HEMOREL A 500 Injection 20ml
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INTRODUCTION ABOUT HEMOREL A 500 INJECTION
HEMOREL A 500 INJECTION contains Fluorouracil, which belongs to a group of medicines called Nucleoside metabolic inhibitors. HEMOREL A 500 INJECTION is used to manage cancer involving the breast, oesophagus, stomach, colon, rectum, pancreas, prostate, ovary, bladder, and head and neck cancer.
HEMOREL A 500 INJECTION should not be used in patients with serious infections (for example, Herpes zoster or chickenpox), non-malignant tumours, poor nutrition, weakened immunity due to long illness, damaged bone marrow due to other antineoplastics or radiotherapy, severe liver disease, or homozygotic or complete deficiency of dihydropyrimidine dehydrogenase (DPD) enzyme.
HEMOREL A 500 INJECTION should be used with caution in patients with decreased blood cells, oral ulcers, fever or haemorrhage at any site or weakness (due to decreased blood cells), kidney or liver problems like jaundice (yellowing of the skin) or heart problems like chest pain, reduced activity or deficiency of the enzyme DPD (dihydropyrimidine dehydrogenase), had high-dose radiation to pelvic, spine, ribs, metastatic tumours with involvement of bone marrow, severe bone marrow suppression include neutropenia, thrombocytopenia, and anaemia, viral, bacterial, fungal and/or parasitic infections, encephalopathy, gastrointestinal side effects like stomatitis, diarrhoea, bleeding from the G.I. tract or haemorrhage at any site, family history of partial or complete deficiency of the enzyme dihydropyrimidine dehydrogenase (DPD), had recent major surgery.
HEMOREL A 500 INJECTION is generally not recommended for use in pregnant women unless recommended by your doctor. HEMOREL A 500 INJECTION is not recommended for use in breastfeeding women as it may pass through the breast milk. HEMOREL A 500 INJECTION is not recommended for use by children. HEMOREL A 500 INJECTION should be used with caution in elderly patients aged 65 years or above.
The most common side effects of receiving HEMOREL A 500 INJECTION are anaemia, neutropenia, leukopenia, loss of appetite, watery diarrhoea, nausea, vomiting, hair loss, general weakness etc. Contact your doctor if any of the symptoms worsen.
USES OF HEMOREL A 500 INJECTION
Manage:
- Breast cancer
- Oesophageal cancer
- Stomach cancer
- Colon cancer
- Rectum cancer
- Pancreatic cancer
- Prostate cancer
- Ovary cancer
- Bladder cancer
- Head and neck cancer
HOW HEMOREL A 500 INJECTION WORKS
HEMOREL A 500 INJECTION works by interfering with the synthesis of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) of cancer cells and affects the rapidly growing cells, leading to cell death.
DIRECTIONS FOR USE
HEMOREL A 500 INJECTION will be given to you only by a doctor or a nurse into a vein as an intravenous injection or infusion. Your physician will decide the correct dose and duration for you depending upon your age, body weight, and disease condition.
