Maball 500mg is a genetically engineered chimeric murine/human monoclonal IgG1 kappa antibody directed against the CD20 antigen. Maball has an approximate molecular weight of 145 kD. Maball has a binding affinity for the CD20 antigen of approximately 8.0 nm.
Maball is produced by mammalian cell (Chinese Hamster Ovary) suspension culture in a nutrient medium that may contain the antibiotic gentamicin.
Gentamicin is not detectable in the final product. Maball 500mg is an anticancer medicine which prevents the growth and spread of cancer cells in the body. Maball 500mg with steroid regimen combination is given for the treatment of some rare disorders which cause blood vessels and other tissues inflammation in the body.
Maball 500mg indicated for
Maball 500mg and hyaluronidase human injection are used as alone or concomitant use with other drugs to treat some types of non-Hodgkin's lymphoma and chronic lymphocytic leukemia (cancer start in WBC).
Maball 500mg injection concomitant use with methotrexate (Otrexup, Rasuvo, Xatmep, others) is also used for the treatment rheumatoid arthritis symptoms in adults that have been already treated with some type of drug knowns as tumor necrosis factor (TNF) inhibitor. Maball 500mg is a type in a classification of drugs called monoclonal antibodies.
Maball 500mg is indicated to killing cancer cells to treat NHL, CLL, rheumatoid arthritis, granulomatosis with polyangiitis, and microscopic polyangiitis by preventing the activity of the immune system parts which can injury the joints, veins, and other blood vessels and cause organs (heart and lungs) damage.
Mechanism of action
Rituximab is belonging to a classification monoclonal antibody which aim the CD20 antigen declare on the surface of pre-B and mature B-lymphocytes. Upon connecting to CD20, rituximab intercedes B-cell lysis.
Probably mechanisms of cell lysis contain complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC).
B cells are believed to play a role in the pathogenesis of rheumatoid arthritis (RA) and analog to chronic synovitis.
In this setting, B cells may be action at multiple sites in the autoimmune/inflammatory process, involving through production of rheumatoid factor (RF) and other autoantibodies, antigen presentation, T-cell activation, and/or proinflammatory cytokine production.
Volume of distribution is 3.1 L There is no human plasma level
Maball 500mg metabolized by human antimurine antibody production.
Not available The drug elimination of half-life of NHL is 22 days and for RA is 18.0 days, GPA and microscopic polyangiitis is 23 days.
Dosage and administration
Maball injection is generally used to given only via intravenous infusion not by IV push or bolus.
Prior to Each Infusion the Drug Is Premedicate
Initial treatment rate of 50 mg/hr is administer, in not showing infusion toxicity, rate increased up to 50 mg/hr. increments at intervals of 30 min and max of 400 mg/hr.
Successive infusion: starting at rate of 100 mg/hr., in not showing infusion toxicity, rate increased up to 100 mg/hr. increments at intervals of 30 min and max of 400 mg/hr. While consolidation with CHOP chemotherapy the injection Maball has not been given. Hence Premedication with corticosteroids must be considered.
CHRONIC LYMPHOCYTIC LEUKEMIA
Prior to starting of FC chemotherapy, dose usual given is 375 mg/m2 followed 500 mg/m2 on day 1 of 2-6 cycles every 28 days.
When combination of Maball injection with methotrexate is administrated.
Maball injectiongiven as two doses of 100mg IV infusion 2 weeks separated.
When glucocorticoids administered as methylprednisolone 100mg IV Subsequent course based on clinical evaluation must administer every 24 weeks, but not early than every 16 weeks.
LOW GRADE OR FOLLICULAR NON-HODGKINS LYMPHOMA
The drug Dose is 375 mg/m2 as an IV infusion.
Once weeks for 4 or 8 doses administrated for Relapsed treatment
Once weekly for 4 doses administrated for Retreatment for relapsed.
Previously untreated: administer on day 1 of each cycle of chemotherapy, up to 8 doses.
In complete or partial response of patient, start with 8 weeks for maintenance following Maball 500mg in combination with chemotherapy completed then administer 8weeks for 12 doses as a single agent.
Once weekly for 4 doses at intervals of 6 months and max of 16 doses for Non – progression (following CVP chemotherapy completion 6 – 8 cycles): On day 1 each cycle of chemotherapy up to 8 infusions for Diffuse Large B- cell NHL
COMPONENT OF ZEVALIN FOR TREATMENT OF NHL
The dose 250 mg/m2 of Maball injection within 4 hours prior to the administration of Indium-111-(In-111-) Zevalin and Yttrium-90- (Y-90-) Zevalin. 7–9 days before to Rituxan and Y-90- Zevalin administrate Rituxan and In-111-Zevalin.
GRANULOMATOSIS POLYANGITIS AND MICROSCOPIC POLYANGITIS
Maball injection administer Dose of 375 mg/m2 IV infusion weekly once for 4 weeks.
When Glucocorticoids given with methylprednisolone by dose of 1000 mg IV/ day for 1- 3 days and purse by oral prednisone 1 mg/kg/day are recommended for the treatment of symptoms of serious vacuities.
This drug should initiate within 14 days before or with the starting of Maball injection and may continue during and after the 4 week course with treatment of Maballinjection drug. Safety and not established for subsequent infusion.
Take an amount Maballinjection is administer and diluted to final concentration of 1 mg/ml upto 4 mg/ml as infusion (containing either 0.9% Nacl or 5% dextrose in water). Gently Invert the bag and mix the solution. Discard unused drug left in vial.
If over dose occurs seek immediately to the emergency department or poison control help line. please consult the doctor for further clarification.
Fever and chills (flu lik symptoms)
Less common side effects
Weakness; nausea; headache; cough;dyspnea ; pharyngitis
Allergic condition against Maball 500mg or any other medication inform your doctor.
Information about past medical history used which include in prescription, non-prescription, vitamins & supplements, nutritional products just inform the doctor.
Avoid use of Maball 500mg if you are pregnant. It will harm the baby unborn, while using Maball 500mg use correct birth control to prevent pregnancy and for at least 2 weeks after your treatment ends. It is unknown whether Maball 500mg passes into breast milk, avoid breast-feed while on Maball 500mg treatment. While using Maball 500mg do not take any vaccination or immunization without taking advice from doctors.