• Blocks Fc receptors on phagocytes, reducing inflammation

✅ Indications:

1. Primary immunodeficiency (PID)

2. Chronic inflammatory demyelinating polyneuropathy (CIDP)

3. Guillain-Barré syndrome

4. Kawasaki disease

5. Immune thrombocytopenia (ITP)

6. Multifocal motor neuropathy (MMN)

7. Myasthenia gravis

8. Post-transplant infections or rejection prophylaxis

9. Off-label in severe COVID-19 or sepsis (select cases)

💉 Dosage & Administration:

• Typical dose: 0.4 g/kg/day for 3–5 days in autoimmune conditions

• For PID: 0.2–0.8 g/kg/month

• Infuse slowly IV (e.g., 0.01–0.08 mL/kg/min) — increase gradually

• Requires pre-hydration and close monitoring for reactions

⚠️ Common Side Effects:

• Mild: Fever, headache, nausea, chills, fatigue

• Moderate: Rash, back pain, hypotension

• Severe (rare):

  • Anaphylaxis (especially in IgA-deficient patients)

  • Thromboembolism

  • Hemolysis

  • Acute renal failure

  • Aseptic meningitis

🧾 Monitoring Parameters:

• Renal function (BUN, creatinine)

• Liver enzymes

• Hematocrit, CBC

• Infusion rate monitoring

• Signs of thrombosis in high-risk patients

🧊 Storage:

• Store in refrigerator (2–8°C)

• Do not freeze

• Use within prescribed period after opening

• Allow vial to come to room temperature before use

💰 Cost:

• India: ₹8,000 – ₹13,000 per 5g vial (~$95 – $155 USD)

• US/EU: $800 – $1,200 per 5g vial

• High-cost product due to plasma processing and safety protocols

📦 Summary Table:

Inj Rituximab 500mg (brand name Rituxan) is a monoclonal antibody used in the treatment of certain autoimmune diseases and types of cancer Rituximab targets the CD20 antigen on the surface of B cells, a type of white blood cell involved in immune responses and certain cancers By binding to CD20, rituximab depletes these B cells, helping to control both the abnormal immune response and the growth of cancer cells
 Medical Description:
 Generic Name: Rituximab   Brand Name: Rituxan   Form: Injectable solution for intravenous (IV) infusion   Strength: 500 mg per vial (singledose)  
 Indications:Rituximab is indicated for the treatment of several autoimmune diseases and hematologic cancers, including:
1 NonHodgkin’s Lymphoma (NHL):    Rituximab is used for the treatment of Bcell nonHodgkin lymphoma (NHL) It is often used in combination with chemotherapy to treat various subtypes of NHL, including diffuse large Bcell lymphoma (DLBCL) and follicular lymphoma    It works by depleting the B cells that drive the cancer, slowing down or stopping the progression of the disease
2 Chronic Lymphocytic Leukemia (CLL):    Rituximab is used in combination with chemotherapy for the treatment of chronic lymphocytic leukemia (CLL), a type of cancer that affects B lymphocytes    It helps target and destroy the malignant B cells, improving treatment outcomes
3 Rheumatoid Arthritis (RA):    Rituximab is used in the treatment of rheumatoid arthritis in adults who have had an inadequate response to other diseasemodifying antirheumatic drugs (DMARDs), such as methotrexate    It helps reduce inflammation and joint damage by targeting B cells involved in the autoimmune process
4 Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA):    Rituximab is used in autoimmune conditions like GPA and MPA, which are types of vasculitis (inflammation of the blood vessels) that affect various organs, including the kidneys, lungs, and skin    It helps control the disease by depleting the B cells responsible for the autoimmune response
5 Idiopathic Thrombocytopenic Purpura (ITP):    Rituximab is used in the treatment of ITP, a condition characterized by low platelet count and increased risk of bleeding, often due to an autoimmune response against platelets
 Mechanism of Action:Rituximab is a monoclonal antibody that specifically targets the CD20 protein found on the surface of B cells, a type of white blood cell involved in both the immune response and certain cancers 
 In cancer, CD20positive B cells are often malignant, and rituximab helps deplete these cells, which slows or stops the growth of tumors In autoimmune diseases, rituximab reduces the autoimmune response by eliminating B cells, which are responsible for producing antibodies that attack the body's own tissues
The mechanism involves multiple immune pathways, including complementdependent cytotoxicity (CDC), antibodydependent cellular cytotoxicity (ADCC), and direct apoptosis of CD20positive cells

