Sofosbuvir-velpatasvir is the first available pangenotypic NS5A-NS5B inhibitor single-pill combination regimen, and is highly efficacious across HCV genotypes 1 to 6. It provides a much-needed interferon-free option for patients with genotype 3 infection that is more economical than sofosbuvir plus daclatasvir, and in patients who have compensated cirrhosis with genotype 3, this single-pill option provides an important ribavirin-free combination that will prove a welcome alternative to what has been available to date. Notably, unlike ledipasvir-sofosbuvir, an abbreviated duration of 8 weeks has not been studied with sofosbuvir-velpatasvir for any of the genotypes, except in conjunction with a third agent (GS-9857, an investigational pangenotypic HCV protease inhibitor). Sofosbuvir-velpatasvir, like ledipasvir-sofosbuvir, will be susceptible to drug interactions with acid-reducing agents particularly proton-pump inhibitors and the impact of these agents on real-world clinical effectiveness remains to be determined.

http://www.hepatitisc.uw.edu/page/treatment/drugs/epclusa

 

Common side effects (in more than 10% of people) are headache, fatigue and nausea.

Ledipasvir is a potent inhibitor of HCV NS5A, a viral phosphoprotein that plays an important role in viral replication, assembly, and secretion. Sofosbuvir is a nucleotide analog inhibitor of hepatitis C virus NS5B polymerase—the key enzyme mediating HCV RNA replication. The triphosphate form of sofosbuvir (GS-461203) mimics the natural cellular uridine nucleotide and is incorporated by the HCV RNA polymerase into the elongating RNA primer strand, resulting in viral chain termination.

http://www.hepatitisc.uw.edu/page/treatment/drugs/ledipasvir-sofosbuvir

The fixed dose combination of ledipasvir-sofosbuvir provides a very attractive and effective one pill once a day option for treatment of genotypes 1, 4, 5, and 6 chronic hepatitis C infection. This regimen is the first FDA-approved interferon- and ribavirin-free regimen to treat hepatitis C. Three phase 3 trials (ION-1, ION-2, and ION-3) have demonstrated SVR rates consistently above 90%. The 24-week regimen for treatment-experienced cirrhotic patients is very expensive; recent data have shown that treatment-experienced patients with genotype 1 and compensated cirrhosis can have the regimen shortened to 12 weeks if ribavirin is added. Ledipasvir-sofosbuvir is a recommended therapy for patients with genotype 1, 4, 5, and 6 in the American Association for the Study of Liver Diseases, Infectious Diseases Society of America, (AASLD/IDSA) guidance. In addition, ledipasvir-sofosbuvir is a very attractive option for treatment of hepatitis C in persons coinfected with HIV.

 

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking ledipasvir / sofosbuvir:

Incidence not known:

• Chest pain or discomfort
• lightheadedness, dizziness, or fainting
• shortness of breath
• slow or irregular heartbeat
• unusual tiredness

Sofosbuvir, sold under the brand names Hepcinat, Sovihep, MyHep among others, is a medication used for the treatment of hepatitis C.

It is only recommended with some combination of ribavirin, peginterferon-alfa, simeprevir, ledipasvir, or daclatasvir.

Sofosbuvir is a new drug candidate for hepatitis C treatment, with the chemical name L-Alanine, N-[[P(S),2′R]-2′-deoxy-2′-fluoro-2′-methyl-P-phenyl-5′-uridylyl]-, 1-methylethyl ester and a molecular formula of C22H29FN3O9P. Previously known as PS-7977 or GS-7977, it has shown promising results in numerous in vitro studies against all the genotypes of HCV. It is a nucleotide analog that is a highly potent inhibitor of the NS5B polymerase in HCV. This drug has shown high efficacy in combination with several other drugs with and without PEG-INF, against HCV. Sofosbuvir is of special interest among the directly acting antiviral drugs under development, due to its high potency, low side effects, oral administration, and high barrier to resistance.

