Oncology Injectables

Carboplatin Injection

Approx Price: Rs 1 / Pack 

Category: Anticancer
Each vial contains:- Carboplatin .. 150mg ,450 mg and 600 mg

It is a platinum coordination complex. It causes cross linking of DNA; favoured site being N7 of guanine residue. It can also react with –SH groups in proteins and has radiomimetic property. It is bound to plasma proteins, enters, tissues & is slowly excreted unchanged in urine. Cisplatin is very effective in metastatic testicular & ovarian carcinoma. It has found use in some other solid tumours as well.

Composition :

150mg,/15ml, 450mg/45ml

Cisplatin Injection

Approx Price: Rs 1 / Pack 

Cisplatin Injection

Category: Anticancer

Each vial contains:-

  • Cisplatin- 10mg and 50mg
  • Quality Specification:
  • Chromatographic Purity: NLT 99.5%

It is a platinum coordination complex. It causes cross linking of DNA; favoured site being N7 of guanine residue. It can also react with SH groups in proteins and has radiomimetic property. It is bound to plasma proteins, enters, tissues & is slowly excreted unchanged in urine. Cisplatin is very effective in metastatic testicular & ovarian carcinoma. It has found use in some other solid tumours as well.

 

Composition

10mg/20ml, 50mg/100ml

Indication

Metastatic testicular and overian carcinoma, advanced bladder, Head & neck cancer.

Dosage

Admin by slow infusion 1060 mg or as required.

Contra Indications

Pregnancy, lactation hypersensitivity, renal impairment.

Special Precautions

Maintain good hydration. Shock like state sometimes occurs during i.v. infusion,. Monitor haematological, neurological status & renal functions. Hypomagnesaemia. Hypocalcaemia. Hyperuricaemia.

Paediatrics

Not usually prescribed. The risk of hearing loss is increased.

Pregnancy

Not usually prescribed.

Lactation

Not advised.

Elderly

Reduced dose may be necessary.

Side Effects

Nausea, vomiting, Tinnitus, deafness, neuropathy, nephrotoxicity, electrolyte imbalance.

Drug Interactions

Potentiates neurotoxicity with aminoglycosides. Ideal combination with other cytotoxic drugs.Synergistic with 5fluorouracil and etoposide.

Purity

Not less than 99%.

Gemcitabine Injection

Approx Price: Rs 1 / Pack 

Gemcitabine Injection

Category: Anti neo-plastic
Each vial contains:-Gemcitabine Hydrochloride equivalent to Gemcitabine 200mg , 1000mg, 1400mg Mannitol 200 mg, 1000mg, 1400mg

Composition :

Each lyophilized vial contains: Gemcitabine Hydrochloride equivalent to Gemcitabine 200mg , 1000mg, 1400mg
Mannitol .200 mg, 1000mg, 1400mg

Indication :

Gemcitabine hcl in combination with carboplatin is indicated for the treatment of patients with advanced ovarian cancer.
Gemcitabine hcl in combination with paclitaxel is indicated for the first-line treatment of patients with metastatic breast cancer.
Gemcitabine hcl is indicated in combination with cisplatin for the first-line treatment of patients with non-small cell lung cancer.
Gemcitabine hcl is indicated as first-line treatment for patients with adenocarcinoma of the pancreas. Gemcitabine hcl is indicated for patients previously treated with 5-FU

Dosage :-

Adult : Administered i.v. at a dose of 1000 mg/m² over 30 minutes, once weekly for upto 7 weeks or if toxicity calls for reducing or holding a dose. Followed by a week of rest from treatment subsequent cycles consist of infusions one weekly for three weeks out of every 4 weeks.

Contra Indications :-

Gemcitabine hcl is contraindicated in those patients with a known hypersensitivity to the drug.

Adverse effect :-

Most adverse reactions are reversible and do not need to result in discontinuation, although doses may need to be withheld or reduced. Myelosuppression, Nausea and vomiting, mild proteinuria and hematuria, fever, rash, dyspnea, edema, infection, alopecia, bronchospasm

Storage:

Gemcitabine hcl are stable when stored at controlled room temperature 20° to 25°C (68° to 77°F) and that allows for excursions between 15° and 30°C (59° and 86°F)

Pharmacological action: B>

Gemcitabine exhibits cell phase specificity, primarily killing cells undergoing DNA synthesis (S-phase) and also blocking the progression of cells through the Gl/S-phase boundary. Gemcitabine is metabolized intracellular by nucleoside kinases to the active diphosphate and triphosphate nucleosides.

