Trade name : Evertor
Active component : Everolimus
Strength : 10MG
Manufactured by : Biocon
Pack : 10 tablets in a strip
Evertor is belongs to class of anti cancer drugs Evertor contains of an active compound known as Everolimus which is interfere with development of cancer cell and process is slows down. Evertor tablets is not a curable medication, which is helps to slow their spreading into the body.
The drug Evertor is mainly indicated for the treatment of following disease
• kidney carcinoma
• Breast carcinoma
• Brain carcinoma
Evertor is also used to treat in various advanced stage cancer in stomach, intestines or pancreas. .
CLINICAL PHARMACOLOGY OF EVERTOR
Evertor is an prohibitor of mTOR, links at peak compatibility to FK506 binding protein 12, through producing drug complex which prevents the productive of mTOR, the main ingredient which is used as everolimus. This inhibition reduce the activity of effectors downstream, which may leads to stoppage of cell progression from G1 into S phase, Finally causes cell growth arrest and apoptosis
The time to peak plasma concentration of Evertor occurs between 1 to 2 hours.
The drug Evertor has Albumin human plasma protein bound of 74%.
In hepatic Evertor metabolism is take place, which is a substrate of CYP3A4.
The Evertor metabolism will occur through 3 process;
• Three monohydroxylated metabolite,
• Two hydrolytic rings opened products,
• Phosphatidylcholine conjugate of Everolimus.
The elimination primarily via 5% in urine; the parent compound has been detected in urine or feces. The drug half life period is 30 hours
Evertor tablets should be given with or without food
Dosage regimen of Evertor;
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 Evertor as a single dose. is 4.5mg/m2 given orally In pediatric: The pediatric dosage of Evertor as a single dose in brain or intracranial tumor is 4.5mg/m2 should be given orally.
Embryo fetal toxicity: using Evertor in pregnancy condition Causes fetal damage Lymphomas : Developed hazard of skin cancers, patient may protect from UV light Serious infections : Patients getting Evertor have severe risk of achieve various infections related to bacteria, virus, and fungi. Hepatic artery thrombosis : Evertor therapy should not be recommended in In liver transplant patients, Hereditary disorders: while using evetor the conditions occurs like galactose intolerance, glucose-galactose malabsorption, Evertor 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 Nephrotoxicity : While using Evertor in renal impaired patients Renal function should be monitored frequently; drug use with caution Angioedema : While patients receiving concomitantly Evertor with Angiotensin converting enzyme agents will cause angiodema Interstitial lung disease: In Evertor therapy interstitial lung disease occur Blood glucose level should be monitored
Drug – Drug interaction
Interaction of Evertor with strong inhibitor of CYP3A4, or P-gp, cause reducing the efflux of Everolimus and high plasma concentration of Everolimus. Concomitant use of Evertor with strong CYP3A4 inducers, will increasing the disclosure of Everolimus. Interaction of Evertor with cyclosporine will increasing the AUC level of Everolimus frequently. Interaction of ketaconazole with Evertor tablet or other CYP3A4 inhibitors will increasing the plasma concentration and AUC of Everolimus. Combination of Evertor with verapamil leads to increasing the plasma concentration of Everolimus. Interaction of Evertor with Atorvastatin or pravastatin leads to rhabdomyolysis, due to increasing concentration of lipid lowering agents. When Evertor 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.