BRIVIACT 10mg/ml Price

Overview

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This medicine contains an important and useful components, as it consists of
Brivaracetamis available in the market in concentration

Name

Busulphan

Precaution

Before starting treatment with **Busulfan**, it is crucial to consult a healthcare provider, as it is a potent chemotherapy agent with several potential side effects. Important precautions include: - **Hematologic Toxicity**: Busulfan can cause **severe bone marrow suppression**, leading to **leukopenia**, **thrombocytopenia**, and **anemia**. Regular monitoring of **blood counts** is required during treatment. Dose adjustments may be necessary if these levels fall too low. - **Infection Risk**: Due to bone marrow suppression, there is an increased risk of **infections**. Patients should avoid exposure to people with **infections** and seek immediate medical attention if any signs of infection appear, such as fever or chills. - **Pulmonary Toxicity**: Busulfan can lead to **pulmonary fibrosis** (scarring of the lung tissue), a serious condition. **Lung function** should be monitored regularly, especially in patients who are undergoing **high-dose Busulfan therapy**. - **Hepatic Toxicity**: Liver damage is a potential side effect of Busulfan, especially in those with preexisting liver conditions. **Liver function tests** should be monitored, and dosage adjustments may be necessary. - **Pregnancy and Breastfeeding**: Busulfan is classified as **Category D** in pregnancy, meaning it can harm the fetus. It is contraindicated during pregnancy unless the benefits outweigh the risks. It is also contraindicated during breastfeeding due to the potential for severe adverse effects on the infant. - **Cardiovascular Concerns**: Patients with existing **cardiovascular conditions** should be closely monitored, as Busulfan can lead to **arrhythmias** or **heart failure** in some individuals, particularly when given in high doses. - **Other Cancer Treatments**: Busulfan can interact with other cancer treatments (e.g., **chemotherapy**, **radiation therapy**), increasing the risk of side effects like bone marrow suppression and infections. Healthcare providers should coordinate therapy to minimize these risks.

Indication

Busulfan is primarily indicated for the treatment of certain cancers and as part of conditioning regimens for **hematopoietic stem cell transplants**: - **Chronic Myelogenous Leukemia (CML)**: Busulfan is used in the treatment of **CML**, particularly in patients who are not candidates for **imatinib** or other tyrosine kinase inhibitors. It works by inhibiting the growth of leukemia cells and preventing further proliferation. - **Bone Marrow Conditioning for Stem Cell Transplantation**: Busulfan is used as part of the **conditioning regimen** before **hematopoietic stem cell transplants** (HSCT), where the patient's diseased bone marrow is destroyed to allow for transplant of healthy stem cells. - **Other Leukemias**: Busulfan is sometimes used to treat other forms of **leukemia** and certain **myeloproliferative disorders** when more conventional treatments are not suitable.

Contra indication

Busulfan is contraindicated in certain conditions and should be avoided in the following scenarios: - **Severe Bone Marrow Suppression**: Busulfan should not be used in patients with preexisting **bone marrow failure** or severely suppressed blood counts, as it will exacerbate these conditions. - **Hypersensitivity**: Individuals who have a known **allergy** to Busulfan or any of its components should not take the drug. - **Active Infections**: Busulfan should not be used in patients with uncontrolled or **active infections**, as it can further suppress the immune system. - **Pregnancy and Breastfeeding**: As mentioned above, **Busulfan is contraindicated** in pregnancy due to potential fetal harm and should not be used during breastfeeding due to excretion in milk. - **Severe Hepatic Dysfunction**: Patients with **severe liver impairment** or liver failure should not receive Busulfan, as it can cause **further liver damage**.