Lapatinib 250 mg Tablets - Medical Description
Generic Name: Lapatinib  Brand Name: Tykerb
Formulation:  Lapatinib is available in oral tablet form, with a common strength of 250 mg per tablet.
Indications:  Lapatinib is primarily used for the treatment of certain types of breast cancer:- Advanced or Metastatic Breast Cancer: It is used in combination with other medications for the treatment of HER2-positive breast cancer, a subtype of breast cancer where the cancer cells have higher-than-normal levels of the HER2 protein, which promotes cancer cell growth. Lapatinib is typically prescribed for patients with breast cancer who have failed prior chemotherapy treatments.- Combination with Capecitabine: Lapatinib is often used in combination with capecitabine (an oral chemotherapy drug) for the treatment of HER2-positive breast cancer that has spread to other parts of the body (metastatic cancer).- Combination with Letrozole: In some cases, Lapatinib may also be used in combination with letrozole (an aromatase inhibitor) for treating hormone receptor-positive breast cancer that is also HER2-positive.
Mechanism of Action:  Lapatinib is a tyrosine kinase inhibitor (TKI). It works by blocking the action of HER2 (human epidermal growth factor receptor 2) and EGFR (epidermal growth factor receptor), both of which are involved in cell growth and division. Overactive signaling through these receptors can contribute to cancer cell proliferation. By inhibiting these receptors, Lapatinib slows down or stops the growth of cancer cells and prevents the spread of the cancer.
Dosage and Administration:  The typical dosage for Lapatinib is:- 250 mg once daily, taken orally, with or without food. - The dosage may be adjusted depending on the patient's medical condition and response to treatment.- For Combination Therapy: When used in combination with capecitabine, the usual dose of Lapatinib is 1,250 mg once daily for 21 days, followed by 7 days off. The specific regimen may vary based on the physician’s recommendation.
It is important to take Lapatinib exactly as prescribed and not to alter the dosage without medical consultation.
Side Effects:  Common side effects of Lapatinib may include:- Diarrhea- Fatigue- Rash (often acne-like)- Nausea- Vomiting- Loss of appetite- Hand-foot syndrome (redness, swelling, and pain on the palms and soles)- Liver enzyme elevations (which may require monitoring)
Serious side effects may include:- Heart problems: Lapatinib can affect heart function, causing heart failure or other cardiovascular issues. Regular monitoring of heart function may be required during treatment.- Liver damage: Lapatinib can cause liver toxicity, which may present as yellowing of the skin or eyes (jaundice), dark urine, or upper stomach pain.- Severe skin reactions: Some patients may experience severe rashes or skin issues that may require dose adjustments or discontinuation of therapy.- Pulmonary issues: In rare cases, Lapatinib may cause interstitial lung disease (ILD), which leads to lung inflammation and requires immediate medical attention.Precautions and Warnings:- Cardiovascular Monitoring: Patients with pre-existing heart conditions should be closely monitored, as Lapatinib can cause heart problems, including heart failure. Regular cardiac assessments are recommended.- Liver Function: Liver function should be monitored, especially if there are signs of liver damage (e.g., jaundice, dark urine).- Pregnancy and Breastfeeding: Lapatinib should not be used during pregnancy as it may harm the fetus. It is also not recommended during breastfeeding, as it is unknown whether the drug is excreted in human milk.

