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Temoside (20mg / 100mg / 250mg)- Temozolomide Capsules

Temoside is an oral chemotherapy medication used to treat certain types of brain tumors, especially glioblastoma multiforme and anaplastic astrocytoma. It belongs to the alkylating agent class, which targets and kills rapidly dividing cancer cells.

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General Information:
Generic Name: Temozolomide
Brand Name: Temoside
Packing: 5 Capsules
Strengths: 20mg, 100mg, 250mg
Manufacturer: Cipla Ltd.
Form: Capsules
Category: Chemotherapy / Alkylating Agent
Prescription Status: Prescription only (Rx)
Product Introduction:
Temoside is a potent antineoplastic (anti-cancer) drug used as a first-line and maintenance therapy for brain cancers. It is frequently used in combination with radiation therapy or alone in recurrent cases. It provides a convenient oral alternative to intravenous chemotherapy.

Uses:
Temoside is used in the treatment of:
  1. Glioblastoma Multiforme (GBM)
  2. Anaplastic Astrocytoma
  3. Recurrent Malignant Gliomas
  4. Brain Metastases (off-label in some cases)
  5. Primary CNS Lymphoma (investigational use)
  6. As adjuvant chemotherapy in high-grade gliomas

Storage Instructions:
  1. Store below 25°C in a dry place.
  2. Keep away from moisture and direct sunlight.
  3. Keep out of reach of children and pets.
  4. Do not use after the expiry date printed on the label.

How It Works (Mechanism of Action):
Temozolomide is an alkylating agent that works by damaging the DNA in cancer cells. It adds a methyl group to the DNA structure, primarily at the O6 and N7 positions of guanine. This damage leads to the inhibition of DNA replication and triggers programmed cell death (apoptosis) in rapidly growing cancer cells.

Side Effects:
Common side effects:
  1. Nausea and vomiting
  2. Loss of appetite
  3. Fatigue
  4. Headache
  5. Constipation
  6. Insomnia
Severe side effects:
  1. Bone marrow suppression (low WBCs, RBCs, platelets)
  2. Infections due to low immunity
  3. Liver function abnormalities
  4. Pulmonary toxicity (rare)
  5. Seizures in patients with brain tumors
  6. Allergic reactions (rash, hives, swelling)

Dosage (Typical Recommended Dose):
  1. For Newly Diagnosed GBM (with radiotherapy):
    75 mg/m²/day orally for 42 days (concurrent with radiotherapy)
  2. Maintenance Therapy:
    150–200 mg/m²/day for 5 days every 28-day cycle
  3. For Recurrent Glioma:
    150 mg/m²/day for 5 consecutive days in 28-day cycles
  4. Dose adjustments may be necessary based on patient response and toxicity.

Method of Administration:
  1. Take orally once daily, with or without food.
  2. Swallow the capsule whole with a glass of water.
  3. Take the medication at the same time each day.
  4. Do not open, crush, or chew the capsule.
  5. Use gloves when handling broken capsules.

Precautions:
  1. Regular monitoring of complete blood count (CBC) is necessary.
  2. Avoid use during pregnancy and breastfeeding.
  3. Use effective contraception during and after therapy.
  4. Caution in patients with liver dysfunction or bone marrow suppression.
  5. Risk of opportunistic infections – patients may need prophylactic antibiotics.

Drug Interactions:
  1. Co-administration with other myelosuppressive agents increases risk of bone marrow toxicity.
  2. Phenytoin and steroids may alter the pharmacokinetics of Temozolomide.
  3. Avoid live vaccines during treatment due to immunosuppression.
  4. Monitor for enhanced effects with valproic acid, which can increase toxicity.

Allergies:
  1. Contraindicated in patients with known hypersensitivity to temozolomide or dacarbazine.
  2. Signs of allergic reaction include rash, itching, swelling, trouble breathing – immediate medical help is advised.

Overdose Information:
  1. Symptoms of overdose include severe bone marrow suppression, bleeding, fever, and infections.
  2. There is no specific antidote; treatment is supportive with blood transfusions or growth factors as needed.
  3. Seek emergency medical attention in case of suspected overdose.

Missed Dose Instructions:
  1. If you miss a dose, take it as soon as you remember unless it's almost time for the next dose.
  2. Do not double the dose to make up for the missed one.
  3. Consult your doctor if multiple doses are missed.

Additional Notes:
  1. Anti-nausea medication (antiemetic) may be prescribed to reduce gastrointestinal side effects.
  2. Inform your doctor of all medications and supplements being taken.
  3. Avoid alcohol during treatment to reduce liver strain.
  4. Patients should be informed of fertility risks – consider sperm or egg banking before treatment.

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