Specification: -

Gemcitabine for injection is a nucleoside metabolic inhibitor that exhibits antitumor activity. Gemcitabine HC1 is 2'-deoxy-2',2'-difluorocytidine monohydrochloride (Ã??²-isomer). The empirical formula for Gemcitabine HC1 is C9H11F2N3O4 HCI It has a molecular weight of 299.66. Gemcitabine HC1 is a white to off-white solid. It is soluble in water, slightly soluble in methanol, and practically insoluble in ethanol and polar organic solvents

Drug Interactions :-

No specific drug interaction studies have been conducted.

Etoposide Injection

Approx Price: Rs 1 / Pack 
Category: Anti neo-plastic
Each ml contains:- Etoposide. 20mg/ml
Pack Size:- 5ml

Etoposide is a semisynthetic derivative of podophyllotoxin used in the treatment of certain neoplastic diseases. It is 4'-demethylepipodophyllotoxin 9-[4,6-O-(R)-ethylidene-β-D-glucopyranoside]. It is very soluble in methanol and chloroform, slightly soluble in ethanol, and sparingly soluble in water and ether. It is made more miscible with water by means of organic solvents. It has a molecular weight of 588.56

Composition : : Each ml contains:
Etoposide .20mg/ml
Indication :Small cell lung cancer. Malignant lymphomas. Acute leukaemias, Testicular tumours. Bladder cancer & trophoblastic diseases.
Dosage :-In small cell lung cancer, the recommended dose of Etoposide Capsules is two times the IV dose rounded to the nearest 50 mg (i.e., two times 35 mg/m2/day for 4 days to 50 mg/m2/day for 5 days). Chemotherapy courses are repeated at 3- to 4-week intervals after adequate recovery from any toxicity.
Contra Indications :-Hypersensitivity, severe liver dysfunction.
Special Precautions :-Renal disease, infections, avoid contact with the skin, mucosa and eye and should not be used in pregnancy, nursing mother and elderly.
Pharmacological action:Etoposide has been shown to cause metaphase arrest in chick fibroblasts. Its main effect, however, appears to be at the G2 portion of the cell cycle in mammalian cells. Two different dose-dependent responses are seen. At high concentrations (10 µg/mL or more), lysis of cells entering mitosis is observed. At low concentrations (0.3-10 µg/mL), cells are inhibited from entering prophase. It does not interfere with microtubular assembly. The predominant macromolecular effect of etoposide appears to be the induction of DNA strand breaks by an interaction with DNA topoisomerase II or the formation of free radicals.
Pregnancy :-Should not be used..
Lactation :-Should not be used.
Elderly :-Should not be used.
Adverse effect: -: Myelosuppression, nausea and vomiting, Anaphylactic-like reactions characterized by chills, fever, tachycardia, bronchospasm, dyspnea, and hypotension, Rash, urticaria, and/or pruritus, Alopecia, abdominal pain, aftertaste, constipation, dysphagia, asthenia, fatigue, malaise, somnolence, transient cortical blindness, optic neuritis, interstitial pneumonitis/pulmonary fibrosis, fever, seizure (occasionally associated with allergic reactions), Stevens-Johnson syndrome, and toxic epidermal necrolysis, pigmentation. .
Storage: -Etoposide Capsules must be stored under refrigeration 2° - 8° C (36° - 46° F). The capsules are stable for 24 months under such refrigeration conditions.
Drug Interactions :-Synergism with other cytotoxic drugs.

Di Sodium Pamidronate Injection

Approx Price: Rs 1 / Pack 

Di Sodium Pamidronate Injection

 

It is a bone resorption inhibitor.

Composition :

15mg, 30mg, 60mg, 90mg

Indications :

Hypercalcaemia of malignancy, Paget's disease, Osteolytic bone metastasis of breast cancer, and Osteolytic lesions of multiple myeloma.

Contraindications :

Patients with clinically significant hypersensitivity to pamidronate or other biphosphonates.

Safety Profile :

Standard hypercalcemia related metabolic parameters such as serum levels of calcium, phosphate, magnesium and potassium should be carefully monitored.

Adverse Effects :

Fluid overload, generalized pain, Hypertension, abdominal pain, anorexia, constipation, nausea, vomiting, urinary tract infection, bone pain, anaemia, hypophosphatemia.