Inj Trastuzumab 440mg is an Injectable medication containing trastuzumab, a monoclonal antibody used primarily in the treatment of HER2positive breast cancer and HER2positive gastric cancer Trastuzumab works by targeting and binding to the HER2 receptor, a protein that is overexpressed in certain types of cancer cells By inhibiting HER2 signaling, trastuzumab helps to slow or stop the growth of cancer cells
 Medical Description:
 Generic Name: Trastuzumab   Brand Name: Herceptin (among others) Form: Injectable solution for intravenous (IV) infusion Strength: 440 mg per vial
 Indication:Trastuzumab is used in the treatment of various cancers that overexpress HER2 (human epidermal growth factor receptor 2), particularly:
1 HER2positive breast cancer:    Used in both earlystage and metastatic HER2positive breast cancer, either as a monotherapy or in combination with other chemotherapy agents    It is often used adjuvantly (after surgery) to reduce the risk of recurrence or neoadjuvantly (before surgery) to shrink the tumor
2 HER2positive metastatic gastric or gastroesophageal junction cancer:    Trastuzumab is used in combination with chemotherapy for the treatment of metastatic gastric cancer that is HER2positive
3 HER2positive breast cancer as adjuvant treatment:    It is administered after surgery in patients with HER2positive early breast cancer to reduce the risk of recurrence
 Mechanism of Action:Trastuzumab is a monoclonal antibody that specifically binds to the HER2 receptor (human epidermal growth factor receptor 2) found on the surface of some cancer cells HER2 is a protein that promotes cancer cell growth when overexpressed Trastuzumab works in several ways:
 Blocking HER2 receptor signaling: Trastuzumab prevents HER2 from transmitting growth signals to the cancer cells, thus inhibiting their growth and survival Antibodydependent cellular cytotoxicity (ADCC): Trastuzumab attracts immune cells to the cancer cells, which can lead to the destruction of the tumor cells Inhibition of angiogenesis: By blocking HER2, trastuzumab may also reduce the formation of new blood vessels that supply tumors, limiting their growth
 Administration: Route: Trastuzumab is administered via intravenous (IV) infusion   Dosing typically starts with a loading dose of 8 mg/kg for the first dose, followed by 6 mg/kg every 3 weeks as maintenance therapy   The dose can vary depending on the cancer type and the stage of treatment The 440 mg dose corresponds to a maintenance dose for certain patients, typically given after the initial loading dose
 The infusion is typically administered over 90 minutes for the first dose and may be shortened to 60 minutes for subsequent doses if the patient tolerates the treatment well
 Side Effects: Common side effects include:   Fever   Fatigue   Nausea   Infusionrelated reactions (such as chills, fever, and headaches during or shortly after the infusion)   Diarrhea   Rash   Pain at the Injection site
 Serious side effects include:   Cardiotoxicity: Trastuzumab can cause heart failure and left ventricular dysfunction, particularly in patients with preexisting heart conditions Cardiac function should be monitored regularly during treatment   Pulmonary toxicity: Including interstitial lung disease or pneumonitis, leading to symptoms like shortness of breath, cough, or fever   Severe infusion reactions: Symptoms such as low blood pressure, trouble breathing, or swelling can occur during the infusion   Neutropenia (low white blood cell count), which may increase the risk of infections

Inj Pertuzumab 420mg is an Injectable monoclonal antibody used primarily in the treatment of HER2positive breast cancer Pertuzumab works by targeting the HER2 receptor, which is overexpressed in some breast cancers, and inhibiting its function, thus preventing the cancer cells from growing and proliferating It is often used in combination with trastuzumab and chemotherapy for more effective treatment
 Medical Description:
 Generic Name: Pertuzumab   Brand Name: Perjeta   Form: Injectable solution for intravenous (IV) infusion   Strength: 420 mg per vial
 Indications:Pertuzumab is primarily indicated for use in the treatment of HER2positive breast cancer, particularly in the following settings:
1 Earlystage HER2positive breast cancer:    Used as neoadjuvant therapy (before surgery) in combination with trastuzumab and chemotherapy (eg, paclitaxel or docetaxel) for patients with operable HER2positive early breast cancer    It may also be used as adjuvant therapy (after surgery) in combination with trastuzumab and chemotherapy to reduce the risk of cancer recurrence
2 Metastatic HER2positive breast cancer:    Pertuzumab is used in combination with trastuzumab and chemotherapy for the treatment of metastatic HER2positive breast cancer, whether the patient has not previously received HER2targeted therapy or has been previously treated with other agents
 Mechanism of Action:Pertuzumab is a monoclonal antibody that targets the HER2 receptor on the surface of cells The HER2 receptor is a protein that plays a key role in the growth and proliferation of certain cancer cells Pertuzumab works in the following ways:
 Inhibition of HER2 signaling: Pertuzumab binds to a distinct part of the HER2 receptor, preventing it from interacting with other receptors and forming a dimer, which is essential for signaling pathways that promote cancer cell growth   Blocking heterodimerization: Pertuzumab prevents the formation of the HER2HER3 heterodimer, a critical signaling complex that drives cancer cell proliferation and survival
 Synergistic effect with trastuzumab: Pertuzumab, when used in combination with trastuzumab (which binds to a different part of the HER2 receptor), leads to a more comprehensive blockade of HER2 signaling This combination enhances the overall anticancer effect, making it more effective in preventing cancer cell growth and promoting tumor cell death
 Administration: Route: Intravenous (IV) infusion   Dosing:   The initial dose is typically 840 mg as a loading dose   Following the initial dose, 420 mg is administered every 3 weeks as a maintenance dose in combination with trastuzumab and chemotherapy   The infusion is given in a clinical setting and may take 60 minutes or longer for the first dose If well tolerated, subsequent doses may be administered over a shorter duration of 30 minutes
 Side Effects: Common Side Effects:   Fatigue   Diarrhea   Hair loss (alopecia)   Rash   Nausea and vomiting   Loss of appetite   Neutropenia (low white blood cell count), which may increase the risk of infections   

