Pomyelo 4mg is anti-cancer medication, which is used by the patients who are having a valid prescription and under the supervision of medical oncologist.
Pomyelo 4mg capsules are used by combination with dexamethasone.
Pomyelo 4mg is used in the patients who are priory receiving two therapies such as Lenalidomide & proteasome inhibitors.
Pomyelo 4mg capsules are FDA approved product, which is orally bioavailable.
Pomalidomide is a thalidomide derivative with superlative activities like anti-angiogenesis, Immuno modulatory & anti-neoplastic effect.
The primary indication of Pomyelo 4mg is used in the treatment of Multiple Myeloma condition.
In this condition, Pomyelo 4mg is used by combining with dexamethasone.
Pomyelo 4mg capsules are used in Patients already got treatment with two medications such as proteasome inhibitor & Lenalidomide.
Patients who are suffered with disease progression condition
Pomyelo 4mg treatment should be followed within 60 days in patients who are concluded the last treatment.
Pomalidomide belongs to immunomodulatory agent with classification of antineoplastic activity. It is performing to prohibit the replication and induce apoptosis of various tumor cells. Furthermore, Pomalidomide increase T cell and natural killer (NK) cell-mediated immunity and prohibited the production of pro-inflammatory cytokines, like TNF-alpha or IL-6, by monocytes. The major target of Pomalidomide is thought to be the protein cereblon. It links to this target and prevents ubiquitin ligase activity. It is also belonging to transcriptional inhibitor of COX2.
The high plasma concentration time of Pomalidomide is reaches between 2 to 3 hours. It can be administered with or without food.
The apparent volume of distribution of Pomalidomide is occurs between 62 & 138L in steady state. Plasma level 67% after 4 hours of drug intake.
Pomalidomide is bounded to human plasma protein by range of 12% & 44%.
The metabolism of Pomalidomide is occurs via hepatically mediated through CYP1A2, CYP3A4.
The Pomalidomide clearance value is 7 to 10L/hr.
Doses are excreted via urine 73% & feces 15% respectively.
Doses are excreted as in unchanged form through urine 2% & feces 8%.
The half-life period of Pomalidomide is 9.5 hours.
During multiple myeloma malignancies:
The dosage recommendation of Pomyelo is 4mg should be administered as a single dose for 1 to 21 days of successive 28-day cycles.
Pomyelo 4mg is combined with dexamethasone with low dose.
Dexamethasone should be administrated on day 1, 8, 15 & 22 of each 28-day cycle.
The patients weighing about ≤ 75kg: The usual dose of dexamethasone is 40mg should be administered.
The patients weighing Greater than 75kg: The usual dose of dexamethasone is 20mg.
Dosage changes occur during hematological toxicities:
ANC <500/mcL: Pomyelo treatment should be postponed and check the CBC weekly.
ANC ≥ 500/mcL: Pomyelotherapy should be continued by 3mg/day
For each successive drop <500/mcL: Pomyeloshould be postponed.
ANC ≥ 500/mcL: Continue the Pomyelo therapy with 1mg/day.
Platelets count <25000/mcL: Pomyelo therapy should be postponed and check CBC
Platelets count ≥50000/mcL: 3mg of Pomyelo should be taken daily
With strong CYP1A2:
Pomyelo combined with CYP1A2 substrates causes increasing the plasma concentration of Pomalidomide and leads to elevate the risk of Pomalidomide.
In renal damaged patients:
In severe renal impaired patients, the suggested dose of Pomyelo is 3mg per day.
In hepatic impaired patients:
For mild to moderate patients, the advised dose is 3mg/day & in severe condition, the suggested dose is 2mg/day.
Common side effects
• GIT problems: constipations, diarrhea, nausea, vomiting
• Life changes: decrease appetite, weight changes, uncontrollable shaking of a part of the body, night sweats
• Arthralgia, myalgia
Serious side effects
• swelling of the eyes, face, tongue, throat, hands, arms, feet, ankles, or lower legs
• difficulty breathing or swallowing
• fever, sore throat, chills, cough, or other signs of infection
• yellow eyes or skin
• dark urine
• pain or discomfort in the right upper stomach area
• difficult, frequent, or painful urination
• pale skin
• rash, itching,hives
Embryo fetal damage
Pomyelo 4mg should not be used during pregnancy will causes Teratogenecity, organogenesis and causes fetal damage.
Do not becoming pregnant during Pomyelo 4mg treatment by using effective contraceptives.
Venous & arterial thromboembolism
Deep vein thrombosis is harm while occurs during the Pomyelo 4mg treatment.
Thromboprophylaxis is started for this condition.
Increase of mortality in case of pembrolizumab taken with thalidomide & dexamethasone.
In multiple myeloma condition, pembrolizumab concomitant use with dexamethasone causes mortality in high range.
The interaction of PD-1 or PD-L1 blocking agent with thalidomide associated with dexamethasone has not evaluated.
Neutropenia, thrombocytopenia is main common side effects occur during the Pomyelo 4mg treatment.
These may counteract by checking the blood counts frequently and postponement of dosage or adjustment of dose is necessary.
During Pomyelo 4mg treatment, there is a possibility of elevation of hepatic enzymes occurs.
This may have reported as increased liver toxicity.
Vertigo & confusion
Instruct the patients to keep away from circumstances where unsteadiness or disturbed state might be an issue and not to take different meds that may leads to dazedness or disturbed state without adequate therapeutic exhortation.