Pharion Speciality Medicines

SAMGOLIX 120 MG is an oral gonadotropin-releasing hormone (GnRH) receptor antagonist used to manage advanced prostate cancer. It lowers testosterone levels, helps control disease progression, and improves symptoms while offering convenient once-daily oral dosing.

Endace Megestrol Acetate 40mg Tablet is used in the treatment of breast and endometrial cancers. It acts as a progestin, slowing cancer growth by altering hormone activity. It also helps improve appetite and weight gain in patients with cancer-related cachexia or significant weight loss.

UNIGEF 250 MG is an oral chemotherapy medication containing Gefitinib, used for the treatment of non-small cell lung cancer (NSCLC) with specific EGFR mutations. It inhibits cancer cell growth, slows tumor progression, and helps improve patient outcomes and quality of life.

SORATIB 200 MG is an oral multi-kinase inhibitor used to treat advanced renal cell carcinoma and hepatocellular carcinoma. It works by blocking tumor cell proliferation and angiogenesis, helping slow cancer progression, reduce tumor growth, and improve patient outcomes.

SAMTICA 500 MG is an oral therapy for metastatic castration-resistant prostate cancer. It inhibits CYP17 enzyme, reducing androgen production, slowing tumor growth, controlling disease progression, and supporting improved quality of life in affected patients.

SAMTICA 250 MG is an oral medication used in the treatment of metastatic castration-resistant prostate cancer. It inhibits CYP17 enzyme, reducing androgen production, slowing cancer growth, and helping manage disease progression while improving patient quality of life.

SAMENZA 160 MG is an oral androgen receptor inhibitor used to treat advanced or metastatic prostate cancer. It blocks testosterone’s action on cancer cells, slowing tumor growth, controlling disease progression, and helping manage cancer-related symptoms effectively.

Caludec Bicalutamide 50mg Tablet is prescribed for prostate cancer treatment. It acts as a non-steroidal anti-androgen, blocking testosterone’s effects on cancer cells. This helps slow tumor growth and improve treatment outcomes, often used alongside other hormone therapies.

• Brand Name: Trombonat 25

• Manufacture: Natco Pharma Ltd.

• Generic Name: Eltrombopag

• Strength: 25 mg

• Dosage Form: Film-coated Tablet

• Therapeutic Class: Thrombopoietin Receptor Agonist

• Treatment of chronic immune (idiopathic) thrombocytopenia (ITP) in adults and children ≥1 year who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.

• Treatment of thrombocytopenia in patients with chronic hepatitis C to allow initiation and maintenance of interferon-based therapy.

• Treatment of severe aplastic anemia (SAA) in adults with insufficient response to immunosuppressive therapy.

Eltrombopag is a thrombopoietin receptor (TPO-R) agonist. It binds to the transmembrane domain of the TPO receptor (c-Mpl) on megakaryocyte precursors, activating intracellular signaling pathways. This stimulates proliferation and differentiation of megakaryocytes, thereby increasing platelet production.

• ITP (adults): Starting dose 50 mg orally once daily (25 mg once daily in patients of East Asian ancestry). Adjust dose to maintain platelet count ≥50×10⁹/L.

• Chronic Hepatitis C–associated thrombocytopenia: Starting dose 25 mg once daily; adjust based on platelet response.

• Severe Aplastic Anemia: Starting dose 50 mg once daily; may be titrated up to 150 mg once daily.

• Administration: Take on an empty stomach (1 hour before or 2 hours after a meal). Avoid concomitant intake with dairy products or mineral supplements (calcium, magnesium, iron, aluminum) as they reduce absorption.

• Dose adjustments are required based on platelet response and safety profile.

• Supplied in blister packs.

• Pack size: 7 or 14 tablets (25 mg each).

• Store below 30°C.

• Keep in original package to protect from moisture and light.

• Keep out of reach of children.

• Hepatotoxicity: Risk of ALT, AST, and bilirubin elevations; monitor liver function tests before and during therapy.

• Thromboembolic Events: Excessive platelet counts may increase risk; dose adjustments required.