Tab Tepotinib 225mg is an oral medication used in the treatment of nonsmall cell lung cancer (NSCLC) with MET exon 14 skipping mutations Tepotinib is a selective MET inhibitor that targets the MET receptor, a protein that is involved in cancer cell growth, survival, and spread By inhibiting the MET receptor, tepotinib can help slow or stop the growth of cancer cells with specific mutations or alterations
 Medical Description:
 Generic Name: Tepotinib   Brand Name: Tepmetko   Form: Oral tablet   Strength: 225 mg per tablet
 Mechanism of Action:
Tepotinib works by specifically targeting and inhibiting the MET receptor tyrosine kinase, which is involved in the growth and survival of cancer cells The MET receptor is frequently overexpressed or mutated in various cancers, including nonsmall cell lung cancer (NSCLC) In NSCLC, mutations or alterations in the MET gene can lead to exon 14 skipping, resulting in abnormal MET signaling that drives tumor growth and metastasis
By inhibiting MET signaling, tepotinib blocks downstream pathways that lead to cell proliferation, migration, and survival This inhibition is particularly effective in NSCLC patients with MET exon 14 alterations, which are associated with poor prognosis and resistance to conventional therapies
 Indications:
Tepotinib 225mg is primarily used for the treatment of:
1 NonSmall Cell Lung Cancer (NSCLC):    Tepotinib is indicated for the treatment of advanced or metastatic NSCLC with MET exon 14 skipping mutations These mutations are present in a subset of patients with NSCLC, and tepotinib has been shown to be effective in treating tumors that have this genetic alteration    Tepotinib is used in patients who have not received prior treatment with MET inhibitors Dosage and Administration: Route: Oral (tablet)   Strength: 225 mg per tablet   Dosage:     The typical starting dose of tepotinib is 225 mg once daily    Tablets should be taken with food, preferably at the same time each day The tablets should be swallowed whole, without breaking, chewing, or crushing    In cases of side effects, the dose may be adjusted, and treatment should be continued as directed by a healthcare provider Side Effects:Common side effects of tepotinib include: Fatigue Diarrhea Nausea Anemia Liver enzyme elevations (transaminitis) Rash Decreased appetite Swelling (edema) Cough Shortness of breathSerious side effects may include: Liver toxicity: Tepotinib can cause liver damage, which can manifest as elevated liver enzymes (ALT, AST) or jaundice Regular monitoring of liver function is important Interstitial lung disease (ILD): Tepotinib has been associated with lung toxicity or ILD, which can cause breathing problems, cough, and chest pain If these symptoms occur, the drug should be stopped, and the patient should receive appropriate treatment Severe skin reactions: Although uncommon, tepotinib can cause severe skin rash, which may require dose adjustments or discontinuation QT prolongation: Tepotinib may cause an extension in the QT interval on an electrocardiogram (ECG), potentially leading to heart rhythm abnormalities Monitoring for QT prolongation may be necessary in certain patients, particularly those with existing heart conditions Contraindications:Tepotinib should be avoided in the following situations: Hypersensitivity to tepotinib or any of its components Pregnancy: Tepotinib is classified as Category D for pregnancy, meaning it can cause harm to a developing fetus It should not be used during pregnancy unless the potential benefit justifies the risk to the fetus Breastfeeding: It is unknown whether tepotinib is excreted in breast milk, so breastfeeding should be avoided during treatment

