Shanxi Iressa drug-resistant drug Tarceva price drug-resistant drug 9291 Purchase channel 13621079267

[
b r>Tarceva
Usage and Dosage]
Tarceva must be used under the guidance of a doctor who has experience in using this type of drug.
The recommended dose of erlotinib alone for non-small cell lung cancer is /day, taken at least one hour before or one hour after a meal. Continue treatment until disease progression or intolerable toxicity occurs. There is no evidence that patients benefit from continuing treatment after progression.
Dose Adjustment
If patients develop new acute exacerbations or progressive pulmonary symptoms, such as dyspnea, cough, and fever, erlotinib treatment should be suspended for diagnostic evaluation. If the diagnosis is (interstitial lung disease), erlotinib should be discontinued and appropriate treatment given. Erlotinib should be discontinued in patients with hepatic failure or gastrointestinal perforation. Erlotinib should be interrupted or discontinued in patients who are dehydrated and at risk for renal failure, who have severe bullous, vesicular, or exfoliative skin disease, or who have acute/exacerbating eye disease
. Diarrhea is usually treated with Erlotinib. Peramide control. Patients with severe diarrhea who are refractory to loperamide or who become dehydrated require dose reduction and temporary discontinuation of treatment. Patients with severe skin reactions may also require dose reduction and temporary discontinuation of treatment.
.If dose reduction is necessary, erlotinib should be reduced each time.
.Concomitant use of strong inhibitors such as atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, sarcoma Consider reducing the dosage of quinavir, telithromycin, ditroleandomycin (), voriconazole and other drugs, or grapefruit and grapefruit juice, otherwise serious adverse reactions may occur. Similarly, if serious adverse reactions occur in patients taking co-inhibitors (such as ciprofloxacin), the dosage of erlotinib should be reduced.
.Using the induction agent rifampicin before treatment can reduce the /-/ of erlotinib. Alternative drugs without induction activity should be considered. If alternatives are not available, a higher dose of erlotinib may be considered, but safety needs to be closely monitored. The study dose of erlotinib when administered concomitantly with rifampicin was. If the dose of erlotinib is increased, erlotinib should be rapidly reduced to the original dose when rifampicin or other inducers are discontinued. Other inducers include, but are not limited to, rifabutin, rifapentine, phenytoin, carbamazepine, phenobarbital, and St. John's wort (.r), and these should also be avoided if possible.
.Erlotinib is metabolized by the liver and secreted by the biliary tract. Although erlotinib exposure in patients with moderate hepatic impairment (Grade-) is similar to that in patients with normal hepatic function, erlotinib should be used with caution in patients with hepatic impairment. Erlotinib should be used with caution in patients with total bilirubin&&. In the case of abnormal pre-treatment tests, the use of erlotinib should be interrupted or discontinued if severe changes in liver function occur, such as a doubling of total bilirubin and/or a three-fold increase in transaminases. When liver function abnormalities continue to worsen, discontinuation and/or dose reduction should be considered before serious abnormalities are reached, and the frequency of liver function test monitoring should be increased at the same time. If pre-treatment examinations are normal, use of erlotinib should be interrupted or stopped if total bilirubin and/or transaminases are normal.
.Efficacy and safety studies have not been conducted in patients with renal impairment (serum creatinine concentration&.&). Based on pharmacokinetic data, no dose adjustment is required in patients with mild or moderate renal impairment. Erlotinib is not recommended in patients with severe renal impairment.
.Smoking has been shown to reduce erlotinib exposure by -%. The tolerated dose of erlotinib in smoking patients is. The efficacy and long-term safety (&days) of giving higher than recommended starting doses of erlotinib to patients who continue to smoke have not been established. If the dose of erlotinib has been increased, it should be reduced to the approved starting dose immediately after the patient stops smoking.