• Bone Marrow Reticulin Formation: Risk of bone marrow fibrosis; monitor blood counts and marrow if indicated.

• Ocular Disorders: Risk of cataracts with long-term therapy.

• Renal Impairment: Use with caution; monitor renal function.

• Drug Interactions: Avoid polyvalent cation-containing medications/foods close to dosing. Eltrombopag is metabolized by UGT1A1 and CYP1A2—use caution with interacting drugs.

• Pregnancy & Lactation: Contraindicated; may cause fetal harm. Avoid breastfeeding.

• Elderly Patients: No specific adjustments, but monitor closely for safety.

TORINAT 5 contains Everolimus, an oral mTOR inhibitor indicated for the treatment of advanced renal cell carcinoma, hormone receptor–positive breast cancer, pancreatic neuroendocrine tumors, and other selected cancers. By targeting the mTOR pathway, it helps slow cancer cell growth and angiogenesis. Therapy must be taken under strict medical guidance with regular monitoring for safety and treatment effectiveness.

• Brand Name: Veenat 400

• Manufacture: Natco Pharma Ltd.

• Generic Name: Imatinib

• Strength: 400 mg

• Dosage Form: Film-coated Tablet

• Therapeutic Class: Antineoplastic agent, Tyrosine Kinase Inhibitor (TKI)

• Treatment of Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic, accelerated, or blast crisis phase.

• Treatment of Philadelphia chromosome–positive acute lymphoblastic leukemia (Ph+ ALL) in adults.

• Treatment of myelodysplastic/myeloproliferative diseases (MDS/MPD) associated with PDGFR gene rearrangements.

• Treatment of hypereosinophilic syndrome (HES) and/or chronic eosinophilic leukemia (CEL).

• Treatment of gastrointestinal stromal tumors (GISTs) that are KIT (CD117)-positive, unresectable, or metastatic.

• Adjuvant treatment of patients following resection of GIST to reduce recurrence risk.

Imatinib is a selective protein tyrosine kinase inhibitor. It blocks the BCR-ABL tyrosine kinase produced by the Philadelphia chromosome translocation. By inhibiting BCR-ABL and other kinases such as c-KIT and PDGFR, it prevents phosphorylation of target proteins, inhibiting proliferation and inducing apoptosis of malignant cells.

• CML (chronic phase): 400 mg orally once daily.

• CML (accelerated/blast crisis): 600 mg orally once daily (can be divided).

• Ph+ ALL: 600 mg orally once daily.

• MDS/MPD: 400 mg once daily.

• GIST (metastatic/unresectable): 400 mg once daily (may increase to 600–800 mg if progression).

• Adjuvant GIST: 400 mg once daily for up to 3 years.

• Tablets should be taken with a meal and a large glass of water.

• Dose adjustments required for toxicity or hepatic impairment.

• Available in blister packs or bottles.

• Pack size: 30 tablets (400 mg each).

• Store below 30°C, in a dry place.

• Protect from light and moisture.

• Keep out of reach of children.

• Hematologic Toxicity: Risk of neutropenia, thrombocytopenia, and anemia; monitor complete blood counts regularly.

• Hepatic Toxicity: Liver enzyme elevations may occur; monitor liver function tests.

• Fluid Retention/Edema: Common; monitor for rapid weight gain, pleural effusion, or ascites.

• Cardiac Risk: Use with caution in patients with heart disease; risk of congestive heart failure.

• Gastrointestinal Effects: Nausea, vomiting, diarrhea, and abdominal pain are common.

• Pregnancy & Lactation: Contraindicated; can cause fetal harm. Avoid breastfeeding during treatment.

• Drug Interactions: Metabolized by CYP3A4. Avoid strong inhibitors/inducers (ketoconazole, rifampin, St. John’s Wort).

• Elderly Patients: Close monitoring required as adverse events may be more pronounced.

