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Glistorma (Temozolamide)
SELECT REF DESCRIPTION MANUFACTURER PACK SIZE STRENGTH OUR PRICE
Out Of Stock P1276 Glistorma (Temozolamide) Alkem 1 x 5 caps 100 mg $306.90
Out Of Stock P1277 Glistorma (Temozolamide) Alkem 1 x 5 caps 250 mg $610.55
Price is per pack & not per tab.. eg: if pack size is 10 tabs & price is $2.75 then for 100 tabs the price would be $27.50
What is temozolomide?
Temozolomide interferes with the development of cancer cells, slowing their growth and spread in the body.

Temozolomide is used together with radiation therapy to treat certain types of brain tumor in adults.

Temozolomide is usually given after other cancer medications have been tried without successful treatment of the tumor.

Temozolomide may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about temozolomide?
Do not this medication if you are allergic to temozolomide or to another cancer medication called dacarbazine (DTIC-Dome). Before taking temozolomide, tell your doctor if you have liver or kidney disease. Do not use this medication without telling your doctor if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Do not open the temozolomide capsule, or use a capsule that has been accidentally broken. The powder inside the capsule can be dangerous if you accidentally inhale it or if it gets in your eyes, mouth, or nose, or on your skin. If you must handle a broken capsule, ask your doctor or pharmacist how to safely handle and dispose of it. Rinse off any medicine that gets on your skin or in your eyes, nose, or mouth.

Temozolomide is often given together with radiation treatment, and then continued for several weeks or months after radiation treatment ends. There may be periods of time when you will take temozolomide for only a few days in a row and then wait another 2 to 4 weeks before you start a new treatment cycle and take it again. Follow your doctor's instructions carefully.

Your doctor may occasionally change your dose to make sure you get the best results from this medication. The size, color, and number of temozolomide capsules you take may be different from time to time as your doctor adjusts your dose. Be sure you know the correct number of capsules to take and on which days to take them. Contact your doctor or pharmacist if you have any questions.

What should I discuss with my healthcare provider before taking temozolomide?
You should not this medication if you are allergic to temozolomide or to another cancer medication called dacarbazine (DTIC-Dome).

Before taking temozolomide, tell your doctor if you are allergic to any drugs, or if you have:

liver disease; or

kidney disease.

If you have any of these conditions, you may not be able to use temozolomide, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use temozolomide without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether temozolomide passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Women and older adults may be more likely to have bone marrow suppression (a weakened immune system) while taking temozolomide, leading to an increased risk of infection or illness.

How should I take temozolomide?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Taking the medicine on an empty stomach or at bedtime may reduce nausea caused by temozolomide. Your doctor may also prescribe other medications to prevent nausea and vomiting.

Swallow the temozolomide capsule whole, with a full glass of water.

If you vomit shortly after taking temozolomide, do not take another capsule until it is time for your next regularly scheduled dose.

Do not open the temozolomide capsule, or use a capsule that has been accidentally broken. The powder inside the capsule can be dangerous if you accidentally inhale it or if it gets in your eyes, mouth, or nose, or on your skin. If you must handle a broken capsule, ask your doctor or pharmacist how to safely handle and dispose of it. Rinse off any medicine that gets on your skin or in your eyes, nose, or mouth.

Temozolomide is often given together with radiation treatment, and then continued for several weeks or months after radiation treatment ends. There may be periods of time when you will take temozolomide for only a few days in a row and then wait another 2 to 4 weeks before you start a new treatment cycle and take it again. Follow your doctor's instructions carefully.

Your doctor may occasionally change your dose to make sure you get the best results from this medication. The size, color, and number of temozolomide capsules you take may be different from time to time as your doctor adjusts your dose. Be sure you know the correct number of capsules to take and on which days to take them. Contact your doctor or pharmacist if you have any questions.

To be sure this medication is not causing harmful effects, your blood will need to be tested before your start taking the medicine and at regular intervals during treatment. Do not miss any scheduled visits to your doctor.

It is important to take temozolomide regularly to get the most benefit. Try to take the medication at the same time each dosing day.

Store temozolomide at room temperature away from moisture and heat.

What happens if I miss a dose?
Contact your doctor if you miss a dose or forget to take your temozolomide.

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Taking temozolomide for longer than recommended can cause a fatal overdose.

Overdose symptoms may include fever, pale skin, increased thirst, dry skin, easy bruising or bleeding, confusion, weakness, urinating less than usual or not at all, and feeling light-headed or fainting.

What should I avoid while taking temozolomide?
Temozolomide can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Do not receive any vaccine or flu shot without your doctor's advice while you are taking temozolomide.

Temozolomide side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

high fever, dry cough, feeling short of breath, weight loss, night sweats;

sore throat, body aches, and other cold or flu symptoms;

pale skin, easy bruising or bleeding, unusual weakness;

pain or burning with urination;

seizure (convulsions); or

white patches or sores inside your mouth or on your lips.

Less serious side effects may include:

nausea, vomiting, stomach pain, loss of appetite;

constipation or diarrhea;

headache, memory problems, blurred vision;

sleep problems (insomnia);

numbness or tingling;

trouble swallowing;

skin rash or redness;

hair loss; or

tired feeling.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Temozolomide Dosing Information
Usual Adult Dose for Anaplastic Astrocytoma:

For the treatment of adult patients with refractory anaplastic astrocytoma:

Initial dose: 150 mg/m2 either orally or by intravenous infusion over 90 minutes once daily for 5 consecutive days per 28 day treatment cycle

If the nadir and day of dosing (Day 29, Day 1 of next cycle) absolute neutrophil counts (ANC) are greater than or equal to 1.5 × 10(9)/L and the nadir and Day 29, Day 1 of next cycle platelet counts are greater than or equal to 100 × 10(9)/L, the dose may be increased to 200 mg/m2/day for 5 consecutive days per 28 day treatment cycle.

