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

Temotero is a chemotherapy capsule used primarily to treat brain cancers such as glioblastoma multiforme and anaplastic astrocytoma. It works by damaging the DNA of cancer cells, thereby stopping their growth and multiplication.

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General Information:
Generic Name: Temozolomide
Brand Name: Temotero
Packing: 5 Capsules
Strengths: 20mg, 100mg, 250mg
Manufacturer: Hetero Healthcare Ltd.
Form: Capsules
Category: Antineoplastic (Alkylating Agent)
Prescription Status: Prescription-only medicine (Rx)
Product Introduction:
Temotero is an oral anticancer drug from the class of alkylating agents, indicated for the treatment of specific brain tumors. It is often used in combination with radiation therapy or as a standalone treatment during maintenance therapy. Its oral formulation offers convenience over intravenous chemotherapy.

Uses:
Temotero is used in the treatment of:
  1. Glioblastoma Multiforme (newly diagnosed or recurrent)
  2. Anaplastic Astrocytoma
  3. Malignant Gliomas
  4. Brain Metastases (off-label use)
  5. Primary CNS Lymphoma (investigational use)
  6. As adjuvant chemotherapy for high-grade gliomas

Storage Instructions:
  1. Store below 25°C in a cool, dry place.
  2. Protect from moisture, light, and heat.
  3. Keep out of reach of children.
  4. Do not use capsules after the expiry date.

How It Works (Mechanism of Action):
Temozolomide is a DNA-alkylating agent. It methylates guanine residues in DNA at the O6 and N7 positions, resulting in DNA strand breaks and triggering apoptosis (programmed cell death) in tumor cells. It works best on rapidly dividing cells like cancer cells.

Side Effects:
Common side effects:
  1. Nausea or vomiting
  2. Fatigue or tiredness
  3. Headache
  4. Constipation
  5. Decreased appetite
  6. Hair thinning
Severe side effects:
  1. Bone marrow suppression (anemia, neutropenia, thrombocytopenia)
  2. Increased risk of infection
  3. Liver enzyme elevation
  4. Seizures
  5. Hypersensitivity reactions
  6. Pneumonitis (rare)

Dosage (Typical Recommended Dose):
  1. Concurrent with radiation (newly diagnosed GBM): 75 mg/m² orally daily for 42 days
  2. Maintenance phase: 150–200 mg/m²/day orally for 5 days every 28 days
  3. Recurrent gliomas: 150 mg/m²/day orally for 5 days in 28-day cycles
  4. Dose adjustments depend on patient tolerance and blood counts.

Method of Administration:
  1. Administer orally, once daily, at the same time each day.
  2. Can be taken with or without food, but consistent timing is recommended.
  3. Swallow whole with water; do not open or crush the capsules.
  4. If a capsule is accidentally opened, avoid contact with skin or mucous membranes.

Precautions:
  1. Monitor blood counts frequently, especially before each cycle.
  2. Avoid use during pregnancy (Category D) and breastfeeding.
  3. Use effective contraception during treatment and for at least 6 months after.
  4. Caution in patients with hepatic or renal impairment.
  5. Prophylactic antibiotics may be prescribed to prevent infections.

Drug Interactions:
  1. Other myelosuppressive drugs may increase the risk of bone marrow toxicity.
  2. Valproic acid can increase temozolomide levels and toxicity.
  3. Avoid use with live vaccines due to immunosuppression.
  4. Interaction may occur with phenytoin, warfarin, or steroids.

Allergies:
  1. Contraindicated in patients with known hypersensitivity to temozolomide or dacarbazine.
  2. Symptoms of allergy may include rash, itching, swelling, and difficulty breathing.
  3. Seek immediate medical attention if allergic reaction occurs.

Overdose Information:
  1. Symptoms include severe neutropenia, thrombocytopenia, and increased infection risk.
  2. There is no specific antidote; treatment is supportive and symptomatic.
  3. Seek emergency medical help if overdose is suspected.

Missed Dose Instructions:
  1. Take the missed dose as soon as remembered, unless it's near the next dose.
  2. Do not double the dose to make up for the missed one.
  3. Contact your doctor if multiple doses are missed.

Additional Notes:
  1. Antiemetic medications may be prescribed to reduce nausea.
  2. Inform your doctor of all current medications, including supplements.
  3. Regular liver function and blood tests are essential during treatment.
  4. Discuss fertility preservation options with your doctor prior to therapy.
  5. Avoid alcohol to reduce liver strain and potential side effects.

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