Dosage :

Paget's disease - 60mg by slow iv infusion at a rate of 15mg/hour, optimal dosing regimen adjusted individually according to response.
Hypercalcaemia of malignancy : Slow iv infusion at a rate of 60 mg/hour dose adjusted according to initial plasma calcium concentration : 30mg when plasma calcium is below 3.00 mmol/L, 30-60mg when plasma calcium 3.0-3.5 mmol/L, 60-90 mg when plasma calcium 3.5-40 mmol/L, 90 mg when plasma calcium is above 4.0 mmol/L Repeat dose every 2-3 weeks as necessary.
Bone metastasIs : Slow iv infusion 2 hours in breast cancer, 4 hours in multiple myeloma, 90mg every 3-4 weeks.

Purity :

Not less than 99%.

L-Asparaginase Injection

Approx Price: Rs 1 / Pack 
L-Asparaginase contains the enzyme L-asparagine amidohydro-lase, type EC-2, derived from Escherichia coli. Elspar activity is expressed in terms of International Units according to the recommendation of the International Union of Biochemistry. One International Unit of asparaginase is defined as that amount of enzyme required to generate 1 ìmol of ammonia per minute at pH 7.3 and 37°C. The specific activity of L - Asparginase is at least 225 International Units per milligram of protein. L - Asparginase is provided as a sterile, white lyophilized plug or powder. Each vial contains 10, 000 International Units of asparaginase and 80 mg of mannitol.

Uses:
Asparaginase is used with or without other anticancer (chemotherapy) drugs to treat acute lymphocytic leukemia (ALL). It works by starving tumor cells of needed nutrients and slowing tumor cell growth.

Other uses :
This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

How to use:
This medication is given by vein (intravenously-IV), into the muscle (intramuscularly-IM), or under the skin (subcutaneously-SubQ). Your doctor will give you pre-medication to help prevent allergic reactions. Unless your doctor instructs you otherwise, drink plenty of fluids while using this medication. Follow all instructions for proper mixing. When mixed in the vial, this medication should be clear. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. When receiving asparaginase by vein, follow all instructions for dilution with the correct IV fluid.

Zolendronic Acid Injection

Approx Price: Rs 1 / Pack 
Category: Anti-neoplastic
Each vial contains:- Zoledronic acid 4mg

Zoledronic acid is a bisphosphonic acid which is an inhibitor of osteoclastic bone resorption. Zoledronic acid is designated chemically as (l-Hydroxy-2-imidazol-l-yl-phosphonoethyl) phosphonic acid monohydrate. Zoledronic acid is a white crystalline powder. Its molecular formula is C5H10N2O7P2•H2O and its molar mass is 290.1g/Mol. Zoledronic acid is highly soluble in 0.1N sodium hydroxide solution, sparingly soluble in water and 0.1N hydrochloric acid, and practically insoluble in organic solvents. The pH of a 0.7% solution of zoledronic acid in water is approximately 2.0.

Composition : Each vial contains: Zoledronic acid monohydrate 4.264mg eq to Zoledronic acid 4mg
Indication :Zoledronic acid is indicated for the treatment of hypercalcemia, multiple myeloma, bone metastases, osteoporosis in men and women.
Dosage :-Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. The maximum recommended dose of Zoledronic acid in hypercalcemia of malignancy (albumin-corrected serum calcium greater than or equal to 12 mg/dL [3.0 mmol/L]) is 4 mg. The 4-mg dose must be given as a single-dose intravenous infusion over no less than 15 minutes. Patients who receive Zoledronic acid should have serum creatinine assessed prior to each treatment.
Contra Indications:-Hypersensitivity reactions including rare cases of urticaria and angioedema, and very rare cases of anaphylactic reaction/shock have been reported.
Precautions:-Patients with hypercalcemia of malignancy must be adequately rehydrated prior to administration of Zoledronic acid, treatment is not recommended in patients with bone metastases with severe renal impairment and in hepatic impairement.
Pharmacological Action: The principal pharmacological action of Zoledronic acid is inhibition of bone resorption. In vitro, zoledronic acid inhibits osteoclastic activity and induces osteoclast apoptosis. Zoledronic acid also blocks the osteoclastic resorption of mineralized bone and cartilage through its binding to bone. Zoledronic acid inhibits the increased osteoclastic activity and skeletal calcium release induced by various stimulatory factors released by tumors.
Drug interaction: In-vitro studies indicate that Zoledronic acid is approximately 22% bound to plasma proteins. In-vitro studies also indicate that Zoledronic acid does not inhibit microtonal CYP450 enzymes. In-vivo studies showed that Zoledronic acid is not metabolized, and is excreted into the urine as the intact drug.
Adverse effect: Administration of Zoledronic acid 4 mg given as a 5-minute intravenous infusion has been shown to result in an increased risk of renal toxicity The most frequently observed adverse events were fever, nausea, constipation, anemia, and dyspnea. rash, pruritus.

