Trade name : Evermil
Active component : Everolimus
Strength : 10mg
Manufactured by : Glenmark Pharmaceutics Ltd
Pack : 10 tablets in a strip
Evermil 10mg is belongs to class of anti-cancer drugs
Evermil 10mg contains of an active compound known as Everolimus which is interfere with development of cancer cell and process is slows down.
Evermil 10mg tablets is not a curable medication, which is helps to slow their spreading into the body.
The drug Evermil 10mg is mainly used for the treatment of following disease
• kidney carcinoma
• Breast carcinoma
• Brain carcinoma
Evermil 10mg is also used to treat in various advanced stage cancer in stomach, intestines or pancreas.
CLINICAL PHARMACOLOGY OF EVERMIL
Everolimus is an prohibitor of mTOR, links at peak compatibility to FK506 binding protein 12, through producing drug complex which prevents the productive of mTOR. This inhibition reduces the activity of effectors downstream, which may lead to stoppage of cell progression from G1 into S phase, finally causes cell growth arrest and apoptosis.Evermil also prohibits the expression of hypoxia-inducible factor, causing to a reduces in the expression of vascular endothelial growth factor. The results of everolimus prevention of mTOR is a reduction in cell multiplication, angiogenesis, and glucose uptake.
The time to peak plasma concentration of Evermil 10mg occurs between 1 to 2 hours.
The drug Evermil 10mg has Albumin human plasma protein bound of 74%.
In hepatic Evermil 10mg metabolism is take place, which is a substrate of CYP3A4.
The Evermil 10mg metabolism will occur through 3 processes;
• Three monohydroxylated metabolite,
• Two hydrolytic rings opened products,
• Phosphatidylcholine conjugate of Everolimus.
The drug excretion primarily through 5% in urine; the parent compound has been detected in urine or feces.
The drug half-life period is 30 hours
Evermil 10mg tablets should be given with or without food.
Dosage regimen of Evermil:
In breast cancer, renal cell cancer, pancreatic cancer, Neuro endocrine cancer:
The prescribed dosage is 10mg should be taken as a single dose.
In Brain or intracranial cancer:
The prescribed dosage of Evermil as a single dose. is 4.5mg/m2 given orally
The pediatric dosage of Evermil as a single dose in brain or intracranial tumor is 4.5mg/m2 should be given orally.
Embryo fetal toxicity:
using Evermil 10mg in pregnancy condition Causes fetal damage
Developed hazard of skin cancers, patient may protect from UV light
Serious infections :
Patients getting Evermil 10mg have severe risk of achieve various infections related to bacteria, virus, and fungi.
Hepatic artery thrombosis :
Evermil 10mg therapy should not be recommended in In liver transplant patients.
while using Evermil the conditions occurs like galactose intolerance, glucose-galactose malabsorption, Evermil 10mg should not be used may results in diarrhea & malabsorption.
Grape juice interaction : avoid these concomitant use with grape juice Causes increasing blood levels of Everolimus
While using Evermil 10mg in renal impaired patients Renal function should be monitored frequently; drug use with caution
While patients receiving concomitantly Evermil 10mg with Angiotensin converting enzyme agents will cause angioedema
Interstitial lung disease:
In Evermil 10mg therapy interstitial lung disease occur
Blood glucose level should be monitored
Drug – Drug interaction
Interaction of Evermil 10mg with strong inhibitor of CYP3A4, or P-gp, cause reducing the efflux of Everolimus and high plasma concentration of Everolimus.
Concomitant use of Evermil 10mg with strong CYP3A4 inducers, will increasing the disclosure of Everolimus.
Interaction of Evermil 10mg with cyclosporine will increasing the AUC level of Everolimus frequently.
Interaction of ketoconazole with Evermil 10mg tablet or other CYP3A4 inhibitors will increasing the plasma concentration and AUC of Everolimus.
Combination of Evermil 10mg with verapamil leads to increasing the plasma concentration of Everolimus.
Interaction of Evermil 10mg with Atorvastatin or pravastatin leads to rhabdomyolysis, due to increasing concentration of lipid lowering agents.
When Evermil 10mg combination with rifampicin will reduces the AUC of Everolimus
The over dosage of Everolimus is limited, If over dosage occurs patient must be provide with supportive measures. And monitor evidence of toxicity in Everolimus over dosage
If the patients missed dose, patients must consult with medical practitioner and follow the instructions given by them. Or missed dose should be avoid and follow the regular dosing schedule.
• Hypersensitivity reactions
• Lymphomas & other malignancy
• Male infertility
• New commencement of diabetes
• Serious infections
• Kidney graft thrombosis
• Hepatic artery thrombosis
• Interstitial lung disease.