SIDE EFFECTS OF HEMOREL A 500 INJECTION
COMMON
- ischemic ECG abnormalities
- neutropenia (a decrease in neutrophils)
- leukopenia (a decrease in white blood cells)
- anaemia (a decreased red blood cells)
- pancytopenia (decreased production of blood cells in the bone marrow)
- high fever with a sharp decrease in white blood cells
- inflammation of the mouth and oesophagus
- pharyngitis
- inflammation of the rectum and anus
- anorexia
- watery stools, nausea, vomiting
- hair loss
- delayed wound healing
- nosebleed
- hand-foot syndrome (redness, tenderness, peeling of hands and soles)
- general weakness, tiredness, malaise
- infections
- increased uric acid in the blood
- angina pectoris (severe chest pain)
UNCOMMON
- abnormal heart rhythm
- heart attack
- myocardial ischemia (decreased oxygen supply to the heart muscle)
- myocarditis (inflammation of the heart muscle)
- heart failure
- dilative cardiomyopathy
- cardiac shock
- low blood pressure
- sleepiness
- dehydration
- bacterial infections
- gastrointestinal ulcers, bleeding, and removal of the skin
- rhythmic movements of the eyes
- headache
- sensations of body imbalance and unsteadiness
- symptoms of Parkinson's disease (Ex. tremors, rigidity, slow movements)
- pyramidal signs
- feeling sick
- inflammation of the skin
- skin alterations such as dry skin, fissures, loss of skin (erosion), redness, itchy maculopapular rash
- skin eruptions accompanying certain infectious diseases
- presence of red marks on the skin, itchy
- sensitivity to the sun light (photosensitivity)
- hyperpigmentation (darkening of the skin)
- hyperpigmentation or depigmentation in veins
- changes in the nails (Ex. blue colour pigmentation, hyperpigmentation, nail deformity, pain, thickening of the nail bed)
- inflammation of the tissue surrounding a fingernail (paronychia)
- inflammation of the nail matrix with pus formation or nail shedding
- disorder of sperm or egg (ovum) production
- liver cell damage
- tears secretion
- blurring of vision
- redness of the whites of the eye and below the eyelid
- change in eye movement
- optic neuritis
- diplopia (double vision)
- decrease in eyesight
- increased sensitivity to sunlight and dislike of sunlight or well-lit places
- chronic inflammation of the eyelid margins
- lower eyelid turns outwards
- blocked tear ducts
- mass of dead tissue separated from surrounding living tissue, like in a wound, a sore, or an inflammation
- euphoria
RARE
- decreased blood flow in the brain, intestine, and peripheral organs
- discoloration of the fingers and toes
- generalized allergic reaction
- swelling of veins caused due to blood clot
- severe, whole-body allergic reaction (anaphylaxis)
- development of a blood clot in arteries or veins
- vasodilation of blood vessels causing low blood pressure
- confusion
- elevated T4 (total thyroxin), and T3 (total triiodothyronine) levels
Stop receiving HEMOREL A 500 INJECTION and contact your doctor immediately if you experience the following side effects:
- severe allergic reaction such as a sudden rash (hives), itching, swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing) or fainting
- blood or black stained stools
- mouth sore or ulcers
- numbness, tingling and tremor in the hands or feet
- confusion, feeling unsteady or coordination problems in arms and legs or altered mental status, difficulty in thinking or speech, problems with memory or vision
- symptoms of cardiotoxicity such as chest pain, shortness of breath, dizziness, or light-headedness
HOW TO MANAGE SIDE EFFECTS
Headache:
Rest and relax. Drink plenty of fluids such as water and electrolytes. Apply a pain-relieving balm on the head if necessary. Contact your doctor if the symptom does not improve.
Nausea and vomiting:
Take the medicine with or just after a meal. Stick to simple meals. Avoid eating oily or spicy foods.
Diarrhoea:
Drink lots of fluids, such as water or fruit juices, to keep yourself hydrated. Do not take any medicine on your own to manage diarrhoea. Contact your doctor if the symptom does not improve.
Itchy skin:
Avoid hot showers because hot water can irritate the skin. Do not scratch the affected area. Use sunscreen and protective clothing when outdoors. Regularly use unscented moisturizers to soothe and hydrate the affected area. Contact your doctor if the symptom does not improve.
WARNING & PRECAUTIONS
PREGNANCY
HEMOREL A 500 INJECTION is generally not recommended for use in pregnant women unless considered clearly necessary. Contact your doctor before receiving HEMOREL A 500 INJECTION.
BREASTFEEDING
HEMOREL A 500 INJECTION is not recommended for use in breastfeeding women as it may pass through breast milk. Contact your doctor before receiving HEMOREL A 500 INJECTION.