TIPANAT 15 contains Trifluridine and Tipiracil, an oral anticancer combination used for metastatic colorectal cancer and gastric cancer in patients previously treated with other therapies. Trifluridine incorporates into DNA to inhibit cancer cell growth, while Tipiracil increases its effectiveness by preventing breakdown. Taken orally in tablet form, it requires strict medical supervision and regular monitoring for safety and efficacy.

TORINAT 10 contains Everolimus, an mTOR inhibitor used in the treatment of advanced renal cell carcinoma, breast cancer, pancreatic neuroendocrine tumors, and certain other cancers. It works by blocking the mTOR pathway, thereby reducing cancer cell growth, proliferation, and angiogenesis. Administered orally, it requires strict medical supervision with regular monitoring to ensure safe and effective therapy outcomes.

• Brand Name: Trombonat 50

• Manufacture: Natco Pharma Ltd.

• Generic Name: Eltrombopag

• Strength: 50 mg

• Dosage Form: Tablet

• Therapeutic Class: Thrombopoietin Receptor Agonist, Hematopoietic Agent

• Treatment of chronic immune (idiopathic) thrombocytopenic purpura (ITP) in adults and children ≥1 year who have had insufficient response to corticosteroids, immunoglobulins, or splenectomy.

• Treatment of thrombocytopenia in patients with chronic hepatitis C to allow initiation and maintenance of interferon-based therapy.

• Treatment of severe aplastic anemia (SAA) in patients who are refractory to prior immunosuppressive therapy.

Eltrombopag is a thrombopoietin receptor agonist.

• Binds to the transmembrane domain of the TPO receptor (c-Mpl).

• Stimulates proliferation and differentiation of megakaryocyte progenitor cells.

• Increases platelet production, thereby reducing bleeding risk in patients with thrombocytopenia.

• Initial dose (ITP, adults): 50 mg once daily; may adjust based on platelet response.

• Hepatitis C-related thrombocytopenia: 25 mg once daily, adjusted as per response.

• Severe Aplastic Anemia: Starting dose 50 mg once daily, titrated according to response.

• Taken on an empty stomach (1 hour before or 2 hours after meals).

• Avoid concurrent administration with antacids, dairy, or supplements containing iron, calcium, aluminum, magnesium, selenium, or zinc, as they reduce absorption.

• Therapy should be individualized and monitored with regular platelet counts.

• Supplied in blister packs.

• Pack size: 7 tablets (50 mg each).

• Store at 20°C–25°C.

• Protect from light and moisture.

• Keep container tightly closed.

• Keep out of reach of children.

• Hepatotoxicity: Risk of elevated liver enzymes; monitor liver function before and during therapy.

• Thrombosis Risk: Excessive platelet increase may lead to thromboembolic complications; adjust dose accordingly.

• Bone Marrow Effects: Risk of bone marrow fibrosis with prolonged use; periodic monitoring recommended.

• Cataracts: Reports of cataract formation; ophthalmologic exams advised during long-term therapy.

• Drug Interactions: Avoid polycationic medications (iron, calcium, magnesium supplements) around dosing time.

• Pregnancy & Lactation: Use only if clearly needed; avoid breastfeeding during treatment.

• Pediatric Use: Approved for children ≥1 year with chronic ITP, dosing based on age and weight.

• Discontinuation: Platelet count typically returns to baseline within 1–2 weeks after stopping therapy; patients remain at risk of bleeding.

SORAFENAT 200 contains Sorafenib, a multikinase inhibitor used for the treatment of advanced renal cell carcinoma, hepatocellular carcinoma, and certain thyroid cancers. It works by blocking tumor cell proliferation and angiogenesis, thereby slowing disease progression. Administered orally as a tablet, it must be taken under strict medical supervision with regular monitoring to ensure safety and effectiveness.

• Brand Name: Bracanat 150

• Manufacture: Natco Pharma Ltd.

• Generic Name: Olaparib

• Strength: 150 mg

• Dosage Form: Tablet

• Therapeutic Class: Antineoplastic Agent, PARP Inhibitor

• Ovarian Cancer: Maintenance treatment of adult patients with platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.

