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TEMOZOLOMIDE: Temozolomide is an imidazotetrazine alkylating agent with antitubour activity. It undergose rapid chemical conversion in the systemic circulation at ohysiologicla pH to active cimpund, monomethly triazeno lidazole carboxamide (MTIC). The cytotoxicity of MTIC is thought ot be due promarily to alkylation at eh O6 Position of guanine with addtional alkylation also occurring at theN7 Position. Cytotoxic tesion that develop subsequently are though involve abrrant repair of the methyl adduct.

Indications: Patients with newly diagnosed glioblastoma mutiforme concomitantly with radiotherapy and then as adjuvant treatment. Patiets with recurrent high grade glooms, such as blioblastoma multiforme or anaplastic astrocytoma, patients with advanced metastaic malignnt melanoma.

Dosage: Concomitant phase consists of Temozolomide administered orally at 75gm/m2 daily for 42 days with focal adotherapy (60Gy dministered in 30fraction) the concomitant phase is followed by the adjuvant phase (Temozolomiode for 6 cycles).

Contra indications: Contraindicated in the case of hypersensitivity, in pregnancy, in Lactation & in patient with swvere myleosuppression.

Drug Interaction: Administration of Tmozolomide with ranitidine did not result in clincally signficant alteration in the extent of absorption of Temozolomide. Co-administration of dexamethasone, prociorperazine, phenytoin cabamazepine ondansetron, H2 receptor antagonists or phenobar administration with valproic acid was associated with a small but stalistically significant decrease up clearnce of Temozolomide. Use of Temozolomide in corbination with other myelosuppressive agents my increase the likeihood of myelosuppression.