DRIVING AND USING MACHINES
Do not drive or operate any machinery if you have nausea and vomiting, acute cerebellar syndrome and neurologic symptoms like decreased alertness, confusion, disorientation, ataxia, visual disturbances, headache or nystagmus after receiving HEMOREL A 500 INJECTION.
KIDNEY
HEMOREL A 500 INJECTION should be used with caution in patients with kidney disease. Contact your doctor before receiving HEMOREL A 500 INJECTION.
LIVER
HEMOREL A 500 INJECTION is not recommended for use in patients with severe liver disease and should be used with caution in patients with jaundice. Contact your doctor before receiving HEMOREL A 500 INJECTION.
ALLERGY
Do not receive HEMOREL A 500 INJECTION if you are allergic to Fluorouracil or any of the other ingredients in this medicine.
HEART DISEASE
HEMOREL A 500 INJECTION should be used with caution in patients with heart diseases such as angina, myocardial infarction, cardiac shock, cardiomyopathy, myocarditis, ECG abnormalities, pericarditis, arrhythmia, and heart failure. Contact your doctor before receiving HEMOREL A 500 INJECTION.
OTHERS
HEMOREL A 500 INJECTION is not recommended for use if you have:
- serious infections (Ex. Herpes zoster, chickenpox)
- non-malignant tumour
- poor nutrition
- weakened immunity due to long illness
- damaged bone marrow due to other antineoplastics or radiotherapy
- homozygotic or complete deficiency of dihydropyrimidine dehydrogenase (DPD) enzyme
Before receiving HEMOREL A 500 INJECTION inform your doctor if you have:
- decreased blood cells
- oral ulcers, fever or haemorrhage at any site or weakness (due to decreased blood cells)
- reduced activity or deficiency of the enzyme DPD (dihydropyrimidine dehydrogenase)
- had high-dose radiation to the pelvic, spine, ribs, etc
- metastatic tumours with involvement of bone marrow
- severe bone marrow suppression includes neutropenia, thrombocytopenia, anaemia
- viral, bacterial, fungal, and/or parasitic infections
- encephalopathy
- mucositis or stomatitis, esophagopharyngitis, mucosal ulcers
- diarrhoea, bleeding from the G.I. tract or haemorrhage at any site
- family history of partial or complete deficiency of the enzyme dihydropyrimidine dehydrogenase (DPD)
- palmar-plantar erythrodysesthesia or hand-foot syndrome
- had recent major surgery
- vaccinations
- urine test for bilirubin
- blood test for thyroid function
- low salt diet
Use in paediatrics:
HEMOREL A 500 INJECTION is not recommended for use in children. Contact your doctor before receiving HEMOREL A 500 INJECTION.
Use in geriatrics:
HEMOREL A 500 INJECTION should be used with caution in elderly patients aged 65 years or above. Contact your doctor before receiving HEMOREL A 500 INJECTION.
INTERACTIONS
A. Drug-Drug interactions:
Before receiving HEMOREL A 500 INJECTION inform your doctor if you are receiving any of the following medicine:
- methotrexate (a medicine used to manage cancer and rheumatoid arthritis)
- metronidazole (a medicine used for bacterial infections)
- calcium leucovorin (a medicine used to reduce the harmful effects of anticancer medicines)
- allopurinol (a medicine used to manage gout)
- cimetidine (a medicine used for stomach ulcers)
- warfarin (a medicine used to manage blood clots)
- interferon alpha 2a, brivudine, sorivudine and analogues (medicines used to manage viral infections)
- medicines used to manage cancer (Ex. cisplatin, cyclophosphamide, vincristine, mitomycin, adriamycin, vinorelbine, tamoxifen, doxorubicin, epirubicin, cytarabine, PALA, hydroxyurea)
- phenytoin (a medicine used for seizures)
- vaccines (a medicine used to manage infections)
- levamisole (a medicine used to manage worm infection)
- dipyridamole (a medicine used to manage platelet clumping)
- diazepam (a medicine used for anxiety, seizures)
Overdosage:
HEMOREL A 500 INJECTION will be administered to you only by a doctor or a nurse in a hospital, and it is unlikely for you to receive an overdose. However, contact your physician or nurse if you experience any unusual symptoms like nausea, vomiting, diarrhoea, severe mucositis, or stomatitis, esophagopharyngitis, gastrointestinal ulceration, bleeding, and severe myelosuppression including thrombocytopenia, leukopenia, and agranulocytosis in chronic overdosage may occur.