Side Effect

Busulfan has several potential side effects, ranging from mild to severe. Notable side effects include: - **Common Side Effects**: - **Nausea and Vomiting**: Gastrointestinal upset is common, especially during the initial phases of treatment. - **Fatigue**: Patients may feel unusually tired or weak, which is a result of **bone marrow suppression** and the body’s response to chemotherapy. - **Hair Loss (Alopecia)**: Busulfan often causes hair loss, which can be temporary. - **Mouth Sores (Stomatitis)**: Mouth ulcers or sores may develop, causing pain and difficulty eating. - **Severe Side Effects**: - **Severe Bone Marrow Suppression**: One of the most serious side effects of Busulfan is its effect on **bone marrow**, leading to **leukopenia**, **thrombocytopenia**, and **anemia**. This makes the patient highly vulnerable to infections and bleeding. - **Pulmonary Toxicity**: Busulfan can cause **pulmonary fibrosis** and other respiratory issues, including **shortness of breath**, **cough**, and **lung damage**. - **Hepatic Toxicity**: Liver damage, including **jaundice**, **hepatitis**, or **liver failure**, can occur, particularly with high doses or prolonged therapy. - **Seizures**: Rarely, **seizures** have been reported, especially when Busulfan is used at high doses. - **Gastrointestinal Bleeding**: Patients may experience bleeding in the gastrointestinal tract, especially if they are also taking **blood thinners**.

Pregnancy Category ID

4

Mode of Action

Busulfan is a **alkylating agent** that works by **cross-linking DNA**, which prevents DNA strands from uncoiling and replicating properly. This inhibition of DNA replication leads to **cell death**. It specifically targets fast-dividing cells, such as those in **cancerous tissues**. In **CML** and other hematological malignancies, Busulfan destroys the malignant cells in the bone marrow and helps restore normal hematopoiesis. Additionally, when used in **stem cell transplants**, Busulfan serves as part of the **conditioning regimen** to eliminate the patient’s diseased bone marrow and create space for the transplant of healthy stem cells.

Interaction

Busulfan can interact with a variety of drugs, which can alter its effectiveness or increase the risk of serious side effects. Notable interactions include: - **CYP450 Enzyme Modulators**: Busulfan is metabolized by the **CYP450 enzyme system**, primarily **CYP3A4**. **Inhibitors** (e.g., **ketoconazole**, **fluconazole**) can increase Busulfan levels, increasing the risk of **toxicity**, while **inducers** (e.g., **rifampin**, **phenytoin**) can reduce its effectiveness. - **Other Chemotherapy Agents**: Concomitant use of Busulfan with other chemotherapy drugs (e.g., **cyclophosphamide**, **etoposide**) can increase the risk of **bone marrow suppression**, **gastrointestinal toxicity**, and **infections**. - **Vaccines**: Because Busulfan suppresses the immune system, patients should not receive live vaccines during therapy. The immunization schedule should be adjusted accordingly. - **Allopurinol**: This medication is sometimes given alongside chemotherapy to prevent **hyperuricemia** (elevated uric acid). However, careful monitoring is required when combined with Busulfan, as it may affect renal function.

Pregnancy Category Note

Information not available

Adult Dose

The dosage of Busulfan varies depending on the condition being treated: - **Chronic Myelogenous Leukemia (CML)**: The typical starting dose is **4 mg twice daily**, which can be adjusted based on the patient's response and tolerance. - **Hematopoietic Stem Cell Transplant Conditioning**: The dosing for conditioning therapy typically involves **1 mg/kg** every six hours for four days prior to transplant, though specific regimens may vary based on the institution’s protocol.

Child Dose

In pediatric patients, the dose of Busulfan is often based on **body weight** or **body surface area**. The typical starting dose for **children** undergoing stem cell transplants is **1 mg/kg every 6 hours** for four days. However, pediatric dosing may vary depending on specific protocols or clinical guidelines, and close monitoring of blood counts and potential side effects is essential. As always, **professional medical consultation** is necessary before starting treatment to ensure that Busulfan is appropriate for the patient's condition and that proper dosing adjustments are made as needed.

Renal Dose

For patients with **renal impairment**, dose adjustments may be required. Busulfan is **excreted by the kidneys**, so in those with **severe renal dysfunction**, the dose may need to be reduced or avoided. Regular monitoring of **renal function** is essential to prevent toxicity.

Administration

Information not available