Uses of Intasmerex

Intasmerex belongs to the group of anti-cancer drugs and affects the immune system, used to treat cancer and autoimmune diseases. Below is detailed information about Intasmerex medicine what is the use and note when using.

Intasmerex drug is prepared in the form of an injection solution, with the main ingredient being Methotrexate 100mg/ml. Methotrexate has anti-cancer effects, resistant to folic acid - an important substance in nucleic acid synthesis. A competitive inhibitor of the enzyme dihydrofolate reductase, which catalyzes the conversion of folic acid to tetrahydrofolate. This phenomenon affects the synthesis of thymidilic acid and purines, thereby inhibiting DNA synthesis and cell reproduction, and to a lesser extent protein and RNA synthesis. Methotrexate has a specific effect on the cell cycle on the S phase. Cells with strong proliferation rates such as cancerous tissue, bone marrow, embryonic cells, epithelial cells are the most sensitive. Therefore, Methotrexate is also used in the treatment of psoriasis because the reproduction rate of skin epithelial cells is much stronger than that of normal cells.

Methotrexate has a broad spectrum of anticancer activity and can be used alone or in combination with other drugs during treatment. The drug can be indicated in the following cases:
Used alone in the treatment of cancer diseases such as: breast cancer, choroidal adenoma, choroidal epithelium, oocyte. Used in combination in the treatment of acute leukemia (acute myelogenous leukemia or lymphoma), Burkitt lymphoma, late stage lymphoma (stage III, IV, according to the Peter system) and late stage of mycosis fungoides. In case of meningeal metastases, intracortical injection can be used (only isotonic preparations are used). Methotrexate can be used in high doses alone or in combination with other drugs to treat the following cases: Acute leukemia, osteosarcoma, bronchial carcinoma, head and neck carcinoma. When taking high doses, it is always necessary to combine with Leucovorin (folinic acid) - a derivative of tetrahydrofolate, which competes with Methotrexate to enter cells, helping to protect normal tissue cells against cell killing effects. cells of high-dose methotrexate. Psoriasis chemotherapy: Drugs are used to treat severe psoriasis, difficult to treat, causing disabling complications, not responding to conventional drugs. However, because methotrexate has many risks, it should be used only when the diagnosis has been confirmed by biopsy and/or skin examination. Do not use Intasmerex in the following cases:
Hypersensitivity to Methotrexate. People with a history of impaired liver and kidney function, hematopoietic disorders, bone marrow failure (leukopenia, thrombocytopenia, anemia). Malnourished people. Pregnant.

Dosage and drug regimen depend on each case:
Drugs for injection: Intramuscular, intravenous or intracortical injection. Methotrexate 1000mg/10ml should not be injected intracortically because the solution is hypertonic. Choroidal carcinoma and similar trophoblastic diseases: The usual dose is 15-30 mg intramuscularly/day for 5 days. Usually 3 to 5 treatments are needed. However, before the next course of treatment, wait until the symptoms of toxicity disappear, which usually takes at least 1 week or more. Treatment effect was assessed by quantitative urine HCG test in 24 hours, HCG should return to normal or < 50 IU/24 hours after 3 or 4 courses of treatment. After the HCG test returns to normal, treatment should be continued for 1-2 more sessions. Careful assessment of the clinical condition should be made prior to initiating each course of treatment. Methotrexate can be combined with other antineoplastic agents cyclically. Breast cancer: The long-term combination of methotrexate with fluorouracil and cyclophosphamide has shown positive results when used as an adjunct to radical mastectomy in the treatment of primary breast cancer with lymph node metastases. The dose of methotrexate is 40mg/m2 intravenously on days 1 and 8. Leukemia: Cyclic combination Methotrexate with corticosteroids and other anti-leukemic drugs, for high efficiency, rapid remission. Dosage is 3.3mg/m2 plus prednisone 60mg/m2 daily. When the disease has resolved, a maintenance dose of 30mg/m2 orally or intramuscularly, twice a week, or 2.5mg/kg IV every 14 days can be used as a maintenance dose. If the disease recurs, the course of treatment can be repeated. Acute granulomatous leukemia is less responsive to chemotherapy, is in remission for a short time, often relapses, and develops drug resistance rapidly. Fungal warts: Intramuscular Methotrexate 50mg/week or 25mg x 2 times/week. Psoriasis chemotherapy: Dosage varies depending on the nature and severity of the disease. Patients must be fully informed of the risks and closely monitored throughout treatment. Severe psoriasis that is not controlled by conventional medications may respond to methotrexate 10-25 mg once a week by intramuscular or intravenous injection, titrated according to therapeutic response, up to a maximum of 50 mg/week. After achieving a therapeutic response, the minimum effective dose should be reduced with as long a break as possible. Assess liver, kidney and hematological factors before, during and after treatment with Methotrexate. Appropriate contraception should be used during and for at least 8 weeks following treatment with Methotrexate. Precautions when mixing Intasmerex:
As with other anticancer drugs, operators should be trained before injecting the drug. Wear protective clothing when preparing medication and do so in an appropriate location (preferably in a laminar drainage safety chamber). When the drug gets on the skin and mucous membranes, wash hands immediately with soap and water thoroughly. It is recommended to use Luer-Lock syringe, wide-barreled needle for dispensing to reduce pressure and aerosol formation, can also limit aerosol generation by using a vented needle. Instruments used in drug preparation and waste products must be placed in double-sealed polythene bags and incinerated at 1100°C. How to handle spillage:
If spilled, limit travel to spilled area, wear gloves (Latex), gown, respirator and eye protection. Limit spillage by covering with absorbent materials such as paper or sawdust or possibly treating with 5% sodium hypochlorite. Remove contaminated items from spilled medication into a non-perforated plastic container and label it. Cytotoxic waste must be considered hazardous and clearly marked "Cytotoxic waste for incineration at 1100°C". This hazardous waste must be incinerated at 1100°C for at least 1 second. Rinse the remaining area with water several times.