SYNOPSIS
| Drug | : |
Fluorouracil |
| Pharmacological Category | : |
Nucleoside metabolic inhibitor |
| Therapeutic Indication | : |
Manages common types of cancer |
| Dosage Forms | : |
Injection, Cream |
MORE INFORMATION
- Keep HEMOREL A 500 INJECTION out of reach from children
- Store HEMOREL A 500 INJECTION at room temperature
FAQs ABOUT HEMOREL A 500 INJECTION
How to use HEMOREL A 500 INJECTION?
HEMOREL A 500 INJECTION will be given to you only by a doctor or a nurse into a vein as an intravenous injection or infusion. Your physician will decide the correct dose and duration for you depending upon your age, body weight, and disease condition.
What are the possible side effects of receiving HEMOREL A 500 INJECTION?
The most common side effects of receiving HEMOREL A 500 INJECTION are anaemia, neutropenia, leukopenia, loss of appetite, watery diarrhoea, nausea, vomiting, hair loss, general weakness, etc. Contact your doctor if any of the symptoms worsen.
How HEMOREL A 500 INJECTION work?
HEMOREL A 500 INJECTION works by interfering with the synthesis of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) of cancer cells and affects the rapidly growing cells, leading to cell death.
Can HEMOREL A 500 INJECTION be used by children?
No. HEMOREL A 500 INJECTION is not recommended for use in children. Contact your doctor before receiving HEMOREL A 500 INJECTION.
Does HEMOREL A 500 INJECTION cause bleeding?
Yes. HEMOREL A 500 INJECTION may cause bleeding from the stomach. Stop receiving HEMOREL A 500 INJECTION and immediately contact your physician if you experience unusual symptoms like blood or black-stained stools.
REFERENCES
1. K D Tripathi. Chemotherapy of Neoplastic diseases. Essentials of medical pharmacology. 7th edition. 2013. Page – 864.
2. Casale J, Patel P. Mechanism of action of Fluorouracil. National Institute of Health. National Library of Medicine. National Centre for Biotechnology Information. Pubmed.gov. January 2022. [Accessed on 10th June 2022] https://www.ncbi.nlm.nih.gov/books/NBK549808/
3. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in December 2021] [Accessed on 10th June 2022] https://www.medicines.org.uk/emc/files/pil.6041.pdf
4. Pharmadox Healthcare Ltd. Health Products Regulatory Authority (HPRA). [Revised in May 2015] [Accessed on 10th June 2022] https://www.hpra.ie/img/uploaded/swedocuments/2164234.PA0405_096_001.df3c67a1-d07a-4417-bfe1-090437d89682.000001Fluorouracil%20PIL.151021.pdf
5. Spectrum Pharmaceuticals, Inc. U.S. Food & Drug Administration. [Revised in July 2016] [Accessed on 10th June 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/012209s040lbl.pdf
6. Pfizer. Fluorouracil. [Revised in August 2019] [Accessed on 10th June 2022] https://www.pfizer.ca/sites/default/files/201908/FLUOROURACIL_PM_E_227813_07Aug2019.pdf
7. Sandoz. Fluorouracil. [Revised in August 2014] [Accessed on 10th June 2022] https://www.pfizer.ca/sites/default/files/201908/FLUOROURACIL_PM_E_227813_07Aug2019.pdf
USEFUL DIAGNOSTIC TESTS
- Complete blood count
- Peripheral smear examination
- Prothrombin time
AUTHOR DETAILS