The efficacy and safety of sofosbuvir in patients with different HCV genotypes and with various combinations of drugs have been tested in numerous clinical trials. A dose of 400 mg of sofosbuvir has been found to be most effective, with treatment durations ranging from 12 to 24 weeks, in various combinations of PEG-IFN and ribavirin in phase 2 clinical trials. The NEUTRINO study found SVR to be 90% (95% CI, 87 to 93) 12 weeks after therapy with sofosbuvir + PEG-INF + ribavirin; this was found to be superior to the adjusted historical response rate of 60% (P < 0.001). Similar positive results have been found in numerous phase 3 clinical trials. Furthermore, recent phase 1 and 2 studies of sofosbuvir in combination with other DAAs have also shown promising results >more info>

Sofosbuvir has shown a good safety profile in clinical trials; a small decrease in the Hb levels (0.54 mg/dl) and reduction in the cumulative events in comparison to interferon-containing regimens is seen. Common adverse events observed include: Headache, insomnia, fatigue, nausea, dizziness, pruritis, upper respiratory tract infections, rash, back pain, grade 1 anemia, and grade 4 lymphopenia. No neutropenia, thrombocytopenia, or any serious adverse events are associated with sofosbuvir treatment. In the monotherapy treatment groups, nausea and fatigue seemed to be the only adverse events possibly correlated to sofosbuvir.

Bendamustine, is a chemotherapy medication used in the treatment of chronic lymphocytic leukemia (CLL), multiple myeloma, and non-Hodgkin’s lymphoma. It is given by injection into a vein.^[2]

Bendamustine was approved for medical use in the United States in 2008. It is on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system.

Bendamustine is a white, water-soluble microcrystalline powder with amphoteric properties. It acts as an alkylating agent causing intra-strand and inter-strand cross-links between DNA bases.

After intravenous infusion it is extensively metabolised in the liver by cytochrome p450. More than 95% of the drug is bound to protein – primarily albumin. Only free bendamustine is active. Elimination is biphasic with a half-life of 6–10 minutes and a terminal half-life of approximately 30 minutes. It is eliminated primarily through the kidneys.

Usual Adult Dose for Chronic Lymphocytic Leukemia

100 mg/m2 IV on Days 1 and 2 of a 28-day cycle
Duration of Therapy: Up to 6 cycles

Comments:
-Administer this drug via IV infusion over 10 or 30 minutes; consult the manufacturer product information for specific IV infusion time period.
-Efficacy of this drug relative to first-line therapies other than chlorambucil has not been established.

Use: Treatment of chronic lymphocytic leukemia

Usual Adult Dose for non-Hodgkin’s Lymphoma

120 mg/m2 IV on Days 1 and 2 of a 21-day cycle
Duration of Therapy: Up to 8 cycles

Comments: Administer this drug via IV infusion over 10 or 60 minutes; consult the manufacturer product information for specific IV infusion time period.

Use: Treatment of indolent B-Cell non-Hodgkin lymphoma that has progressed during or within 6 months of treatment with rituximab or a rituximab-containing regimen.

Common side effects include low blood cell counts, fever, nausea, diarrhea, loss of appetite, cough, and rash. Other severe side effects include allergic reactions and increased risk of infection. Use in pregnancy is known to harm the baby. Bendamustine is in the alkylating agents family of medication. It works by interfering with the function of DNA and RNA.

Megestrol is a man-made version of the human hormone progesterone. It treats breast cancer and endometrial cancer by affecting female hormones involved in cancer growth. It increases weight gain by increasing appetite.

Megestrol Acetate belongs to a group of medicine known as progestogens. It is mainly used in the treatment of prostate cancer apart from various other uses. The main ingredient in the medicine is Megestrol Acetat

We offer to ship Megestrol 40mg, Generic Megace, to your address in USA, UK, AU, Europe, we have best prices for Endace, guarantee delivery for each package, full support of your order every 24 hours.

Megestrol tablets are used to relieve the symptoms and reduce the suffering caused by advanced breast cancer and advanced endometrial cancer (cancer that begins in the lining of the uterus). Megestrol suspension is used to treat loss of appetite, malnutrition, and severe weight loss in patients with acquired immunodeficiency syndrome (AIDS).

Megestrol should not be used to prevent loss of appetite and severe weight loss in patients who have not yet developed this condition. Megestrol is a man-made version of the human hormone progesterone. It treats breast cancer and endometrial cancer by affecting female hormones involved in cancer growth. It increases weight gain by increasing appetite.