Cyclophosamide Injection

Approx Price: Rs 1 / Pack 
Composition: Each vial contains: Cyclophosphamide eq. to Cyclophosphamide (anhydrous) 200mg ,500mg, 1000mg.
It is an antineoplastic and immuno modulating agent. It is bio-transformed in liver to active alkylated metabolite. These metabolites interfere with growth of susceptible rapidly multiplying malignant cells by cross-linking of tumour cell-DNA.
Specification-cyclophosphamide for injection, is a sterile white powder containing cyclophosphamide monohydrate. Cyclophosphamide is a synthetic antineoplastic drug chemically related to the nitrogen mustards. Cyclophosphamide is a white crystalline powder with the molecular formula C7H15Cl2N2O2P•H2O and a molecular weight of 279.1. Cyclophosphamide is soluble in water, saline, or ethanol .
pH--- 3.0 to 9.0
Indication :Cyclophosphamide although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs. The following malignancies are often susceptible to cyclophosphamide treatment:
• Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin's disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt's lymphoma.
• Multiple myeloma.
• Leukemias: Chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenous and monocyticleukemia, acute lymphoblastic (stem-cell) leukemia in children cyclophosphamide given during remission is effective in prolonging its duration)..
• Carcinoma of the breast.
Dosage :-Adults and Children:
When used as the only oncolytic drug therapy, the initial course of cyclophosphamide for patients with no hematologic deficiency usually consists of 40 to 50 mg/kg given intravenously in divided doses over a period of 2 to 5 days. Other intravenous regimens include 10 to 15 mg/kg given every 7 to 10 days or 3 to 5 mg/kg twice weekly.
Contraindications:-In patients with history of hypersensitivity to the drug, pregnancy, location.
Precautions:-Special attention to the possible development of toxicity should be exercised in patients being treated with cyclophosphamide if any of the following conditions are present.

• Leukopenia
• Thrombocytopenia
• Tumor cell infiltration of bone marrow
• Previous X-ray therapy

Previous therapy with other cytotoxic agents

Dactinomycin Injection

Approx Price: Rs 1 / Pack 

Dactinomycin Injection

 

Category: Anti-neoplastic
Each vial contains: Dactinomycin USP 500 mcg
Good evidence exists that this drug bind strongly, but reversibly, to DNA, interfering with synthesis of RNA (prevention of RNA polymerase elongation) and, consequently, with protein synthesis.

 

Specification-

pH range- 5.5 to 7.5
Dactinomycin is a clear, gold-colored liquid given into a vein (IV).
A compound composed of a two cyclic peptides attached to a phenoxazine that is derived from streptomyces parvullus. It binds to DNA and inhibits RNA synthesis (transcription), with chain elongation more sensitive than initiation, termination, or release. As a result of impaired mRNA production, protein synthesis also declines after dactinomycin therapy.

Indication :

For the treatment of Wilms' tumor, childhood rhabdomyosarcoma, Ewing's sarcoma and metastatic, nonseminomatous testicular cancer as part of a combination chemotherapy and/or multi-modality treatment regimen.

Dosage :-

Dose intensity per 2-week cycle for adults or children should not exceed 15 mcg/kg/day or 400-600 mcg/m²/day intravenously for five days.

Contra Indications:-

Active infection with chiken pox or herpes zoster (a severe generalized form of disease may occure), infants less than12 months.

Precautions:-

This drug is not recommended for use during pregnancy. Precaution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially the effect on blood cell production (myelosuppression).

Drug interaction:

Trastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events.

Adverse effects:

Nausea, vomiting, malaise, fatigue, cheilitis, dysphagia, bone marrow depression gastric ulceration, hepatitis, hepatomegaly, abnormal liver function, alopecia, skin eruotion.

Storage:

Powder for injection at room temperature (59° to 86°F). Protect from light and humidity.

Vincristine Injection

Bleomycin Injection

Approx Price: Rs 1 / Pack 

Category: anti-neoplastic
Each vial contains:- Bleomycin sulphate 15 units, 30 units
Bleomycin sulfate for injection is a mixture of cytotoxic glycopeptide antibiotics isolated from a strain of streptomyces verticillus. It is freely soluble in water. Between 4. 5 to 6. 0

 

Pharmacological Action :

Bleomycin is a mixture of cytotoxic glycopeptide antibiotics. It inhibits DNA synthesis. When administered intrapleurally, bleomycin acts as a sclerosing agent.