During treatment, a complete blood count should be obtained on Day 22 (21 days after the first dose) or within 48 hours of that day, and weekly until the ANC is above 1.5 × 10(9)/L and the platelet count exceeds 100 × 10(9)/L. The next cycle of temozolomide should not be started until the ANC and platelet count exceed these levels.

If the ANC falls to less than 1.0 × 10(9)/L or the platelet count is less than 50 × 10(9)/L during any cycle, the next cycle should be reduced by 50 mg/m2, but not below 100 mg/m2 , the lowest recommended dose.

Usual Adult Dose for Glioblastoma Multiforme:

For patients with newly diagnosed high grade glioma:

Initial dose: 75 mg/m2 daily either orally or by intravenous infusion over 90 minutes for 42 days concomitant with focal radiotherapy (RT).

The initial dose is followed my maintenance temozolomide for 6 cycles. No dose reductions are recommended during the concomitant phase. However, dose interruptions or discontinuation may occur based on toxicity. The dose should be continued throughout the 42 day concomitant period up to 49 days if all of the following conditions are met: absolute neutrophil count (ANC) greater than or equal to 1.5 x 10(9)/L, platelet count greater than or equal to 100 x 10(9)/L, common toxicity criteria (CTC) nonhematologic toxicity less than or equal to grade 1 (except for alopecia, nausea, and vomiting). During treatment, a complete blood count should be obtained weekly. Temozolomide dosing should be interrupted or discontinued during concomitant phase according to the hematologic and nonhematologic toxicity criteria as noted below. Pneumocystis carinii pneumonia (PCP) prophylaxis is required during the concomitant administration of temozolomide and radiotherapy and should be continued in patients who develop lymphocytopenia until recovery from lymphocytopenia (CTC grade less than or equal to 1).

Temozolomide dosing interruption or discontinuation during concomitant radiotherapy and temozolomide:

Absolute Neutrophil Count (ANC)

Interrupt temozolomide if greater than or equal to 0.5 and less than 1.5 x 10(9)/L

Discontinue temozolomide if less than 0.5 x 10(9)/L

Platelet Count

Interrupt temozolomide if greater than or equal to 10 and less than 100 x 10(9)/L

Discontinue temozolomide if less than 10 x 10(9)/L

CTC - Nonhematologic Toxicity (except for alopecia, nausea, and vomiting)

Interrupt temozolomide if CTC grade 2

Discontinue temozolomide if CTC grade 3 or 4

If treatment with concomitant temozolomide is interrupted, it may be continued when all of the following conditions are met: ANC greater than or equal to 1.5 x 10(9)/L and CTC nonhematologic toxicity less than or equal to grade 1 (except for alopecia, nausea, and vomiting)

Maintenance Phase Cycle 1:
Four weeks after completing the temozolomide and RT phase, temozolomide is administered for an additional 6 cycles of maintenance treatment. Dosage in cycle 1 (maintenance) is 150 mg/m2 once daily for 5 days followed by 23 days without treatment.

Cycles 2 through 6:
At the start of cycle 2, the dose is escalated to 200 mg/m2, if the CTC nonhematologic toxicity for cycle 1 is less than or equal to grade 2 (except for alopecia, nausea, and vomiting), ANC is greater than or equal to 1.5 x 10(9)/L, and the platelet count is greater than or equal to 100 x 10(9)/L. The dose remains at 200 mg/m2 per day for the first 5 days of each subsequent cycle except if toxicity occurs. If the dose was not escalated at cycle 2, then escalation should not be done in subsequent cycles.

Dose reduction or discontinuation during maintenance:

During treatment, a complete blood count should be obtained on day 22 (21 days after the first dose of temozolomide) or within 48 hours of that day, and weekly until the ANC is above 1.5 x 10(9)/L and the platelet count exceeds 100 x 10(9)/L. The next cycle of temozolomide should not be started until the ANC and platelet count exceeds these levels.
Dose reductions during the next cycle should be based on the lowest blood counts and worst nonhematologic toxicity during the previous cycle.

Temozolomide dose levels for maintenance treatment:

Dose level -1 is a dose of 100 mg/m2/day (reduction for prior toxicity).
Dose level 0 is a dose of 150 mg/m2/day (dose during cycle 1).
Dose level 1 is a dose of 200 mg/m2/day (dose during cycles 2 through 6 in the absence of toxicity).

Temozolomide reduction or discontinuation during maintenance treatment:

Absolute Neutrophil Count
Reduce temozolomide by one dose level if ANC is less than 1.0 x 10(9)/L.

Discontinue temozolomide if dose reduction to less than 100 mg/m2 is required or if the same grade 3 nonhematologic toxicity (except for alopecia, nausea, or vomiting) recurs after dose reduction.

Platelet Count

Reduce temozolomide by one dose level if the platelet count is less than 50 x 10(9)/L.

Discontinue temozolomide if dose reduction to less than 100 mg/m2 is required or if the same grade 3 nonhematologic toxicity (except for alopecia, nausea, or vomiting) recurs after dose reduction.

CTC - Nonhematologic Toxicity (except for alopecia, nausea, and vomiting)

Reduce temozolomide by one dose level if CTC grade 3.

Discontinue temozolomide if CTC grade 4.

What other drugs will affect temozolomide?
Before taking temozolomide, tell your doctor if you are using any of the following drugs:

divalproex sodium (Depakote);

valproic acid (Depakene, Depacon); or

steroids (prednisone and others).

This list is not complete and there may be other drugs that can interact with temozolomide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?
Your pharmacist can provide more information about temozolomide.

 

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