veronicaAndrews

1
ENZALUTAMIDE 40MG
2
DESCRIPTION

• Xtandi containing Enzalutamide is also
  categorized as an anti-androgen chemo
  medicine. Xtandi 40mg is not self medication it
  is used under the knowledge of medical oncologist.

3
(No Transcript)
4
XTANDI 40MG TABLET USES

• Xtandi 40mg tablets are prescribing for
  Metastatic or long lasting castration resistant
  prostate cancer

5
XTANDI 40MG TABLET MECHANISM

• Xtandi 40mg containing anti-androgen agent like
  Enzalutamide, it expels an anti-tumor activity in
  different steps. Xtandi tablets are interfere in
  androgen receptor signaling pathway, which
  prohibiting androgen binding to androgen
  receptors leads to androgen receptor nuclear
  translocation inhibition and interact with DNA.

6

• The major metabolite of Xtandi is N-desmethyl
  Enzalutamide which is similar to Enzalutamide
  activity. The anti-tumor activity of Xtandi is
  exposed by depleting the multiplication and
  persuades cell lysis in prostate cancer cells.

7
(No Transcript)
8
PHARMACOKINETICS

• After an oral administration of Xtandi
  40mg tablets (160mg of dose), undergoes ADME
  process and exhibits activity. The peak plasma
  concentration time of Xtandi occurs at 1 hour
  with the range of 0.5 to 3 hours). The steady
  state of Xtandi occurs in day 28. The volume of
  distribution occur after single dose of Xtandi is
  110LXtandi has highly bounds to the human plasma
  protein with the range of 97 to 98. 

9

• The major metabolite of Enzalutamide is
  N-desmethyl Enzalutamide has 95 bound to human
  plasma protein. The most important isoenzymes
  responsible for the metabolism of Enzalutamide
  are CYP2C8 CYP3A4. CYP2C8 is involved in the
  formation of an active metabolite N-desmethyl
  Enzalutamide. Xtandi is majorly excreted through
  liver metabolism, 71 of metabolite present in
  urine and 14 in feces.

10
DOSAGE MANAGEMENT

• The usual recommended dosage of Xtandi is 160mg,
  but available strength of Xtandiis 40mg. Four
  tablets of Xtandi 40mg should be taken at a time
  as a single dose.Xtandi tablet should be
  administered with or without food.
• Dosing alteration In grade 3 toxicity or
  extreme side effects Postpone the dose
  ofXtandi for 1 week or as far as symptoms
  progress to grade 2, continue at the same or
  reduced to 120mg or 80mg.

11
In case of combination with strong CYP2C8
inhibitors, diminish the dose of Xtandi to 80mg
as a single dose. Concurrent use with strong
CYP3A4 inducers In case of combination with
strong CYP3A4 inducers, increasing the dose
of Xtandi 160mg to 240mg as a single dose.

• Concurrent use with strong CYP2C8 inhibitors
• In case of combination with strong CYP2C8
  inhibitors, diminish the dose of Xtandi to 80mg
  as a single dose. Concurrent use with strong
  CYP3A4 inducers In case of combination with
  strong CYP3A4 inducers, increasing the dose
  of Xtandi 160mg to 240mg as a single dose.

12
PRECAUTIONS

• XTANDI 40MG TABLETS SAFETY PRECAUTIONS
• The major adverse effect during the therapy
  of Xtandi tablets are
• SEIZURE Seizure may produce during the treatment
  with Xtandi tablets, if seizure occurs the
  treatment should be discontinued until seizure
  resolved. To avoid this condition,

13

• patient should be counsel about the problems
  occurred during the therapy before starting the
  treatment. Seizure may leads to loss of
  consciousness. 
• POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME PRES
   Patient who are all taking Xtandi tablets
  acquired PRES, is a neurological problem produce
  symptoms like headache, lethargy, confusion, loss
  of vision, other neurological problems related
  with hypertension.

14
SIDE EFFECTS

• XTANDI 40MG TABLETS CAUSING SIDE EFFECTS
• Asthenia
• Peripheral edema
• Back pain, arthralgia
• Musculoskeletal pain
• Muscular weakness
• Musculoskeletal stiffness

15

• Diarrhea
• Headache
• Dizziness
• Spinal cord compression
• Caude equine syndrome
• Paresthesia
• Mental disorders
• Hypoesthesia
• Respiratory tract infections

16

• Hot flush
• Hypertension
• Insomnia
• Anxiety
• Hematuria
• Pollakiuria
• Non pathologic fractures
• Pruritus Dry skin
• Epistaxis

17
PREGNANCY LACTATION

• The pregnancy category of Xtandi tablet is
  X Xtandi tablets are contraindicated to pregnancy
  conditions it may cause fetal harm even to
  death. Xtandi tablets are contraindicated in
  lactation period, breast feeding should not be
  recommended.

18
STORAGE

• The storage condition of Xtandi tablets container
  at 20C to 25C (68F to 77F). Container should
  be kept at dry and cool place.

19
MISSED DOSE

• Xtandi is a chemo tablets, if patient fail to
  take the dose of Xtandi tablets must be consult
  with medical oncologist and take the dose within
  a time. In any other way the missed dose should
  be avoid and follow the regular dosing schedule.

20
OVER DOSAGE

• In case of over dosage of Xtandi tablets,
  patients must provided with some supportive
  measures and discontinue the therapy. The half
  life of Xtandi is occurs for 5.8 days. Seizure is
  the major adverse effect occurred due to over
  dosage of Xtandi . Seizure is not described at
  240mg daily since three seizures occurs at
  360mg, 480mg and 600mg daily.

21
THANK YOU