Precautions:

It is recommended that Bleomycin be administered under the supervision of a qualified health care provider experienced in the use of cancer chemotherapeutic agents. Appropriate management of therapy and complications is possible only when adequate diagnostic and treatment facilities are readily available. Before using Bleomycin Sulfate for injection medication, tell your doctor or pharmacist your medical history, especially: immune system problems (e.g., chemotherapy, bone marrow problems), kidney disease, liver disease, lung problems.

Indications:

Bleomycin Sulfate Injection should be considered a Palliative Treatment. It has been shown to be useful in the management of the following neoplasms either as a single agent or in proven combinations with other approved
chemotherapeutic agents: Squamous Cell Carcinoma in Head and neck including mouth, tongue, tonsil, Nasopharynx, Oropharynx, Sinus, palate, Lip, Buccal Mucosa, Gingivae , Epiglottis, skin, Larynx, Cervix, and Vulva. Lymphomas, Testicular Carcinoma, Malignant Pleural Effusion.

Contraindications :

Bleomycin Sulfate injection is contraindicated in patients who have demonstrated a hypersensitive or an idiosyncratic reaction to it.

Adverse Effects :

Pneumonitis progressing to pulmonary anaphylactoid reactions, erythema, rash, striae, vesiculation, hyperpigmentation, rarely myocardial infarction, cerebrovascular accident, haemolytic uraemia syndrome, cerebral arthritis.
Local reactions : Pain, pruritus, hyperpigmentation, scarring, suppuration scaling.

Dosage :

Bleomycin Sulfate injection may be given by the Intramuscular, intravenous, subcutaneous, or Intrapleural routes. Squamous cell carcinoma, non-Hodgkin's lymphoma, testicular carcinoma- 0.25 to 0.50 units/kg (10 to 20 units/m) given intravenously, intramuscularly, or subcutaneously weekly or twice weekly.
Hodgkin's disease :- 0.25 to 0.50 units/kg (10 to 20 units/m) given intravenously, intramuscularly, or subcutaneously weekly or twice weekly.
Note: When Bleomycin sulfate injection is used in combination with other antineoplastic agents, pulmonary toxicities may occur at lower doses.
Malignant Pleural Effusion - 60 units administered as a single dose Bolus Intrapleural Injection.
Intramuscular or Subcutaneous: Bleomycin Sulfate injection 15 units vial should be reconstituted with 1 to 5 ml of Sterile Water for Injection, Sodium Chloride for Injection 0.9% or Sterile Bacteriostatic Water for Injection. Bleomycin Sulfate injection 30 units vial should be reconstituted with 2 to 10 ml of the above diluents.
Intravenous: The contents of the 15 units or 30 units vial should be dissolved in 5 ml or 10 ml, respectively, of Sodium Chloride for Injection, 0.9% and administered slowly over a period of 10 minutes.

Daunorubicin Injection

Approx Price: Rs 1 / Pack 

Daunorubicin Injection

It is an anthracycline cytotoxic antibioticproduced by a strain of streptomyces peucetius. It inhibits the synthesis of nucleic acids and effects on DNA & particularly rapid and marked.

Composition :

20mg

Indications :

Remission indication in non lymphocytic leukemias, acute erythroid, leukemia, acute monocytic, leukemia, acute myelogenous leukemia, acute Lymphoblastic leukemia in children and adults.

Contraindications :

Pre- existing drug induced bone marrow supression, pre-existing heart disease, pregnancy.

Safety Profile :

Cardiac, renal & hepatic functions adn serum uric levels should be evaluated prior to treatment. Completed blood count should be frequently monitored during the therapy extravasation at the site of injections may causes severe local tissue necrosis.

Adverse Effects :

Myelosuppression, myocardial toxicity, infants and children's are more susceptible to congestive heart failure (CHF), reversible alopecia gastrointestinal toxicity, acute nausea, vomiting, rare anaphylactoid reactions, hyperuricaemia, transient red urine.
A special preparation as daunorubicin citrate liposome contain an equal amount of citrate encapsulated in lipid vesicles, formulated to maximize the selectivity of the drug for soiled tumors in sites.

Drug Interactions :

1st line drug for advanced HIV associated keposi's saecoma.