• Breast Cancer: Treatment of adult patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative metastatic breast cancer, previously treated with chemotherapy.

• Pancreatic Cancer: In patients with deleterious germline BRCA-mutated metastatic pancreatic adenocarcinoma who have received ≥16 weeks of platinum-based chemotherapy without disease progression.

• Prostate Cancer: For deleterious or suspected deleterious germline or somatic BRCA-mutated metastatic castration-resistant prostate cancer (mCRPC) following prior therapy.

Olaparib is a poly (ADP-ribose) polymerase (PARP) inhibitor.

• Inhibits PARP-1 and PARP-2, enzymes vital for DNA single-strand break repair.

• Leads to accumulation of DNA damage and double-strand breaks.

• Causes cancer cell death, especially in tumors with BRCA1/2 mutations or homologous recombination deficiency (HRD).

• Standard dose: 300 mg orally twice daily (total 600 mg/day).

• Typically administered as two 150 mg tablets twice daily.

• Tablets should be swallowed whole, not crushed or chewed.

• May be taken with or without food.

• Continue treatment until disease progression or unacceptable toxicity.

• Dose adjustments: May be required for hematologic toxicity, renal impairment, or drug interactions.

• Supplied in blister packs.

• Pack size: 56 tablets (150 mg each).

• Store at 20°C–25°C (room temperature).

• Protect from moisture and light.

• Keep container tightly closed.

• Keep out of reach of children.

• Hematologic Toxicity: Anemia, neutropenia, thrombocytopenia common; CBC monitoring required monthly.

• MDS/AML Risk: Rare but serious cases of myelodysplastic syndrome and acute myeloid leukemia reported.

• Pulmonary Toxicity: Rare cases of pneumonitis; discontinue if confirmed.

• Renal Impairment: Dose modification needed in moderate impairment; avoid in severe renal dysfunction.

• Drug Interactions: Olaparib is metabolized by CYP3A; avoid strong CYP3A inhibitors/inducers. Avoid grapefruit and Seville oranges.

• Pregnancy & Lactation: Contraindicated; may cause fetal harm. Breastfeeding should be avoided.

• Contraception: Effective contraception during and after therapy (6 months for women, 3 months for men).

• Elderly Use: No major differences noted, but monitor carefully.

• Brand Name: Afanat 40

• Manufacture: Natco Pharma Ltd.

• Generic Name: Afatinib

• Strength: 40 mg

• Dosage Form: Film-coated Tablet

• Therapeutic Class: Antineoplastic agent, Tyrosine Kinase Inhibitor (TKI)

• First-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) harboring EGFR (epidermal growth factor receptor) mutations.

• Treatment of patients with metastatic, squamous NSCLC progressing after platinum-based chemotherapy.

Afatinib is an irreversible ErbB family blocker. It covalently binds to and irreversibly inhibits the tyrosine kinase activity of EGFR (ErbB1), HER2 (ErbB2), and HER4, leading to inhibition of downstream signaling pathways, suppression of tumor cell proliferation, and induction of apoptosis.

• Recommended Dose: 40 mg orally once daily.

• Take at the same time each day, at least 1 hour before or 2 hours after a meal.

• Continue until disease progression or unacceptable toxicity.

• Dose adjustment may be required for adverse reactions (diarrhea, skin reactions, liver function changes).

• Available in blister packs.

• Pack size: Bottle/Blister of 30 tablets (40 mg each).

• Store below 30°C.

• Keep in a dry place, protected from light and moisture.

• Keep out of reach of children.

• Diarrhea: May be severe; requires prompt management with anti-diarrheal agents and dose adjustment.

• Skin Reactions: Rash, acneiform eruptions, paronychia may occur; monitor and manage accordingly.

• Interstitial Lung Disease (ILD): Rare but potentially fatal; discontinue if ILD is suspected.

• Hepatic Impairment: Use with caution; monitor liver function.

• Cardiac Risk: Monitor in patients with left ventricular dysfunction.

• Pregnancy & Lactation: May cause fetal harm; avoid use during pregnancy and breastfeeding.

