Sri Jayalakshmi Pharma Distributors

My360 is an enteric formulation of Mycophenolate sodium that delivers the active moiety Mycophenolic acid (MPA). My360 is an immunosuppressant agent. MPA is chemically designated as(E)-6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoic acid sodium salt. Its empirical formula is C17H19O6 Na and molecular weight is 342.32.

Composition:

Each film-coated tablet contains enteric coated Mycophenolate Sodium 360 mg.

Mode of Action
The mechanism of action of MPA is based on interference with purine synthesis. It is a reversible, noncompetitive inhibitor of inosine monophosphate dehydrogenase (IMPDH), which is an enzyme that facilitates the conversion of inosine monophosphate (IMP) to xanthosine monophosphate, a precursor of guanine nucleotides. This blocks the de novo synthesis of guanosine nucleotides that are necessary substrates for DNA and RNA synthesis. Unlike other cell types which can use the salvage pathways, B and T lymphocytes are dependent upon the de novo pathway for the generation of guanosine. My360 is designed to reduce the adverse GI events of MPA (in particular nausea, vomiting, dyspepsia and abdominal pain).

Pharmacokinetics:
Absorption

My360 is extensively absorbed from the GI tract. The protein binding of Mycophenolic acid glucuronide (MPAG) is 82%. The free MPA concentration may increase under conditions of decreased protein binding (uremia, hepatic failure and hypoalbuminemia). Vitro studies demonstrated that the enteric-coated My360 tablet does not release MPA under acidic conditions (pH <5) as in the stomach, but is highly soluble in neutral pH conditions as in the intestine.

Distribution

Mycophenolic acid is 97% bound to plasma proteins. The mean (± SD) volume of distribution at steady state and elimination phase for MPA is 54 (± 25) L and 112 (± 48) L respectively. MPA is highly protein bound to albumin >98%. The protein binding of Mycophenolic acid glucuronide (MPAG) is 82%. The free MPA concentration may increase under conditions of decreased protein binding (uremia, hepatic failure, and hypoalbuminemia).

Metabolism

Mycophenolate is converted to active MPA, which undergoes enterohepatic recirculation. MPA is metabolised by glucuronidation to the inactive glucuronide.

Excretion

Via urine (as the glucuronide and negligible amounts of MPA); via faeces (about 6% of a dose). Mean half-life of MPA: 17.9 hours (as oral Mycophenolate mofetil) and 16.6 hours (as IV Mycophenolate mofetil); 12 hours (as Mycophenolate sodium).

Indication

Mycophenolate Sodium is indicated for the prophylaxis of organ rejection in patients receiving allogenic renal transplants, administered in combination with Cyclosporine and corticosteroids.

Contraindication

My360 is contraindicated in patients with a hypersensitivity to Mycophenolic acid, Mycophenolate mofetil (MMF) or to any of its excipients.

Precautions

Monitoring: Perform complete blood counts weekly during first month of treatment, twice monthly for second and third months, then monthly throughout the first year.

GI hemorrhage: Since Mycophenolate has been associated with an increased incidence of GI adverse events, including infrequent cases of GI tract ulceration, hemorrhage and perforation.

Delayed renal graft function post transplant: No dose adjustment is recommended for these patients.

• Prevention of organ rejection in transplant patients

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Headache
• High blood pressure
• Decreased white blood cell count (neutrophils)
• Bacterial infection

The amount of Mycofit 500 Tablet you take and how often you take it depends on the type of transplant you have. Follow your doctor’s instructions on this. Take it on an empty stomach, at least 1 hour before or 2 hours after a meal, unless your doctor suggest otherwise. Swallow it as a whole, do not crush, chew, or break it. Take the medicine regularly to get maximum benefit and keep taking it even when you feel well. The treatment will continue for as long as you need it to prevent rejection. 