Dosage :

Acute nonlymphocytic leukemia: Less than 60 years age -45 mg/m²/day i.v on days 1,2,3 on first course and on day 1&2 on subsequent course with cytosine.
Acute Lymphocytic leukemia (All): Chlidren 25 mh/ m² i.v on day every week with prednisolone and vincristine.In < 2yrs of age: mg/kg dose in same manner Adult: 45 mg/m²per day i.v on drug 1,2,3 with vincristine., prednisolone and L-asparaginase.
In < 2yrs of age: mg/kg dose in same manner Adult: 45 mg/m²per day i.v on drug 1,2,3 with vincristine., prednisolone and L-asparaginase.

Epirubicin Injection

Approx Price: Rs 1 / Pack 

Category: Anti-neoplastic

It is a new anthracycline antibioticwith antiblastic activity. The mechanism of action of it is related to its ability to bind to DNA. Cell culture studies have shown rapid cell penetration, localization in the nucleus and inhibition of nucleic acid synthesis and mitosis.

Composition :

Each lyophilized Vial contains: Epirubicin Hydrochloride – 10mg, 50mg, 100mg

Mitoxantrone Injection

Approx Price: Rs 1 / Pack 
It is a synthetic antineoplastic anthracenedione for intravenous use. Although its mechanism of action is not fully elucidated, it is a DNA - reactive agent. It has a cytocidal effect on with proliferating and non proliferating cultured small cells suggesting lock of cell cycle specifically.
Composition :Each ml contains: Mitoxantrone ----2 mg
Indications :It is used in the treatment of metastatic breast cancer and of non-Hodgkin’s lymphomas, alone or with other agents. It may also be given to treat adult acute myeloid leukemia. Mitoxantrone has also been used in patients with hormone-refractory prostate cancer, liver cancer, and ovarian cancer. In addition, mitoxantrone is used in the management of secondary progressive or relapsing multiple sclerosis, to reduce neurological disability or the frequency of relapses.
Contraindications :Mitoxantrone for injection is contraindicated in patients who have demonstrated prior hypersensitivity to it.
Adverse Effects :Serious adverse reactions including anaphylaxis and allergic reactions, neuropathy,pulmonary toxicities and hepatotoxicities can occur..
Dosage :In the treatment of breast cancer, prostate cancer, liver cancer, and lymphomas, a dose equivalent to mitoxantrone 14 mg/m2 is given initially and then repeated every 3 weeks. It is diluted to at least 50 ml in sodium
chloride 0.9% or glucose 5% and injected over at least 3 minutes into a freely-running intravenous infusion of
either. Subsequent doses may be adjusted according to the degree of Myelosuppression produced. Initial dosage
may need to be reduced to 12 mg/m2 in debilitated patients or those who have had previous Hemotherapy.
Precautions:Special Populations in Carcinogenesis, Mutagenesis, Impairment of Fertility, Hepatic Impairment, Pregnancy, Nursing Mothers, Pediatric Use, Geriatric Use, Multiple Sclerosis, Hormone-Refractory Prostate Cancer, Acute Nonlymphocytic Leukemia.

Vinorelbine Injection

Approx Price: Rs 1 / Unit 
It is a semi-synthetic vinca alkaloid. It interfere with microtubules, which compose of miotic spindle fibres leading to cell cycle arrest in the metaphase.
Composition : 10mg/1ml,20mg/5ml,50mg/5ml
Indications : Non small cell lung carcinoma, breast carcinoma, Hodgkin's disease, ovarian carcinoma, squamous cell carcinoma of the head and neck, cervical, SCLC, renal cell cancer and kaposi's sarcoma.
Contraindications :Hypersensitivity, intrathecal administration as it is extremely irritating.
Safety Profile : Monitor patients with pre-existing neuropathy. Careless causes extravasation.
Adverse Effects : Granulocytopenia, anaemia thrombocytopenia, vomiting, nausea, muscle weakness.
Dosage :Initial dose of 30mg/m² weekly over a period of 6-10 min. No dose adjustment is required for renal insufficiency.