Tab Cabozantinib 40mg is an oral medication containing Cabozantinib, a multikinase inhibitor used in the treatment of several types of cancer It works by targeting and inhibiting specific enzymes involved in cancer cell growth and tumor blood vessel formation
 Active Ingredient: Cabozantinib (40 mg per tablet): Cabozantinib is a tyrosine kinase inhibitor that targets multiple receptors involved in cancer cell growth, spread, and tumor angiogenesis (formation of new blood vessels) These include receptors such as VEGFR (vascular endothelial growth factor receptor), MET (mesenchymalepithelial transition factor), and AXL, which are involved in promoting tumor growth and metastasis
 Mechanism of Action:Cabozantinib inhibits multiple kinases that are involved in several key processes in cancer progression, including:
 Angiogenesis: Inhibition of VEGFR reduces the ability of tumors to form new blood vessels, thereby limiting their growth Tumor Cell Proliferation: By inhibiting MET and AXL receptors, Cabozantinib blocks signaling pathways that promote cancer cell survival, proliferation, and metastasis Metastasis: By targeting MET, Cabozantinib interferes with processes involved in cancer cell migration and invasion, potentially reducing the spread of cancer to other parts of the body
These combined actions make Cabozantinib effective in the treatment of several types of cancer, including renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC)
 Indications:Cabozantinib is primarily used for the treatment of the following cancers:
 Renal Cell Carcinoma (RCC): For the treatment of advanced or metastatic renal cell carcinoma, especially after other treatments have failed Hepatocellular Carcinoma (HCC): For the treatment of hepatocellular carcinoma (liver cancer) in patients who have previously been treated with sorafenib Medullary Thyroid Cancer (MTC): For the treatment of progressive, metastatic medullary thyroid cancer (MTC) in patients who have received prior therapy Other Cancers: It may also be used in certain cases of colorectal cancer, nonsmall cell lung cancer (NSCLC), and other malignancies where Cabozantinib’s multikinase targeting can be beneficial
 Dosage and Administration: Recommended Dose: The standard dose of Cabozantinib for most indications is 40 mg taken orally once daily For some patients, a dose adjustment may be necessary based on tolerability Administration: Cabozantinib should be taken once a day at the same time each day, with or without food The tablets should be swallowed whole with water and should not be crushed or chewed Dosage Adjustments: The dose may be adjusted based on side effects or changes in the patient's health status, especially liver function or blood pressure
 Contraindications: Hypersensitivity: Cabozantinib is contraindicated in patients with known hypersensitivity to the drug or any of its components   Precautions: Liver Function: Regular monitoring of liver function is necessary because Cabozantinib can cause liver toxicity, including elevated liver enzymes and jaundice Blood Pressure: Cabozantinib can cause hypertension (high blood pressure) Blood pressure should be monitored regularly, and treatment for hypertension should be initiated if needed Bleeding: Cabozantinib may increase the risk of bleeding Patients with a history of bleeding disorders or those undergoing surgery should be monitored closely Wound Healing: Since Cabozantinib can affect tissue growth and repair, it may interfere with wound healing It is generally advised to stop the medication before any surgery and resume after adequate wound healing Pregnancy and Breastfeeding: Cabozantinib can harm an unborn baby and is contraindicated in pregnancy It is also not recommended during breastfeeding, as it can pass into breast milk 

Ferric Carboxymaltose – Medical Description

Generic Name: Ferric Carboxymaltose
Brand Names: Injectafer®, Ferinject®
Drug Class: Parenteral iron replacement
Route of Administration: Intravenous (IV) only

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Mechanism of Action:

Ferric carboxymaltose is a colloidal iron-carbohydrate complex that allows for controlled release of bioavailable iron. It replenishes iron stores and supports hemoglobin production by delivering iron directly into the bloodstream, bypassing gastrointestinal absorption.

