Evertor belongs to anti-neoplastic agent; it comes under mTOR kinase inhibitor (single transduction inhibitor). Evertor is an immunosuppressive macrolide.
Evertor used for
Patient who fail to respond the tablet letrozole or anastrozole therapy, would be treated with Evertor. Evertor is used in advanced stage of breast cancer.
Evertor involved in the treatment of some neuroendocrine tumors like pancreatic, gastrointestinal or lung cancer.
Renal cell cancer
Patient treating with Evertor after the failure of treatment with Sunitinib or Sorafenib.
Evertor also used in the condition of: Heart, liver, kidney transplantation, Waldenstrom macroglobulinemia, Other carcinoid tumors
Mechanism of action
Evertor is prohibitor of mammalian target of rapamycin (mTOR), a serine threonine kinase.
Evertor bind with intercellular protein (FKBP-12), leads to inhibitory complex formation with mTOR complex 1 (mTORC1) this leads to inhibition of mTOR kinase activity.
Evertor 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 Evertor lead to reduce cell multiplication and angiogenesis.
The peak plasma concentration of Evertor reached within 1 to 2 hours after administration.
The blood plasma ratio of Evertor occurs over the range of 5 to 5000ng/ml.
On oral administration, Evertor is metabolized into six main metabolites; Three monohydroxylated Two hydrolytic ring opened product Phosphatidylcholine conjugate of Evertor . Evertor is a substrate of CYP3A4 and PgP. Evertor is mixed inhibitor of CYP2D6 substrate dextromethorphan Evertor inhibits the metabolism of CYP3A4.
The 80% of the drug eliminated through feces. The half life time of drug Evertor is approximately 30 hours.
Dosage and administration of Evertor
The recommended dose of the Tablet Evertor is 10mg should be taken as a single dose in all carcinogenic condition, except organ transplantation.
0.75mg orally twice daily.
4.5mg/m2 orally once a day (for both pediatric and adult dose)
dose reduced to 7.5mg once daily followed by 5mg as a single dose. Evertor is in tablet form. It should be administered orally at same time every day. Evertor should be taken with or without food. Evertor tablets should not crush or broken.
The over dosage of Everolimus 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.
Evertor SIDE EFFECTS
The side effects of Evertor tablets are predicted by the terms of their onset, duration, and severity Side effects of Evertor 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 Evertor therapy, doctor should consult with patient whether they are taking any medicines like:
Aspirin, Any kind of immunization or vaccine, Care should be taken in pregnancy condition.
Some list of medications should not be taken with Tablet Evertor, they will interact with Evertor to produce serious ill;
Angiotensin converting enzyme inhibitors: Evertor increases the adverse effect of ACE inhibitors. Anti diabetic agents, Anti hepaciviral increase the serum concentration of Evertor , Amphetamine/dextroamphetamine, Aspirin, Lorazepam, Amoxicillin/clavulanate, Sulfamethoxazole/trimethaprim, Vitamin D, Fish oil, Fluconazole, Atorvastatin, Paracetamol, Clopidogrel, Pantoprazole, Sorafenib, Sunitinib