Cytosine Arabinoside Injection

Approx Price: Rs 1 / Pack 
It is phosphorylated in the body to corresponding nucleotide, which inhibits DNA repair. Cytorabine is cell cycle specific and acts primarily during phase. Its main use is to induce remission in acute leukemia.
Composition :100mg/1ml, 500mg/5ml, 1000mg/10ml
Indications :Acute leukemias, lymphosarcomas.
Dosage:3-6 mg/Kg body wt. i.v daily in 2 divided doses for 5-10 days.
Contraindications:Hypersensitivity, Pregnancy.
Special Precautions :Hepatic impairment.
Paediatrics : Indicated in certain leukemia, under strict supervision.
Pregnancy : Safety not established
Lactation : Safety not established
Elderly : Use with caution
Side- Effect :Bone marrow suppression. G.I.T disturbances.
Drug Interaction :Potentiates bone marrow depression with radiotherapy and other myelotoxic drugs. Reduces plasma concentration of digoxin,antagonizes gentamicin. Decr

Mesna Injection

Approx Price: Rs 1 / Pack 
  • Category: Chemoprotectant/Cytoprotective Agent/ Antidotes
  • Composition- : Each ml contains: Mesna 100mg Water for Injection q.s.

Mesna is used to reduce the incidence of ifosfamide-induced hemorrhagic cystitis. Mesna disulfide is reduced to the free thiol compound, mesna, which reacts chemically with the urotoxic ifosfamide metabolites, resulting in their detoxification.
Specification-pH range – : 4.5 to 7.0
Mesna Injection is a detoxing agent to inhibit the hemorrhagic cystitis induced by ifosfamide. It is a sterile, nonpyrogenic, aqueous solution of clear and colorless to light pink appearance in clear glass multidose vials for intravenous administration. It is used to prevent bleeding from the bladder during ifosfamide or cyclophosphamide chemotherapy.
Indication :Prevention of toxicity to the urinary passage caused by cyclophosphamide or Trofosfamide.
Dosage :-I.V. 20% of the dose of anti-neoplastic on weight basis, over 15-30 minutes at 4 hours interval
Contraindications:-Hypersensitivity.
Precautions:-Tell your doctor and pharmacist if you are allergic to mesna or any other drugs.
Tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including vitamins.
Tell your doctor if you have or have ever had liver or kidney disease.
Tell your doctor if you are pregnant or breast-feeding. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy.
Do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.
Drug interaction: Mercaptopurine, Cyclophosphamide, , Digoxin.
Adverse Effect-: G.I. Disturbance, headache, skin rash, tachycardia, hypotension
Storage:After preparation, this medication is stable for 24 hours at 77 degrees F (25 degrees C). Before preparation, store the vials at room temperature between 59 and 86 degrees F (15-30 degrees )

Epirubicin Injection

Approx Price: Rs 1 / Pack 
Category: Anti-neoplastic. Each vial contains:-

  • Epirubicin - 10mg , 50mg and 100mg
  • Chromatographic Purity: NLT 99.5%

It is a new anthracyclineantibiotic with antiblastic activity. The mechanism of action of it is related to its ability to bind to DNA. Cell culture studies have shown rapid cell penetration, localization in the nucleus and inhibition of nucleic acid synthesis and mitosis.
Composition : Each lyophilized Vial contains:
Epirubicin Hydrochloride – 10mg, 50mg, 100mg
Indication :It is used in the Adjuvant Treatment of Breast Cancer
Specification: :Epirubicin Hydrochloride Injection is supplied as a sterile, clear, red solution and is available in polypropylene vials containing 50 and 200 mg of Epirubicin Hydrochloride as a preservative-free, ready-to-use solution. pH Between 4.0 to 5.5
Dosage :-Administer Epirubicin Injection by intravenous infusion. Give Epirubicin in repeated 3- to 4-week cycles. The total dose of Epirubicin may be given on Day 1 of each cycle or divided equally and given on Days 1 and 8 of each cycle.
Patients administered the 120-mg/m² regimen of Epirubicin should receive prophylacticantibiotic therapy. Administering a lower starting dose (75-90 mg/m²) for heavily pretreated patients, patients with pre-existing bone marrow depression, or in the presence of neoplastic bone marrow infiltration
Contra Indications:-Patients should not be treated with Epirubicin Injection if they have any of the following conditions:Severe myocardial insufficiency, recent myocardial infarction or severe arrhythmias
Special Precautions:-Administer Epirubicin Injection only under the supervision of qualified physicians experienced in the use of cytotoxic therapy. Before beginning treatment with Epirubicin, patients should recover from acute toxicities (such as Stomatitis, neutropenia, thrombocytopenia, and generalized infections) of prior cytotoxic treatment. Also, precede initial treatment with Epirubicin by a careful baseline assessment of blood counts; serum levels of total Bilirubin, AST, and Creatinine; and cardiac function as measured by left ventricular ejection function (LVEF). Carefully monitor patients during treatment for possible clinical complications due to Myelosuppression.
Pharmacological Action:
Epirubicin forms a complex with DNA by intercalation of its planar rings between nucleotide base pairs, with consequent inhibition of nucleic acid (DNA and RNA) and protein synthesis.Such intercalation triggers DNA cleavage by topoisomerase II, resulting in cytocidal activity. Epirubicin also inhibits DNA helicase activity, preventing the enzymatic separation of double-stranded DNA and interfering with replication and transcription