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Indications:

Iron deficiency anemia (IDA) in:

Patients with intolerance or non-response to oral iron
Chronic kidney disease (non-dialysis dependent)
Inflammatory bowel disease
Heavy uterine bleeding
Postpartum anemia
Iron deficiency in heart failure patients (as adjunct to improve symptoms and quality of life)

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Typical Dosage (Adults):

Up to 750–1000 mg per infusion, depending on the formulation and patient’s weight/iron deficit
Can often be administered in 1–2 doses total over 1–2 weeks

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Common Side Effects:

Nausea
Headache
Dizziness
Hypophosphatemia (low phosphate levels, especially with repeated dosing)
Injection site reactions
Flushing or transient hypertension

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Serious (but rare) Reactions:

Hypersensitivity or anaphylactic reactions
Severe hypophosphatemia leading to muscle weakness, bone pain, or osteomalacia with long-term/repeated use

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Warnings and Precautions:

Monitor serum phosphate levels in patients receiving multiple high-dose infusions
Caution in patients with iron overload disorders or active infections
Not for use in patients with known hypersensitivity to ferric carboxymaltose or components

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Contraindications:

Known hypersensitivity to ferric carboxymaltose
Iron overload syndromes (e.g., hemochromatosis)
Anemia not related to iron deficiency

Would you like a dosing chart or a comparison with other IV iron therapies (like iron sucrose or iron dextran)?

Livocee 25%=25gm Injection – Medical Description

Generic Name: Ascorbic Acid (Vitamin C)
Brand Name: Livocee
Drug Class: Water-soluble vitamin
Route of Administration: Intravenous (IV) only

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Mechanism of Action:

Livocee 25% Injection delivers a high concentration of vitamin C (ascorbic acid) directly into the bloodstream. Vitamin C is essential for collagen synthesis, wound healing, iron absorption, and acts as a potent antioxidant. It also plays a role in immune function and the maintenance of skin, blood vessels, bones, and cartilage.([Farmako][1])

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Indications:

Livocee 25% Injection is primarily used to treat:

Scurvy: A condition resulting from severe vitamin C deficiency.
Vitamin C deficiency: In patients who cannot meet their nutritional needs through diet alone.
Adjunctive therapy: In conditions where vitamin C supplementation is beneficial.

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Dosage:

The dosage of Livocee 25% Injection is determined by a healthcare professional based on the patient's age, weight, and severity of deficiency. It is administered intravenously under medical supervision.

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Side Effects:

Common side effects may include:

Injection site reactions (pain, swelling, redness)([1mg][2])

Serious side effects are rare but can include allergic reactions. Patients should inform their healthcare provider of any known allergies before administration.

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Precautions:

Pregnancy: Consult a doctor before use during pregnancy.
Breastfeeding: Generally considered safe during breastfeeding.
Kidney Disease: Use with caution in patients with kidney issues; consult a doctor.
Liver Disease: Use with caution; consult a doctor for dosage adjustments.([1mg][2])

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Contraindications:

Known hypersensitivity to ascorbic acid or any component of the injection.([Lotus][3])

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Storage:

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

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Tofacitinib 5 mg tablet
Brand Names:

• Xeljanz® (Pfizer – original brand)

• Tofajak®, Tofasure®, Tofacinix®, Jaknat®, Jakura (Generic brands in India)

�� Drug Class:

Janus kinase (JAK) inhibitor – targets JAK1 and JAK3 enzymes, modulating immune response

⚙️ Mechanism of Action:

Tofacitinib blocks the JAK-STAT signaling pathway, reducing the transcription of inflammatory cytokines.

• ↓ IL-6, IL-2, interferon-gamma, and other pro-inflammatory mediators

• Helps control autoimmune inflammation

✅ Indications:

1. Rheumatoid arthritis (RA) – moderate to severe, in patients unresponsive to methotrexate

2. Psoriatic arthritis (PsA)

3. Ulcerative colitis (UC)

4. Ankylosing spondylitis (AS) (approved in some regions)

5. Alopecia areata (emerging/off-label use)

6. Dermatologic and autoimmune diseases (off-label: vitiligo, lupus)

�� Dosage:

• Standard: 5 mg twice daily (BID)

• For Ulcerative Colitis: 10 mg BID for 8 weeks, then 5 mg BID

• May reduce to 5 mg once daily in hepatic impairment or based on tolerance

Note: An extended-release version (11 mg once daily) also exists.