The most common side effects of this medicine include nausea, vomiting, diarrhea, stomach pain, headache, high blood pressure, infections (viral, fungal, bacterial), and changes in the number of white blood cells amongst others. You may catch more infections than usual as medicine suppresses the immune system. There is also an increased risk of developing some cancers for this reason. To reduce your risk of skin cancer, limit your exposure to the sun and use sunscreen. There is a long list of potential side effects of this medicine. You should ask your doctor about them and what signs to look out for because some of them can be serious and need urgent medical attention.

Mycofit 500 Tablet can cause birth defects and abortion so do not take it if you are pregnant, planning to become pregnant, or breastfeeding. You should talk to your doctor before taking this medicine if you have any signs of infection or if you have any unexpected bruising or bleeding. You should also let your healthcare team know all other medicines you are taking as they may affect, or be affected by, this medicine. You will have regular tests to check for any changes in the number of your blood cells and the amount of sugar and cholesterol in your blood.

• Prevention of organ rejection in transplant patients

• Bacterial infection
• Fungal infection
• Viral infection
• Anemia (low number of red blood cells)
• Decreased white blood cell count (lymphocytes)
• Increased glucose level in blood
• Increased potassium level in blood

Clexane 40mg Injection is used to prevent or treat blood clots caused by medical conditions, such as unstable angina, after an operation or long periods of bed rest due to illness, after a heart attack, and the formation of blood clots in the dialysis machine

Viraday Tablet restricts the growth of HIV in the body and reduces the risk of getting HIV-related complications to improve the lifespan of an individual. The medicine should be taken in an empty stomach for better efficacy. Taking these medicines regularly at the same time increases their effectiveness. A dose of this medicine should not be missed as it can affect your recovery. It is important to complete the full course of the treatment until your doctor advises you to stop it.

Common side effects of this medicine include nausea, vomiting, diarrhea, flatulence, trouble sleeping, headache, rash, sinusitis. These are usually not serious, however, inform your doctor if they bother you or do not go away. This medicine can also make you feel dizzy or drowsy, so it is advised to avoid driving. In addition to that, avoid alcohol consumption as it may increase the intensity of the side effects. While on the treatment, generally, some people may experience bone pain. To cope up with this you can take calcium and vitamin D supplements as per your doctor’s advice. Birth control pills are ineffective with this medicine, therefore other reliable birth controls should be used.

Before starting with the treatment, you should consult your doctor if you are pregnant or breastfeeding, or have any kidney, liver, or bone disease. Your doctor may suggest regular blood tests to check your blood counts, liver function, and kidney function. If you are HIV positive, you should not breastfeed or share personal belongings like razors or toothbrushes. Consult your doctor to know about safe sex methods in order to prevent transmission of HIV during intercourse.

• HIV infection

Renostead Tablet is taken with or without food in a dose and duration as advised by the doctor. The dose you are given will depend on your condition and how you respond to the medicine. You should keep taking this medicine for as long as your doctor recommends. If you stop treatment too early your symptoms may come back and your condition may worsen. Let your doctor know about all other medications you are taking as some may affect, or be affected by this medicine.

The most common side effects are nausea, vomiting, fever, runny nose, diarrhea, abdominal pain, skin irritation and rashes, and throat irritation. These are temporary and usually resolve with time. Contact your doctor straight away if you are at all concerned about any of these side effects.

Before taking it, you should tell your doctor if you have any kidney or liver diseases. Let your doctor also know about all the other medicines you are taking. Pregnant and breastfeeding women should consult their doctors before taking this medicine.

• Treatment of Chronic kidney disease

Viropil Tablet belongs to a group of antiretroviral medicines indicated for the treatment of HIV-1 infection in adults and children weighing at least 35kgs. Dolutegravir is an integrase inhibitor that increases the immune cells that help fight infections in the body and decreases the amount of HIV in the blood.

• Helps support healthy phosphorous levels

• Useful for managing iron deficiency 

• Improves iron levels

• Helps relieve fatigue