When using Intasmerex, some unwanted effects may occur:
Bone marrow suppression: Anemia, leukopenia, thrombocytopenia, hypogammaglobulinemia, hemorrhage, sepsis. These side effects are dose and regimen dependent. Itching, urticaria, erythema on the skin, hypersensitivity to pigment, hematoma, vasodilatation, boils. Psoriasis lesions may be aggravated by simultaneous UV exposure. Hair loss may occur, but is usually reversible. Gingivitis, stomatitis, nausea, vomiting, hematemesis, anorexia, diarrhea, inflammation of the small intestine, ulceration and gastrointestinal bleeding, hepatotoxicity due to acute liver atrophy, necrosis, periportal fibrosis or Cirrhosis. Renal failure, hypernatremia, hematuria, cystitis, ovulatory or spermatogenic defects, menstrual disorders, miscarriage, infertility, embryo malformations. Headache, lethargy, blurred vision, aphasia, convulsions, unilateral paresis, Guillain-Barré syndrome, increased cerebrospinal fluid pressure after intracortical injection. Pneumonia, diabetes, osteoporosis, abnormal cell changes or even sudden death have been reported. When using Intasmerex, if the patient experiences any serious side effects, stop taking the drug and immediately contact the treating doctor or go to a medical facility for timely treatment.

When using Intasmerex at the same time can interact with some of the following drugs:
Do not combine methotrexate with non-steroidal anti-inflammatory drugs (NSAIDs) (Azapropazon, Ibuprofen, Ketoprofen, Ketorolac, Naproxen, Diclofenac, Indomethacin, Probenecid, derivatives, etc.) salicylates). Absorption may be altered when the following drugs are co-administered: Methylprednisolone, Hydrocortisone succinate, Asparaginase, Bleomycin, Cephalothin, Penicillin, Kanamycin, Vincristine and Vinblastine.

When using Intasmerex, caution should be exercised in the following cases:
There have been cases of death due to Methotrexate treatment of psoriasis. Methotrexate should only be used in cases of severe psoriasis, difficult to treat, causing disabling complications, not responding to conventional treatment and with a confirmed diagnosis. Methotrexate use can also cause lung toxicity (pneumonia, pulmonary fibrosis), severe and potentially fatal, which can happen with any dose, even doses as low as 7.5mg/week . This possibility should therefore be considered in any patient with pulmonary manifestations during administration (dry cough, dyspnea). If these symptoms are present, the drug should be discontinued and careful clinical evaluation, including exclusion of the cause of the infection. Treatment of methotrexate pulmonary toxicity is primarily supportive and ventilatory, which may not be fully reversible. Methotrexate may cause bone marrow suppression (bone marrow depression, anemia, leukopenia/thrombocytopenia) even at recommended doses. The patient's hematological status must be assessed before and during treatment. Any cytopenias requires discontinuation of the drug and appropriate treatment. Methotrexate should be used with caution in patients with a history of marrow aplasia, anemia, leukopenia or thrombocytopenia. If your white blood cell count is low, you may be susceptible to infection and require appropriate antibiotic treatment. If you have severe myelosuppression, a blood transfusion or platelet transfusion may be needed. Use in people with kidney damage may cause drug accumulation, consequent toxicity. The patient's renal function must be assessed before and during treatment. If lesions occur, the drug should be discontinued or the dose reduced. Avoid co-administration with other nephrotoxic drugs. Liver function should be assessed before and during treatment with methotrexate, as the drug can cause hepatotoxicity with high doses and prolonged use. Particular caution should be exercised in people with a history of liver dysfunction. Avoid co-administration with other hepatotoxic drugs. Methotrexate should only be used under the supervision of a specialist and when the potential benefits outweigh the risks. Patients must be informed of the potential for toxicity or death of methotrexate and must be carefully examined to detect undesirable effects as soon as possible. Adequate facilities should be prepared for the treatment of drug-induced complications when necessary. Particular caution should be exercised when methotrexate is used in patients with peptic ulcer disease, ulcerative colitis, infection, asthenia, children, or the elderly. In all cases, when considering methotrexate for treatment, the risk/benefit ratio must be considered. If detected in time, the harmful effects of the drug can be reversed, then reduce the dose or stop the drug and apply appropriate treatment measures. Always use in combination with Leucovorin when using high doses of Methotrexate, but only under the direction of a specialist doctor and in a medical facility with all necessary equipment. High doses of methotrexate should not be used in patients with impaired renal function, ascites or pleural effusion. Do not use in pregnant women because Methotrexate has the potential to be embryotoxic and mutagenic. The drug should only be used in women of childbearing potential if the benefits outweigh the risks and appropriate contraception is used. If pregnancy occurs while taking the drug, the patient must be informed of the possible risk to the fetus. Breast-feeding: It is not known whether the drug is excreted in human milk, therefore breast-feeding should be discontinued while taking this medicine. Above is the complete information about Intasmerex drug. Note, Intasmerex is a prescription drug, made under the infusion technique from medical staff, the patient needs to use the drug as prescribed by the doctor, absolutely do not change the dose or other route of administration.