Evermil 10mg belongs to anti-neoplastic agent; it comes under mTOR kinase inhibitor (single transduction inhibitor). Evermil 10mg is an immunosuppressive macrolide.
patient who fail to respond the tablet letrozole or anastrozole therapy, would be treated with Evermil. Evermil 10mg is used in advanced stage of breast cancer.
Evermil 10mg involved in the treatment of some neuroendocrine tumors like pancreatic, gastrointestinal or lung cancer.
Renal cell cancer
patient treating with Evermil 10mg after the failure of treatment with Sunitinib or Sorafenib.
Evermil 10mg also used in the condition of;
Heart, liver, kidney transplantation
Other carcinoid tumors
Mechanism of action
Evermil is prohibitor of mammalian target of rapamycin (mTOR), a serine threonine kinase.
Evermil bind with intercellular protein (FKBP-12), leads to inhibitory complex formation with mTOR complex 1 (mTORC1) this leads to inhibition of mTOR kinase activity.
Evermil decreased the effect of S6 ribosomal protein kinase (S6K1) and eukaryotic elongation factor 4E binding protein (4E-BP1) which are essential for protein synthesis.
mTOR inhibited by Evermil lead to reduce cell multiplication and angiogenesis.
The peak plasma concentration of Evermil reached within 1 to 2 hours after administration.
The blood plasma ratio of Evermil occurs over the range of 5 to 5000ng/ml.
On oral administration, Evermil is metabolized into six main metabolites;
Two hydrolytic ring opened product
Phosphatidylcholine conjugate of Evermil.
Evermil is a substrate of CYP3A4 and PgP.
Evermil is mixed inhibitor of CYP2D6 substrate dextromethorphan
Evermil inhibits the metabolism of CYP3A4.
The 80% of the drug eliminated through feces. The half-life time of drug Evermil is approximately 30 hours.
Dosage and administration
The recommended dose of the Tablet Evermil is 10mg should be taken as a single dose in all carcinogenic condition, except organ transplantation.
Organ transplant: 0.75mg orally twice daily.
Brain/intracranial tumor: 4.5mg/m2 orally once a day (for both pediatric and adult dose)
Hepatic impairment: dose reduced to 7.5mg once daily followed by 5mg as a single dose.
Evermil is in tablet form. It should be administered orally at same time every day.
Evermil should be taken with or without food.
Evermil tablets should not crush or broken.
The over dosage of Evermil 10mg is rarely occur, in case of over dosage patient must be provide with supportive measures. The acute toxicity of Everolimus over dosage should be monitored.
The side effects of Evermil 10mg tablets are predicted by the terms of their onset, duration, and severity
Side effects of Evermil 10mg is preventable and it is minimized:
Mouth sores, Mucositis, Stomatitis or esophagitis, Infection, Rash, itching or dry skin, Fatigue, Diarrhea, Edema, Stomach pain, Nausea, vomiting, Fever, Weakness or asthenia, Headache.
Blood test abnormalities
Hypercholesterolemia, High triglycerides, High blood sugar level, Low calcium, Low phosphate, Low blood counts, Liver problems, Kidney problems.
Cough, Loss appetite, Shortness of breath, Hypertension, Bleeding problems, Joint pain, Muscle pain, Loss of fertility.
Before going to start the Evermil 10mg therapy, doctor should consult with patient whether they are taking any medicines like;
Any kind of immunization or vaccine
Care should be taken in pregnancy condition.
Some list of medications should not be taken with Tablet Evermil, they will interact with Evermil 10mg to produce serious ill;
Angiotensin converting enzyme inhibitors: Evermil 10mg increases the adverse effect of ACE inhibitors.
Anti-hepaciviral increase the serum concentration of Evermil 10mg