Introduction
Cytogem 200 is used in the treatment of non-small cell lung cancer, breast cancer, pancreatic cancer, urinary bladder cancer, and ovarian cancer.
Cytogem 200 is given as an injection by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
The most common side effects of this medicine include nausea, vomiting, loss of appetite, hair loss and low blood platelets. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with heart, liver, and blood uric acid levels.
Before taking it, tell your doctor if you have heart disease, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy.
Uses of Cytogem 200
- Non-small cell lung cancer
- Breast cancer
- Pancreatic cancer
- Urinary bladder cancer
- Ovarian cancer
Side effects of Cytogem 200
Common
- Nausea
- Vomiting
- Loss of appetite
- Hair loss
- Low blood platelets
- Allergic reaction
- Breathlessness
- Decreased white blood cell count
- Increased liver enzymes
- Anemia (low number of red blood cells)
- Flu-like symptoms
- Blood in urine
- Skin rash
- Protein in urine
How to use Cytogem 200
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Cytogem 200 works
Cytogem 200 interferes with the growth of DNA and RNA of the cancer cells by substituting their building blocks. It prevents the cancer cells from growing and multiplying.
Indication
Lung cancer, pancreatic cancer, bladder cancer, breast cancer, ovarian carcinoma
Administration
IV Preparation
Reconstitute 200 mg vial with 5 mL 0.9% NaCl OR 1000 mg vial with 25 mL 0.9% NaCl
IV Administration
For IV infusion only
Concentrated injection (10 mg/mL) must be diluted to 2 mg/mL prior to administration
Infuse over 30 min
Avoid rapid infusions
Adult Dose
Pancreatic Cancer
Indicated as first-line treatment for locally advanced (nonresectable Stage II or Stage III) or metastatic (Stage IV) adenocarcinoma of the pancreas
1000 mg/m² IV infusion over 30 minutes once/week x7 weeks; rest 1 week, THEN
1000 mg/m² IV on Days 1, 8, and 15 of each 28-day cycle
Various regimens exist including monotherapy and in combination with other chemotherapy agents (eg, erlotinib, paclitaxel protein bound, capecitabine)
Non-small Cell Lung Cancer
1000 mg/m² IV infusion over 30 minutes on days 1, 8, and 15 of each 28-day cycle, OR
1250 mg/m² IV infusion over 30 minutes on days 1 and 8 of each 21-day cycle
Administer cisplatin 100 mg/m² IV after gemcitabine on day 1
Breast Cancer
1250 mg/m² IV infusion over 30 minutes on Days 1 and 8 of each 21-day cycle
With paclitaxel 175 mg/m² on Day 1 as a 3 hr infusion before gemcitabine
Ovarian Cancer
1000 mg/m² IV infusion over 30 minutes on Days 1 and 8 of each 21-day cycle
With carboplatin AUC 4 on Day 1 after gemcitabine
Contraindication
Concurrent radical radiotherapy; pregnancy, lactation; hypersensitivity.
Mode of Action
Gemcitabine is a synthetic pyrimidine nucleoside and cytarabine analogue which is metabolised intracellularly to active diphosphate and triphosphate nucleosides. It inhibits DNA synthesis by inhibiting DNA polymerase and ribonucleotide reductase. It also induces apoptosis and is primarily active against cells in the S-phase, but may also arrest cells at the G1-S border.
Precaution
Children, hepatic and renal impairment. May impair ability to drive or operate machinery. Discontinue on 1st sign of microangiopathic haemolytic anaemia. Prolonged infusion time (>60 minutes) and more frequent than wkly dosing may increase toxicity. Monitor CBC before every dose. Increased risk of haemolytic uraemic syndrome and/or thrombocytcpenic purpura which may lead to irreversible renal failure.
Lactation: not known if excreted in breast milk; do not nurse
Side Effect
>10%
N/V (69%),Anemia (65%),Elev LFTs (68%),Neutropenia (63%),Leukopenia (62%),Pain (48%),Proteinuria (45%),Fever (41%),Hematuria (35%),Rash (30%),Thrombocytopenia (24%),Dyspnea (23%),Constipation (23%),Diarrhea (19%),Flu-like syndrome (19%),Hemorrhage (17%),BUN increased (16%),Infection (16%),Alopecia (15%),Edema (13%),Elev bilirubin (13%)
1-10%
Paresthesia (2-10%),Creatinine increased (2-8%),Inj site reactions (4%),Bronchospasm (2%)
Potentially Fatal: Oesophagitis and pneumonitis when given with radical radiotherapy to the thorax.
Interaction
May increase the anticoagulant effect of warfarin when used together.