• Drug Interactions: Avoid strong P-gp inhibitors/inducers unless necessary; may alter Afatinib levels.

• Elderly Patients: Higher frequency of adverse events; dose adjustments may be needed.

• Brand Name: Afanat

• Generic Name: Afatinib

• Strength: 30 mg per tablet

• Dosage Form: Oral tablet

• Therapeutic Class: Tyrosine Kinase Inhibitor (TKI) / Targeted Anticancer Agent

• First-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) with:

  • EGFR exon 19 deletions or exon 21 (L858R) substitution mutations

• Also indicated for:

  • Squamous cell carcinoma of the lung progressing after platinum-based chemotherapy (in select cases)

• Irreversibly inhibits the ErbB family of tyrosine kinases, including:

  • EGFR (HER1)

  • HER2

  • HER4

• Blocks signaling pathways that promote tumor growth and survival

• Standard starting dose: 30 mg once daily, adjusted based on tolerance and patient response

• Should be taken at least 1 hour before or 2 hours after food

• Swallow tablets whole with water — do not crush or chew

• Supplied in blister packs, usually in strips of 7 or 10 tablets (depending on the manufacturer)

• Store below 30°C

• Keep away from moisture, heat, and direct sunlight

• Prescription-only (Rx) — use under oncologist supervision

• Common side effects: diarrhea, rash, stomatitis, dry skin, paronychia

• Monitor for pulmonary toxicity, hepatic function, and ocular disorders

• Not recommended during pregnancy or breastfeeding

• Brand Name: Afanat 20

• Manufacture: Natco Pharma Ltd.

• Generic Name: Afatinib

• Strength: 20 mg

• Dosage Form: Film-coated Tablet

• Therapeutic Class: Antineoplastic agent, Tyrosine Kinase Inhibitor (TKI)

• First-line treatment of metastatic NSCLC (non-small cell lung cancer) with EGFR mutation-positive tumors.

• Treatment of patients with squamous NSCLC progressing after platinum-based chemotherapy.

• The 20 mg strength is generally prescribed when dose reduction is required due to intolerance or toxicity at higher doses (40 mg or 30 mg).

Afatinib is an irreversible blocker of the ErbB family of receptors. It covalently binds to and inhibits EGFR (ErbB1), HER2 (ErbB2), and HER4 tyrosine kinase activity. This leads to inhibition of tumor growth, reduced cellular proliferation, and induction of programmed cell death.

• Initial recommended dose: 40 mg once daily.

• Afanat 20 is typically used when patients require further dose reductions (after 30 mg) due to adverse effects.

• Take orally once daily, at least 1 hour before or 2 hours after meals, at the same time every day.

• Treatment is continued until disease progression or unacceptable toxicity occurs.

• Available in blister packs.

• Pack size: Bottle/Blister of 30 tablets (20 mg each).

• Store below 30°C, in a cool and dry place.

• Protect from light and moisture.

• Keep out of reach of children.

• Diarrhea: Very common; may be severe. Early intervention with antidiarrheal agents is required.

• Skin Toxicity: Rash, acneiform lesions, and paronychia may occur; dose adjustment may be necessary.

• Pulmonary Toxicity: Risk of interstitial lung disease (ILD); discontinue immediately if suspected.

• Hepatic Impairment: Use with caution; monitor liver enzymes regularly.

• Cardiac Risk: Monitor patients with pre-existing left ventricular dysfunction.

• Pregnancy & Lactation: Contraindicated; can cause fetal harm. Breastfeeding should be avoided.

• Drug Interactions: Concomitant use with strong P-gp inhibitors/inducers can alter Afatinib exposure.

• Elderly Population: Higher risk of toxicity; monitor closely.

Rebopag 75 mg Tablet contains Eltrombopag, a thrombopoietin receptor agonist that boosts platelet production in patients with chronic immune thrombocytopenia (ITP) or aplastic anemia. It helps reduce bleeding risk, improve platelet counts, and support better blood cell recovery and overall treatment outcomes.