 

Usual Adult Dose for Breast Cancer-Palliative

Megestrol tablets are indicated for use in the palliative treatment of advanced carcinoma of the breast: 160 mg/day (40 mg of oral tablets four times a day)

Usual Adult Dose for Endometrial Carcinoma

Megestrol tablets are indicated for use in the palliative treatment of advanced carcinoma of the endometrium: 40 to 320 mg/day of oral tablets in divided doses

Usual Adult Dose for Anorexia

Megestrol oral suspension is indicated for use in the treatment of anorexia at a dose of 800 mg/day.

Alternatively, 625 mg/5 mL of the concentrated formula (Megace ES formula) may be given.

Note: 800 mg/20 mL of the regular formula is equivalent to 625 mg/ 5 mL of the concentrated formula.

Usual Adult Dose for Cachexia

Megestrol oral suspension is indicated for use in the treatment of cachexia at a dose of 800 mg/day.

Alternatively, 625 mg/5 mL of the concentrated formula (Megace ES formula) may be given.

Note: 800 mg/20 mL of the regular formula is equivalent to 625 mg/ 5 mL of the concentrated formula.

Usual Adult Dose for Weight Loss

Megestrol oral suspension is indicated for use in the treatment of unexplained, significant weight loss in patients with a diagnosis of acquired immunodeficiency syndrome (AIDS) at a dose of 800 mg/day.

Megestrol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• impotence
• decreased sexual desire
• unexpected vaginal bleeding
• difficulty falling asleep or staying asleep
• gas
• rash

 

• Pemetrexed is used in the treatment of malignant mesothelioma
• Locally advanced or metastatic nonsquamous nonsmall cell lung cancer.

• Premetrexed is given as an infusion into the vein (intravenous, IV).
• Patients treated with premetrexed will usually require folic acid and vitamin B12 supplementation to reduce treatment related side effects.
• The amount of premetrexed that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated.  Your doctor will determine your dose and schedule.

Important things to remember about the side effects of premetrexed:

• Most people do not experience all of the side effects listed.
• Side effects are often predictable in terms of their onset and duration.
• Side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent side effects.
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking pemetrexed:

• Low white blood cell count. (This can put you at increased risk for infection.)
• Low red blood cell count (Anemia).
• Fatigue
• Nausea and vomiting
• Constipation
• Poor appetite
• Shortness of breath
• Chest pain

These side effects are less common side effects (occurring in about 10-29%) of patients receiving pemetrexed:

• Low platelet count.  (This can put you at increased risk for bleeding.)
• Increase in blood test creatinine.
• Fever
• Flu-like symptoms: Fever, chills, generalized aches and pains, headache, poor appetite.
• Mouth sores
• Numbness or tingling of hands or feet
• Depression
• Rash, skin irritation

Buy Generic Sirolimus at our website for saving money, we have best prices for Generic Rapamune (Sirolimus) contact us fo future informating regarding how to order Generic Rapamune in India, we have best supply from manufacturer in direct. Deliver is guarantee to the United States of America, United Kingdom, Australia, China, Japan, we do all the best, for ordering Generic Rapamune for our customers from this countries, Generic Sirolimus availble at 1 mg tablets from manufacturer Biocon founded in 1978, it’s very trusted company in world, and in India, do not worry about quality of Generic Rapamune blisters, tablets. Biocon company which made generic rapamune sirolimus is is an Indian biopharmaceutical company based in Bangalore, India. We have bes cost on Sirolimus from Biocon Ltd.

Sirolimus, also known as rapamycin, is a macrolide compound that is used to coat coronary stents, prevent organ transplant rejection and to treat a rare lung disease called lymphangioleiomyomatosis. It has immunosuppressant functions in humans and is especially useful in preventing the rejection of kidney transplants.

Sirolimus is used with other medications to prevent rejection of a kidney transplant. This medication belongs to a class of drugs known as immunosuppressants. It works by weakening your body’s defense system (immune system) to help your body accept the new organ as if it were your own.

Consult with your doctor about dosage and side effect, Rapamune is serious medication, there many different dosage and side effects.

