Nublexa 40mg tablet - Apple pharmaceutical

Nublexa 40mg

Nublexa 40mg is an antineoplastic drug which prohibits Nublexa 40mg tablet price  the growth and spread of cancer cells in the body.
Nublexa 40mg tab  is needed to treat colorectal cancer and liver cancer.Nublexa 40 mg tablet  It is also needed to treat a rare type of tumor which can affect the esophagus, stomach, or intestines.
Nublexa 40mg tablet  is commonly Nublexa 40 mg tablet  given after other cancer regimens have been tried without success.
Nublexa 40mg is a prescription drug which is used under the supervision of medical practitioners.

INDICATION :

Nublexa 40mg tablet is indicated for the treatment of metastatic colorectal cancer (CRC) who have been Nublexa 40mg  previously treated with or are not considered candidates for, available therapies. These include fluoropyrimidine-based chemotherapy, an anti-VEGF therapy, and an anti-EGFR therapy (see section 5.1)

Nublexa 40mg tablet  tumors (GIST) who progressed on or are intolerant to prior treatment with imatinib and sunitinib

Nublexa 40mg tablet price  is indicated for the treatment of hepatocellular carcinoma (HCC) who have been previously treated with sorafenib.

Nublexa 40mg tablet 

DOSAGE :

Colorectal cancer :

The  Nublexa 40mg usual dose is 160mg (four 40mg tablets) Po q Day for the first 21 days of each 28-day cycle.
Gastrointestinal stromal tumor :
The usual dose is 160mg Nublexa 40mg  (four 40mg tablets) Po q Day for the first 21 days of each 28-day cycle.
Hepatocellular carcinoma :
The usual dose is 160mg (four 40mg tablets) Nublexa 40mg Po q Day for the first 21 days of each 28-day cycle.
Follow the treatment of these conditions until disease progression or undesirable toxicity .Nublexa 40mg 

MECHANISM :

Regorafenib belongs to oral Nublexa 40mg  tumour deactivation agent which potently stops multiple protein kinases, contain kinases included in tumour angiogenesis (VEGFR1, -2, -3, TIE2), oncogenesis Nublexa 40mg  (KIT, RET, RAF-1, BRAF, BRAFV600E), metastasis (VEGFR3, PDGFR, FGFR) and tumour immunity (CSF1R). Regorafenib prohibits mutated KIT, a major oncogenic driver in gastrointestinal stromal tumours, and thereby stops tumour cell multiplication. In preclinical studies regorafenib has described potent anticancer activity in a broad spectrum of tumour models containing colorectal, gastrointestinal stromal and hepatocellular tumour models which is likely mediated by its anti-angiogenic and anti-proliferative effects. In addition, regorafenib decreased the levels of tumour analogue macrophages and has shown anti-metastatic effects in vivo. Major human metabolites (M-2 and M-5) displayed similar efficacies, compared to regorafenib in in vitro and in vivo models.
ADME

Absorption:

time to peak plasma is 4 hours and concentration is 2.5mcg/mL for single dose; 3.9mcg/mL for steady state and bioavailability is 69-83%
Distribution:
regorafenib has protein bounding about 99.5% and M-2 active metabolite is 99.8%; M-5 active metabolite is 99.95%
Metabolism:
Regorafenib is metabolized by CYP3A4 and UGT1A9
Elimination:
excreted via feces 71%; 19% urine (within 12 days of single dose)
Half-life of
Regorafenib is 28 hr
M-2 active metabolite is 25 hr.
M-5 active metabolite is 51hr.

PRECAUTION :

Myocardial ischemia and infarction seen in clinical trials; withhold Nublexa 40mg for new or acute cardiac ischemia/infarction and restart only after resolution of acute ischemic events 

While treatment with Nublexa, one case report of reversible posterior leukoencephalopathy syndrome (RPLS) reported (1 of 1100 treated patients); interrupt therapy if RPLS occurs
serious drug-induced liver injury with fatal outcome appeared in Nublexa 40mg-treated patients in clinical trials. Some of the cases, liver dysfunction resulted within the first 2 months of treatment and was characterized by a hepatocellular pattern of injury.

While treatment with Nublexa 40mg will Increases risk for haemorrhage; stop therapy for severe or life-threatening haemorrhage Nublexa 40mg

While treatment with Nublexa will Increased risk of infections resulted; most common infections contains urinary tract infections, nasopharyngitis, mucocutaneous and systemic fungal infections and pneumonia

While treatment with Nublexa will Increases risk for HFSR/PPES and rash; a higher incidence of HFSR resulted in Asian patients; discontinue and then decrease or stop regorafenib depending on severity and persistence of dermatologic toxicity

DRUG INTERACTION

Nublexa 40mg concomitant use with strong CYP3A4 inducers will decrease Regorafenib plasma concentrations and increased plasma concentration of active metabolite M-2; M-5.
Nublexa 40mg interaction with strong CYP3A4 inhibitor will increase Regorafenib plasma concentration and reduced the plasma concentration of active metabolite M-2; M-5.
Nublexa 40mg interaction with BCRP substrate will increased the plasma concentration of the BCRP substrate.
MISSED DOSE

If a dose is missed, patients must consult with a medical practitioner and follow the instructions given by them. Thereby missed dose should be avoided and follow the regular dosing schedule
STORAGE

Store the Nublexa 40mg at 25℃ (77℃)

Keep the drug in its original container bottle
Keep the bottle tightly closed after one time used.

SIDE EFFECTS : 

Common side effects occurring in greater than 30% : Nublexa 40 mg tablet
Hand-foot syndrome , Diarrhea, Low platelets, Mouth sores/inflammation, Weight loss, Infection,  Nublexa 40 mg tablet Anemia, Increased liver enzymes (AST, ALT), Fatigue, High blood  Nublexa 40mg pressure, Voice disorder (Dysphonia), Protein in the urine, Low calcium, Nublexa 40 mg tablet  Low phosphorous, Low white blood cells, Decreased appetite, Increased lipase & amylase, High bilirubin in the blood, Low sodium, Nausea. Nublexa 40mg

Less common side effects occurring in about 10-29% of patients receiving  Nublexa 40mg :

Pain, Fever, Rash, Low potassium, Decreased blood clotting, Increased bleeding, Headache, Alopecia. Nublexa 40 mg tablet .

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