Rebopag 50 mg Tablet contains Eltrombopag, a thrombopoietin receptor agonist used to treat low platelet counts in chronic immune thrombocytopenia (ITP) and aplastic anemia. It works by stimulating platelet production in the bone marrow, reducing bleeding risk and improving blood cell levels.

About the product:

• Brand Name: REGONAT
• Generic Name: Regorafenib
• Strength: 40 mg
• Dosage Form: Tablet
• Therapeutic Class: Multikinase Inhibitor / Anticancer.

Indications:

• Metastatic colorectal cancer (mCRC)
• Gastrointestinal stromal tumor (GIST)
• Hepatocellular carcinoma (HCC)

Mechanism of Action:

• Inhibits multiple protein kinases involved in tumor angiogenesis, oncogenesis, and tumor microenvironment.

Dosage & Administration:

• Usual dose: 160 mg (4 tablets) once daily for 21 days of a 28-day cycle.
• To be taken after a low-fat meal.
• Dose adjustment as per tolerance.

Packaging:

• Bottle of 28 tablets

Storage Instructions:

• Store below 25°C
• Keep in original container, tightly closed
• Protect from moisture

Precautions:

• Use under medical supervision only
• Monitor liver function
• Avoid during pregnancy & breastfeeding
• May cause hand-foot skin reaction, hypertension, fatigue

About the product:

• Contains 250 mg lapatinib, a dual EGFR/HER2 tyrosine kinase inhibitor used for HER2-positive advanced or metastatic breast cancer

• Taken orally once daily on an empty stomach — at least 1 hour before or after meals

• Often used in combination with capecitabine or letrozole depending on treatment protocol

• Mechanism: inhibits EGFR and HER2 signaling pathways to slow tumor growth and reduce angiogenesis

• Common side effects: diarrhea, rash, fatigue, nausea, vomiting, hand–foot syndrome, mouth sores, headache, breathlessness, and nail changes

• Serious risks: liver toxicity, QT interval prolongation (heart rhythm disturbances), reduced heart function, interstitial lung disease, and severe skin reactions such as Stevens–Johnson syndrome

• Requires regular monitoring:

  • Liver function tests before and every 4–6 weeks

  • ECG and electrolyte levels (potassium, magnesium) at baseline and periodically

  • Left ventricular ejection fraction (LVEF), and watch for signs of pulmonary or skin toxicity

• Drug interactions: avoid grapefruit juice and QT-prolonging medications; use caution with CYP3A4 inhibitors or inducers

• Not recommended during pregnancy or breastfeeding — effective contraception must be used during treatment and for at least 1 week after stopping

• May cause dizziness or fatigue — avoid driving or operating machinery until effects are known

• Administration tips: swallow tablets whole, take at the same time daily; if a dose is missed, skip it — do not double up

• Store at room temperature (15–30 °C) in a dry, cool place away from light and moisture

• Brand Name: Cazanat 60

• Manufacture: Natco Pharma Ltd.

• Generic Name: Cabozantinib

• Strength: 60 mg

• Dosage Form: Tablet

• Therapeutic Class: Antineoplastic Agent, Tyrosine Kinase Inhibitor (TKI)

• Renal Cell Carcinoma (RCC): Treatment of advanced RCC in adults, either as monotherapy or in patients previously treated with other systemic therapy.

• Hepatocellular Carcinoma (HCC): For adult patients previously treated with sorafenib.

• Differentiated Thyroid Carcinoma (DTC): For adults and adolescents ≥12 years with locally advanced or metastatic DTC refractory to radioactive iodine therapy.

• Other cancers (investigational/limited use): RET-driven tumors, colorectal cancer, prostate cancer, etc.

Cabozantinib is a multi-kinase inhibitor.

• Blocks the activity of VEGFR, MET, AXL, RET, KIT, ROS1, FLT3.

• Inhibits angiogenesis, tumor proliferation, and metastatic spread.

• Targets resistance pathways, making it effective in aggressive and treatment-resistant cancers.

• RCC (monotherapy): 60 mg orally once daily (standard full dose).