⚠️ Common Side Effects:

• Headache, nausea, diarrhea

• Increased cholesterol and triglycerides

• Infections: upper respiratory tract, herpes zoster

• Anemia, neutropenia

• Liver enzyme elevation

�� Serious Risks:

• Serious infections: TB, fungal, viral (test before starting)

• Malignancy risk (lymphomas, lung cancer – especially in smokers)

• Thrombosis: risk of DVT/PE with higher doses

• GI perforation (rare)

�� Monitoring Requirements:

• CBC (baseline, then every 3 months)

• LFTs, lipid profile after 4–8 weeks

• TB screening (Mantoux or IGRA) before starting

• Hepatitis B/C testing

• Monitor for signs of infection or thrombosis

�� Cost (India):

• Generic brands: ₹25 – ₹50 per tablet

• Monthly cost: ₹1,500 – ₹3,000 ($18 – $35)

• Branded (Xeljanz): significantly higher

⚖️ Contraindications:

• Active or chronic infections

• Severe liver disease

• History of thromboembolic events

• Pregnancy & breastfeeding (not recommended)

�� Storage:

• Store at room temperature (15–30°C)

• Keep in a dry, light-protected place

Tab Afatinib 40mg is an oral medication used in the treatment of nonsmall cell lung cancer (NSCLC) and head and neck cancers Afatinib is a tyrosine kinase inhibitor that specifically targets and blocks the activity of the epidermal growth factor receptor (EGFR) family of receptors, which includes EGFR (HER1), HER2, and HER4 These receptors are often overexpressed or mutated in various types of cancers, leading to increased cell growth and survival By inhibiting these receptors, afatinib helps to stop the growth of cancer cells
 Medical Description:
 Generic Name: Afatinib   Brand Name: Gilotrif   Form: Oral tablet   Strength: 40 mg per tablet
 Mechanism of Action:
Afatinib is a tyrosine kinase inhibitor that irreversibly binds to and inhibits the activity of epidermal growth factor receptors (EGFRs), HER2, and HER4 These receptors are involved in signaling pathways that regulate cancer cell growth and survival When overexpressed or mutated, these receptors can lead to uncontrolled cell proliferation and survival, driving cancer progression By blocking these signals, afatinib interferes with the ability of cancer cells to grow and divide, leading to cell death or growth inhibition
Afatinib works particularly well in EGFRmutated nonsmall cell lung cancer (NSCLC), as EGFR mutations are a common driver of tumor growth in this type of cancer
 Indications:
Afatinib 40mg is primarily used for the treatment of:
1 NonSmall Cell Lung Cancer (NSCLC):    Afatinib is indicated for the treatment of locally advanced or metastatic NSCLC with EGFR mutations It is particularly used in patients whose tumors have specific mutations in the EGFR gene, such as the exon 19 deletions or L858R point mutations    It is used in patients who have not received prior EGFRtargeted therapy or those who have experienced progression after chemotherapy or prior EGFR inhibitor therapy
2 Head and Neck Squamous Cell Carcinoma (HNSCC):    Afatinib is also used for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) in patients whose cancer has progressed after platinumbased chemotherapy It is indicated for patients with EGFRpositive tumors
 Dosage and Administration:
 Route: Oral (tablet)   Strength: 40 mg per tablet   Dosage:     NonSmall Cell Lung Cancer (NSCLC): The recommended dose of afatinib is 40 mg once daily, taken orally Treatment should be continued until disease progression or unacceptable toxicity occurs    Head and Neck Squamous Cell Carcinoma (HNSCC): The recommended starting dose is also 40 mg once daily This may be adjusted based on the patient’s response to therapy and side effects
The tablets should be taken with or without food and should be swallowed whole Afatinib should not be broken, chewed, or crushed
 Side Effects:
Common side effects of afatinib include:
 Diarrhea (very common and may be severe) Rash (acneiform, usually on the face, chest, and back) Stomatitis (mouth sores or ulcers) Fatigue Decreased appetite Nausea and vomiting Dry skin Paronychia (nail infections) Conjunctivitis (eye irritation) Abdominal pain