It was initially intended as a treatment for multiple myeloma, for which thalidomide is an accepted therapeutic treatment. Lenalidomide has also shown efficacy in the class of hematological disorders known as myelodysplastic syndromes (MDS). Along with several other drugs developed in recent years, lenalidomide has significantly improved overall survival in myeloma (which formerly carried a poor prognosis), although toxicity remains an issue for users. It costs $163,381 per year for the average patient.

In 2006, lenalidomide, an orally administered thalidomide analogue, received FDA approval for use with dexamethasone in patients with multiple myeloma who received at least one prior therapy. In 2015, the indication was expanded for use in combination with dexamethasone for the treatment of patients with multiple myeloma, to include newly diagnosed multiple myeloma patients who are not eligible for autologous stem cell transplant. Lenalidomide is also approved in myelodysplastic syndromes and mantle cell lymphoma.

The current approval was based on two randomized, controlled trials evaluating the efficacy and safety of lenalidomide maintenance therapy for the treatment of multiple myeloma patients after autologous stem cell transplant (CALGB 100104 and IFM 2005-02 trials). These trials demonstrated approximately a 15-month (CALGB) and 18-month (IFM) progression-free survival advantage, at the time of the primary analysis, in patients treated with lenalidomide compared with patients receiving placebo (hazard ratio (HR) in CALGB=0.38; 95% CI: 0.27, 0.54; p<0.001 and HR in IFM=0.50; 95% CI: 0.39, 0.64; p<0.001). The median overall survival was 111 and 106 months for patients treated with lenalidomide compared with 84 and 88 months for patients receiving placebo in the CALGB and IFM trials, respectively.

The types, frequency, and severity of adverse events (AEs) observed in the two trials were similar to those previously described in the product label. Neutropenia, affecting 56% of the 517 patients treated with lenalidomide in both trials, was the most frequently reported grade 3/4 AE. An increased incidence of second primary malignancies was reported among patients treated with lenalidomide compared with those receiving placebo. The lenalidomide product label notes an increase in second primary malignancies in patients with multiple myeloma treated with lenalidomide.

The recommended dose and schedule for lenalidomide is 10mg once daily continuously on days 1-28 of repeated 28-day cycles.

Usual Adult Dose for Myelodysplastic Disease

10 mg orally once daily

Approved indication: Treatment of patients with transfusion-dependent anemia due to low- or intermediate-1-risk myelodysplastic syndromes (MDS) associated with a deletion 5q cytogenetic abnormality with or without additional cytogenetic abnormalities.

Usual Adult Dose for Multiple Myeloma

25 mg/day of lenalidomide with water orally as a single 25 mg capsule on days 1 through 21 of repeated 28 day cycles.

(The recommended dose of dexamethasone is 40 mg/day on days 1 through 4, 9 through 12, and 17 through 20 of each 28 day cycle for the first 4 cycles of therapy and then 40 mg/day orally on days 1 through 4 every 28 days.)

The effects of substituting lesser strengths of lenalidomide to equal a 25 mg capsule dose is unknown.

Usual Adult Dose for Lymphoma

25 mg orally once a day on Days 1 to 21 of repeated 28 day cycles.

Duration of therapy: Treatment should be continued until disease progression or unacceptable toxicity.

Approved indication: Treatment of mantle cell lymphoma (MCL) in patients whose disease has relapsed or progressed after two prior therapies, one of which included bortezomib.

The most common side effects of Lenalid seen in large clinical studies are:

• Gastrointestinal effects (diarrhea, constipation, or nausea)
• Fatigue or loss of strength
• Low red blood cell or white blood cell counts
• Swelling in the arms and legs (peripheral edema)
• Insomnia
• Muscle cramps
• Back pain
• Fever
• Rash

The most common severe side effects of Lenalid seen in large clinical studies are:

• Low white blood cell, red blood cell, or platelet counts
• Fatigue
• Pneumonia
• Blood clots

Bortezomib (BAN, INN and USAN; marketed as Velcade by Millennium Pharmaceuticals; Neomib by Getwell and Bortecad by Cadila Healthcare) is an anti-cancer drug and the first therapeutic proteasome inhibitor to be used in humans. Proteasomes are cellular complexes that break down proteins. In some cancers, the proteins that normally kill cancer cells are broken down too quickly. Bortezomib interrupts this process and lets those proteins kill the cancer cells. It is approved in the U.S. and Europe for treating relapsed multiple myeloma and mantle cell lymphoma. In multiple myeloma, complete clinical responses have been obtained in patients with otherwise refractory or rapidly advancing disease.