• RCC (with nivolumab): 40 mg once daily.

• HCC: 60 mg once daily.

• DTC: 60 mg once daily.

• Cazanat 60 is the full-dose strength commonly used in monotherapy across multiple cancer types.

• Take on an empty stomach (≥1 hour before or ≥2 hours after meals).

• Swallow tablets whole; do not chew or crush.

• Continue until disease progression or unacceptable toxicity.

• Dose reductions: May be required in case of toxicity, hepatic/renal impairment, or drug interactions.

• Supplied in bottle packs.

• Pack size: 30 tablets (60 mg each).

• Store at 20°C–25°C.

• Keep container tightly closed and protect from light/moisture.

• Keep out of reach of children.

• Hypertension: Frequent; monitor and control before/during therapy.

• Bleeding Risk: Serious hemorrhage may occur; avoid in patients with recent bleeding.

• Thromboembolic Events: Risk of arterial and venous thrombosis.

• GI Toxicity: Includes diarrhea, nausea, stomatitis, and risk of fistula or perforation.

• Wound Healing Issues: Discontinue prior to major surgery; restart only after adequate recovery.

• Hepatic Impairment: Dose reduction in moderate impairment; avoid in severe impairment.

• Renal Impairment: Limited data; caution in moderate/severe dysfunction.

• Drug Interactions: CYP3A4 substrate – avoid strong inhibitors/inducers and grapefruit products.

• Pregnancy & Lactation: Contraindicated due to risk of fetal harm. Breastfeeding not recommended.

• Pediatric Use: Approved for ≥12 years with DTC; safety not established below 12 years.

• Brand Name: Cazanat 40

• Manufacture: Natco Pharma Ltd.

• Generic Name: Cabozantinib

• Strength: 40 mg

• Dosage Form: Tablet

• Therapeutic Class: Antineoplastic Agent, Tyrosine Kinase Inhibitor (TKI)

• Renal Cell Carcinoma (RCC): Advanced RCC as monotherapy or in combination with nivolumab.

• Hepatocellular Carcinoma (HCC): For patients previously treated with sorafenib.

• Differentiated Thyroid Carcinoma (DTC): Adults and adolescents ≥12 years with locally advanced or metastatic DTC refractory to radioactive iodine.

• Other cancers (under evaluation/limited use): RET fusion-positive tumors, metastatic colorectal cancers, etc.

Cabozantinib is a multi-targeted tyrosine kinase inhibitor.

• Inhibits VEGFR, MET, AXL, RET, ROS1, FLT3, KIT.

• Blocks angiogenesis and tumor cell proliferation.

• Reduces metastasis potential by targeting tumor microenvironment.

• Effective in overcoming resistance pathways in solid tumors.

• RCC (monotherapy): 60 mg orally once daily.

• RCC (with nivolumab): 40 mg orally once daily (standard combination dose).

• HCC: 60 mg once daily.

• DTC: 60 mg once daily.

• Cazanat 40 is the standard strength for RCC in combination therapy and also used for dose modification in other settings.

• Take on an empty stomach (≥1 hour before or ≥2 hours after food).

• Swallow tablets whole, do not crush or chew.

• Continue until disease progression or unacceptable toxicity.

• Supplied in bottle packs.

• Pack size: 30 tablets (40 mg each).

• Store at 20°C–25°C.

• Protect from moisture and direct light.

• Keep container tightly closed.

• Keep out of reach of children.

• Hypertension: Monitor and manage prior to and during treatment.

• Bleeding Risk: Higher incidence of hemorrhage; caution in patients with bleeding history.

• Thromboembolism: May cause venous/arterial events; discontinue if severe.

• GI Toxicities: Risk of diarrhea, nausea, mucositis, perforation, and fistulas.

• Wound Healing: Interrupt therapy before surgery; resume only after adequate recovery.

• Hepatic Impairment: Dose adjustment in moderate impairment; avoid in severe impairment.

• Renal Impairment: Use caution in moderate/severe renal dysfunction.

