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  • ALEXAN 100 MG/5 ML

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    Description

    ALEXAN 100 MG/5 ML is an injectable formulation of cytarabine, an antimetabolite chemotherapy agent primarily used in the treatment of certain types of cancers, including acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), and chronic myelogenous leukemia (CML) in blast crisis. Cytarabine is known for its role in inhibiting DNA synthesis in rapidly dividing cancer cells, making it an essential drug in oncological therapy.

    How ALEXAN Works

    Mechanism of Action:

    Cytarabine, the active ingredient in ALEXAN, is a pyrimidine analog that interferes with DNA replication and repair mechanisms in cancer cells. Here’s how it works:
    1. Conversion to Active Form:
      • Cytarabine is initially inactive. Once inside the body, it undergoes phosphorylation to form cytarabine triphosphate (ara-CTP), which is the active form of the drug.
    2. Inhibition of DNA Synthesis:
      • Ara-CTP is incorporated into the DNA of rapidly dividing cells during the S-phase of the cell cycle. This incorporation causes the termination of DNA chain elongation and inhibits DNA polymerase, an enzyme crucial for DNA replication and repair.
      • This disruption of DNA synthesis prevents cancer cells from replicating, leading to cell death.
    3. Induction of Apoptosis:
      • The inhibition of DNA synthesis and repair mechanisms results in DNA damage, triggering apoptosis (programmed cell death) in cancerous cells.
      • Cytarabine selectively targets rapidly dividing cells, making it effective against leukemia cells, which proliferate uncontrollably.
    4. High Selectivity for Cancer Cells:
      • Cytarabine’s selective action on dividing cells reduces the growth of cancerous cells, allowing the body to better manage the disease. However, normal cells that divide rapidly, such as those in the gastrointestinal tract, bone marrow, and hair follicles, may also be affected, contributing to side effects.

    Combined Effect:

    Overall, cytarabine’s ability to inhibit DNA synthesis and induce apoptosis in cancer cells makes it a powerful chemotherapeutic agent, particularly in the management of acute leukemias.

    Side Effects

    Cytarabine, like other chemotherapeutic agents, can cause a range of side effects. These can vary from mild to severe and may require supportive care or dose adjustments.

    Common Side Effects:

    • Nausea and Vomiting
    • Diarrhea
    • Loss of Appetite
    • Mouth Sores
    • Fever and Chills
    • Rash
    • Fatigue
    • Hair Loss
    • Low Blood Cell Counts (Anemia, Neutropenia, Thrombocytopenia)

    Serious Side Effects:

    • Severe Bone Marrow Suppression: Increased risk of infections, bleeding, and anemia.
    • Neurological Toxicity: Including confusion, ataxia, and seizure; more common with high-dose therapy.
    • Pulmonary Toxicity: Such as interstitial pneumonitis or acute respiratory distress syndrome (ARDS).
    • Hepatotoxicity: Liver damage manifesting as elevated liver enzymes, jaundice, or hepatic failure.
    • Pancreatitis: Inflammation of the pancreas, which can be life-threatening.
    • Cytarabine Syndrome: Characterized by fever, muscle pain, chest pain, and malaise.

    Indications

    ALEXAN (Cytarabine) is primarily indicated for the treatment of various hematological malignancies. It is often used in combination with other chemotherapy agents.

    Approved Indications:

    • Acute Myeloid Leukemia (AML): Used as induction and consolidation therapy to achieve and maintain remission.
    • Acute Lymphocytic Leukemia (ALL): Employed in the treatment regimen for relapsed or refractory cases.
    • Chronic Myelogenous Leukemia (CML) in Blast Crisis: Used in patients who have progressed to an aggressive, blast-phase disease.
    • Non-Hodgkin’s Lymphoma: Occasionally used in specific protocols for aggressive forms.
    • Meningeal Leukemia: Administered intrathecally to treat leukemic involvement of the central nervous system.

    Contraindications

    Cytarabine should be used with caution and is contraindicated in certain situations where the risk of severe adverse effects outweighs the potential benefits.

    Contraindications:

    • Hypersensitivity: Known allergy to cytarabine or any component of the formulation.
    • Severe Bone Marrow Suppression: Patients with profound neutropenia and thrombocytopenia, unless in a controlled setting where marrow recovery is anticipated.
    • Active Severe Infections: Cytarabine’s immunosuppressive effects can exacerbate infections.
    • Pregnancy and Breastfeeding: Cytarabine is teratogenic and should not be used during pregnancy or while breastfeeding.
    • Severe Liver Dysfunction: Patients with compromised hepatic function may experience increased toxicity.

    Price in Different Countries

    The cost of ALEXAN (Cytarabine) varies depending on the country, availability, and healthcare system policies. Below is a table showing the approximate price in various countries.
    Country Price (Per Vial) Reference
    United States $50 – $100 GoodRx
    United Kingdom £40 – £80 NHS BNF
    Canada CAD $60 – $90 Health Canada
    Australia AUD $70 – $110 PBS Australia
    India ₹800 – ₹1500 1mg

    Top 5 Global Brands

    Several pharmaceutical companies manufacture cytarabine, marketed under different brand names globally. Below are some of the top brands:

    1. Pfizer

    • Pfizer manufactures Cytosar-U, a widely recognized brand of cytarabine. Pfizer is known for its extensive range of oncology products and is a global leader in the pharmaceutical industry.

    2. Fresenius Kabi

    • Fresenius Kabi produces cytarabine injections that are widely used in cancer treatments. They are known for their comprehensive oncology product portfolio and global distribution network.

    3. Hospira (Now part of Pfizer)

    • Hospira was a significant manufacturer of generic cytarabine before being acquired by Pfizer. Their products remain a staple in chemotherapy protocols worldwide.

    4. Teva Pharmaceuticals

    • Teva is a leading generic drug manufacturer and produces cytarabine injections for use in various cancer treatments. Their products are known for affordability and accessibility.

    5. Accord Healthcare

    • Accord Healthcare manufactures generic cytarabine, providing essential chemotherapy medications at competitive prices. They are known for their focus on cancer treatment medications.
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