Ifosfamide Injection

Approx Price: Rs 1 / Unit 
  • Category: Anti-neoplastic
  • Composition- : Each lyophilized vial contains :- Ifosfamide USP 1gm/2 gm
Specification-pH range – : 4.0 to 7.0
Description-: Ifosfamide belongs to the group of medicines called alkylating agents. It is used to treat cancer of the testicles as well as some other kinds of cancer. Another medicine, called mesna, is usually given along with ifosfamide to prevent bladder problems that can be caused by ifosfamide.
Indication :Ifosfamide , used in combination with certain other approved antineoplastic agents, is indicated for third line chemotherapy of germ cell testicular cancer. It should be used in combination with a prophylactic agent for hemorrhagic cystitis.
Dosage :-Ifosfamide should be administered intravenously at a dose of 1.2 g/m² per day for 5 consecutive days. Treatment is repeated every 3 weeks or after recovery from hematologic toxicity.
Contra Indications:-Continued use of ifosfamide is contraindicated in patients with severely depressed bone marrow function ifosfamide is also contraindicated in patients who have demonstrated a previous hypersensitivity to it.
Precautions:-Ifosfamide should be discontinued if neurologic symptoms of somnolence, irritability, anxiety, confusion, hallucinations, or coma are observed. Use with caution in patients with renal or hepatic impairment.
Drug interaction:The concurrent use of ifosfamide may enhance the anticoagulant effect of and thus raise the risk of haemohorrage .
Side Effect-:Severe nausea, vomiting, Dizziness, Fatigue, Bone marrow depression and Allergic reaction like difficult breathing and swelling of face and lips.
Storage:Store at 2-8ºC (35-46ºF) and protect from light.

Methotrexate Injection

Approx Price: Rs 1 / Pack 
  • Category: Anticancer
  • Each vial contains: Each ML contains: Methotrexate(anhydrous) USP 7.5mg/25mg, 50 mg
  • Specifications: Methotrexate is an antimetabolite used in the treatment of certain neoplastic diseases, severe psoriasis, and adult rheumatoid arthritis. Between 7.5 to 9.0.
Composition : Each ml contains:
Methotrexate(anhydrous) USP 7.5mg/25mg, 50 mg
q.s.
Indications : Methotrexate is indicated in the treatment of Gestational Choriocarcinoma, Chorioadenoma Destruens and Hydatidiform mole. In acute lymphocytic leukemia, Methotrexate is indicated in the prophylaxis of Meningeal leukemia and is used in maintenance therapy in combination with other chemotherapeutic agents. Methotrexate is also indicated in the treatment of Meningeal leukemia. Methotrexate is used alone or in combination with other anticancer agents in the treatment of breast cancer, Epidermoid cancers of the head and neck, advanced mycosis fungoides , and lung cancer, particularly Squamous cell and small cell types. Methotrexate is indicated in the symptomatic control of severe, recalcitrant, disabling psoriasis
Rheumatoid Arthritis including Polyarticular-Course Juvenile Rheumatoid Arthritis.
Contraindications : Methotrexate can cause fetal death or teratogenic effects when administered to a pregnant woman. Patients with psoriasis or rheumatoid arthritis with alcoholism, alcoholic liver disease or other chronic liver disease should not receive Methotrexate. Patients with psoriasis or rheumatoid arthritis who have overt or laboratory evidence of immunodeficiency syndromes should not receive Methotrexate. Patients with psoriasis or rheumatoid arthritis who have preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia, should not receive methotrexate.
Patients with a known hypersensitivity to methotrexate should not receive the drug..
Pharmacological action: Methotrexate inhibits dihydrofolic acid reductase. Dihydrofolates must be reduced to tetrahydrofolates by this enzyme before they can be utilized as carriers of one-carbon groups in the synthesis of purine nucleotides and thymidylate. Therefore, Methotrexate interferes with DNA synthesis, repair, and cellular replication. Actively proliferating tissues such as malignant cells, bone marrow, fetal cells, buccal and intestinal mucosa, and cells of the urinary bladder are in general more sensitive to this effect of Methotrexate..

StorageStore at room temperature 15° to 30°C (59° to 86°F),
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