[
b r>Tarceva
Precautions]
Tarceva must be used under the guidance of a doctor experienced in the use of such drugs, and only in countries
Used in tumor drug clinical trial bases or tertiary A hospitals. Erlotinib may have clinically significant drug interactions. WARNINGS Serious interstitial lung disease-like events, including fatal cases, have occasionally been reported in patients receiving erlotinib for causes of pulmonary toxicity, pancreatic cancer, or other solid tumors. In randomized monotherapy trials (see [Clinical Trials]), the incidence of interstitial lung disease-like events (.%) was the same in the erlotinib and placebo groups. In trials of pancreatic cancer in combination with gemcitabine (see [Clinical Trials]), the incidence of interstitial lung disease-like events was .% in the erlotinib + gemcitabine group and .% in the placebo + gemcitabine group. The overall incidence rate in erlotinib-treated patients across all trials (including trials without a control group and trials with concurrent chemotherapy) was approximately .%. Diagnostic reports of patients with suspected ILD-like events include pneumonia, radiation pneumonitis, hypersensitivity pneumonitis, interstitial pneumonia, interstitial lung disease, bronchiolitis obliterans, pulmonary fibrosis, and acute respiratory distress syndrome, pulmonary infiltrates, and alveolaritis. Symptoms may appear days to more than a month (median) after taking erlotinib. Most cases are associated with other causes of interstitial lung disease, such as concurrent or previous chemotherapy, previous radiation therapy, pre-existing interstitial lung disease, metastatic lung disease, or pulmonary infection. In the event of new acute exacerbations or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever, erlotinib therapy should be temporarily discontinued during diagnostic evaluation. Once confirmed (interstitial lung disease), discontinue erlotinib treatment if necessary and administer appropriate treatment (see [Adverse Reactions] and [Dosage and Administration]). Diarrhea, Dehydration, Electrolyte Imbalance, and Renal Failure Diarrhea may occur in patients receiving erlotinib, and moderate or severe diarrhea should be treated with loperamide. Some patients may require dose reduction. For severe or persistent dehydration-related diarrhea, nausea, anorexia, or vomiting, patients need to discontinue the drug and take appropriate treatment measures for dehydration (see Adverse Reactions). Severe dehydration with hypokalemia and renal failure (including fatal) has occurred rarely, mainly in patients receiving concurrent chemotherapy. For patients with severe diarrhea or persistent diarrhea, or even dehydration, especially those with high risk factors (such as those who receive concurrent chemotherapy, have other symptoms or diseases, or have other basic factors including older age) , erlotinib therapy should be interrupted and appropriate measures should be taken to provide intravenous fluid rehydration to the patient. While replenishing fluids, monitor the patient's renal function and blood electrolytes, including serum potassium. Myocardial infarction/myocardial ischemia In the pancreatic cancer clinical trial, myocardial infarction/myocardial ischemia occurred in 4 patients (incidence %) in the erlotinib/gemcitabine group, and 1 patient died due to myocardial infarction. In contrast, 0 patients in the placebo/gemcitabine group experienced myocardial infarction (incidence .%), and 10 patients died due to myocardial infarction. Cerebrovascular Accidents In pancreatic cancer clinical trials, cerebrovascular accidents occurred in 40% of patients in the erlotinib/gemcitabine group (incidence rate .%), of which bleeding was the most fatal event. In contrast, there were no cerebrovascular accidents in the placebo/gemcitabine group. Microvascular Hemolytic Anemia Due to Thrombocytopenia In clinical trials in pancreatic cancer, microvascular hemolytic anemia due to thrombocytopenia occurred in 40 patients (incidence .%) in the erlotinib/gemcitabine group. Both patients were treated with erlotinib and gemcitabine simultaneously. In contrast, no microvascular hemolytic anemia due to thrombocytopenia occurred in the placebo/gemcitabine group. Hepatitis, Hepatic Failure Rare cases of hepatic failure, including death, have been reported during use of erlotinib. Confounding factors include preexisting liver disease or concomitant use of hepatotoxic drugs. Therefore, such patients should undergo regular liver function tests. Patients with severe liver function abnormalities should stop taking erlotinib (see [Adverse Reactions]). Both in vitro and in vivo experiments in patients with abnormal liver function have shown that erlotinib is mainly eliminated in the liver. Therefore, erlotinib exposure is increased in patients with abnormal hepatic function (see [Pharmacokinetics] Special Populations—Patients with Abnormal Hepatic Function and [Dosage and Administration] Dose Adjustments). Elevated INR and Bleeding Possibility Elevated INR (R) and rare bleeding events, including gastrointestinal bleeding and non-gastrointestinal bleeding, have been reported in clinical trials, some associated with concomitant use of warfarin. Patients taking warfarin or other dicoumarol anticoagulants should have their prothrombin time or R monitored regularly (see Adverse Reactions).