Bortezomib is an antineoplastic (cancer chemotherapy) medicine. It works by blocking certain proteins within the cancer cell, causing the cell to die. This helps to slow the growth and spread of the cancer.

Usual Adult Dose for Lymphoma

DOSAGE IN PREVIOUSLY UNTREATED MANTLE CELL LYMPHOMA:
1.3 mg/m2 as a bolus IV injection twice weekly in combination with IV rituximab, cyclophosphamide, doxorubicin, and oral prednisone for two weeks (days 1, 4, 8, and 11) followed by a ten day rest period (days 12 through 21)

Comments:
-The three week period is considered a treatment cycle.
-A minimum of 72 hours should elapse between consecutive doses of bortezomib.
-For patients with a response first documented at cycle 6, two additional cycles (for a total of 8 cycles) are recommended.

FOR USE IN THE TREATMENT OF RELAPSED MANTLE CELL LYMPHOMA:
-Usual dose: 1.3 mg/m2 as a bolus IV injection or subcutaneously twice weekly for two weeks (days 1, 4, 8, and 11) followed by a ten day rest period (days 12 through 21). Therapy extending beyond 8 cycles may be administered by the standard schedule or may be given once weekly for 4 weeks (days 1, 8, 15, and 22), followed by a 13-day rest (days 23 through 35).

Uses: For the treatment of mantle cell lymphoma

Usual Adult Dose for Multiple Myeloma

FOR USE IN THE TREATMENT OF PREVIOUSLY UNTREATED MULTIPLE MYELOMA:
-Usual dose: 1.3 mg/m2 administered as a 3 to 5 second bolus IV injection or subcutaneously in combination with oral melphalan and oral prednisone for nine 6-week treatment cycles:
-In cycles 1 through 4, bortezomib is administered twice weekly (days 1, 4, 8, 11, 22, 25, 29, and 32). In cycles 5 through 9, bortezomib is administered once weekly (days 1, 8, 22, and 29).

Comments:
-At least 72 hours should elapse between consecutive doses of bortezomib.

FOR USE IN THE TREATMENT OF RELAPSED MULTIPLE MYELOMA:
-Usual dose: 1.3 mg/m2 as a bolus intravenous injection or subcutaneously twice weekly for two weeks (days 1, 4, 8, and 11) followed by a ten day rest period (days 12 through 21). Therapy extending beyond 8 cycles may be administered by the standard schedule or may be given once weekly for 4 weeks (days 1, 8, 15, and 22), followed by a 13-day rest (days 23 through 35).

Comments:
-Bortezomib may be administered alone or in combination with dexamethasone.
-The three week period is considered a treatment cycle.
-A minimum of 72 hours should elapse between consecutive doses of bortezomib.
-Patients with multiple myeloma who have previously responded to treatment with bortezomib (either alone or in combination) and who have relapsed at least 6 months after their prior therapy may be started on the last tolerated dose.

Use: For the treatment of multiple myeloma (who had previously responded to treatment with this drug and who have relapsed at least 6 months after completing treatment)

Bortezomib is associated with peripheral neuropathy in 30% of patients; occasionally, it can be painful. This can be worse in patients with pre-existing neuropathy. In addition, myelosuppression causing neutropenia and thrombocytopenia can also occur and be dose-limiting. However, these side effects are usually mild relative to bone marrow transplantation and other treatment options for patients with advanced disease. Bortezomib is associated with a high rate of shingles, although prophylactic acyclovir can reduce the risk of this. Acute interstitial nephritis has also been reported.

Gastro-intestinal (GI) effects and asthenia are the most common adverse events.

Imatinib may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• nausea
• vomiting
• change in the way things taste
• mouth sores or swelling inside the mouth
• loss of appetite
• weight loss
• heartburn or indigestion
• dry mouth
• headache
• joint swelling or pain
• bone pain
• muscle cramps, spasms, or pain
• tingling, burning. or prickling feeling on the skin
• difficulty falling asleep or staying asleep
• sweating
• teary eyes
• pink eye
• flushing
• dry skin
• rash
• itching
• nail changes
• hair loss