• Drug Interactions: CYP3A4 substrate – avoid strong inducers/inhibitors and grapefruit products.

• Pregnancy & Lactation: Contraindicated; may cause fetal harm. Avoid breastfeeding.

• Pediatric Use: Approved in ≥12 years with DTC; not recommended in younger children.

• Brand Name: Cazanat 20

• Manufacture: Natco Pharma Ltd.

• Generic Name: Cabozantinib

• Strength: 20 mg

• Dosage Form: Tablet

• Therapeutic Class: Antineoplastic Agent, Tyrosine Kinase Inhibitor (TKI)

• Renal Cell Carcinoma (RCC): Advanced RCC in adults as monotherapy or in combination with nivolumab.

• Hepatocellular Carcinoma (HCC): For patients previously treated with sorafenib.

• Differentiated Thyroid Carcinoma (DTC): For adults and adolescents ≥12 years with locally advanced or metastatic DTC refractory to radioactive iodine therapy.

• Other solid tumors (under investigation/limited use): Metastatic colorectal cancer with RET fusions, etc.

Cabozantinib is a multi-kinase inhibitor.

• Inhibits tyrosine kinases including VEGFR, MET, AXL, RET, ROS1, KIT, FLT3.

• Suppresses tumor growth, angiogenesis, metastasis, and drug resistance.

• Reduces tumor cell proliferation and survival by targeting multiple oncogenic pathways.

• RCC (monotherapy): 60 mg orally once daily.

• RCC (in combination with nivolumab): 40 mg orally once daily.

• HCC: 60 mg orally once daily.

• DTC: 60 mg orally once daily.

• Cazanat 20 is used for dose modification/adjustment in cases of adverse events, intolerance, or special populations (elderly, renal/hepatic impairment).

• Take on an empty stomach (1 hour before or 2 hours after food).

• Tablets should be swallowed whole, not crushed or chewed.

• Continue until disease progression or unacceptable toxicity.

• Supplied in bottle packs.

• Pack size: 30 tablets (20 mg each).

• Store at 20°C–25°C (room temperature).

• Keep container tightly closed and protect from moisture.

• Keep out of reach of children.

• Hypertension: Monitor blood pressure regularly; manage before and during treatment.

• Hemorrhage Risk: Increased bleeding tendency; caution in patients with bleeding disorders.

• Thromboembolic Events: Risk of venous and arterial thromboembolism.

• Gastrointestinal Perforation/Fistulas: Rare but serious; discontinue if suspected.

• Wound Healing Complications: Withhold prior to major surgery; resume only after adequate wound healing.

• Hepatic Impairment: Dose reduction required in moderate impairment; avoid in severe impairment.

• Renal Impairment: Use caution in moderate to severe renal dysfunction.

• Drug Interactions: Substrate of CYP3A4; avoid strong inhibitors/inducers. Grapefruit should be avoided.

• Pregnancy & Lactation: Contraindicated; may cause fetal harm. Breastfeeding not recommended.

• Pediatric Use: Approved for ≥12 years with DTC; safety in younger children not established.

Caludec Bicalutamide 50mg Tablet is an anti-androgen medicine used in the treatment of prostate cancer. It works by blocking the action of male hormones, slowing cancer cell growth and spread. Taken orally, it is usually prescribed with other therapies for effective cancer management.

XTANE 25 contains Exemestane, an aromatase inhibitor used in the treatment of hormone receptor–positive breast cancer in postmenopausal women. It works by lowering estrogen levels, slowing the growth of hormone-dependent tumors. Commonly prescribed after other endocrine therapies, this oral tablet should be taken under strict medical supervision with regular monitoring for safe and effective results.

PAZONAT 400 contains Pazopanib, an oral tyrosine kinase inhibitor used for the treatment of advanced renal cell carcinoma and soft tissue sarcoma. It works by blocking vascular endothelial growth factor receptors (VEGFR) and other kinases involved in tumor growth and angiogenesis, thereby slowing disease progression. Therapy should be taken strictly under medical supervision with regular monitoring for safety and efficacy.