Investigation of Biopharmaceutical and Physicochemical Drug
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CASODEX (Bicalutamide)
HIGHLIGHTS OF PRESCRIBING INFORMATION • Gynecomastia and breast pain have been reported during treatment with These highlights do not include all the information needed to use CASODEX 150 mg when used as a single agent. (5.3) CASODEX® safely and effectively. See full prescribing information for • CASODEX is used in combination with an LHRH agonist. LHRH CASODEX. agonists have been shown to cause a reduction in glucose tolerance in CASODEX® (bicalutamide) tablet, for oral use males. Consideration should be given to monitoring blood glucose in Initial U.S. Approval: 1995 patients receiving CASODEX in combination with LHRH agonists. (5.4) -------------------------- RECENT MAJOR CHANGES -------------------------- • Monitoring Prostate Specific Antigen (PSA) is recommended. Evaluate Warnings and Precautions (5.2) 10/2017 for clinical progression if PSA increases. (5.5) --------------------------- INDICATIONS AND USAGE -------------------------- ------------------------------ ADVERSE REACTIONS ----------------------------- • CASODEX 50 mg is an androgen receptor inhibitor indicated for use in Adverse reactions that occurred in more than 10% of patients receiving combination therapy with a luteinizing hormone-releasing hormone CASODEX plus an LHRH-A were: hot flashes, pain (including general, back, (LHRH) analog for the treatment of Stage D2 metastatic carcinoma of pelvic and abdominal), asthenia, constipation, infection, nausea, peripheral the prostate. (1) edema, dyspnea, diarrhea, hematuria, nocturia, and anemia. (6.1) • CASODEX 150 mg daily is not approved for use alone or with other treatments. (1) To report SUSPECTED ADVERSE REACTIONS, contact AstraZeneca Pharmaceuticals LP at 1-800-236-9933 or FDA at 1-800-FDA-1088 or ---------------------- DOSAGE AND ADMINISTRATION ---------------------- www.fda.gov/medwatch The recommended dose for CASODEX therapy in combination with an LHRH analog is one 50 mg tablet once daily (morning or evening). -
COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone During SARS-Cov-2 Infection
pharmaceuticals Review COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone during SARS-CoV-2 Infection Katarzyna Kotfis 1,* , Kacper Lechowicz 1 , Sylwester Drozd˙ zal˙ 2 , Paulina Nied´zwiedzka-Rystwej 3 , Tomasz K. Wojdacz 4, Ewelina Grywalska 5 , Jowita Biernawska 6, Magda Wi´sniewska 7 and Miłosz Parczewski 8 1 Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; [email protected] 2 Department of Pharmacokinetics and Monitored Therapy, Pomeranian Medical University, 70-111 Szczecin, Poland; [email protected] 3 Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland; [email protected] 4 Independent Clinical Epigenetics Laboratory, Pomeranian Medical University, 71-252 Szczecin, Poland; [email protected] 5 Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland; [email protected] 6 Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland; [email protected] 7 Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; [email protected] 8 Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, 71-455 Szczecin, Poland; [email protected] * Correspondence: katarzyna.kotfi[email protected]; Tel.: +48-91-466-11-44 Abstract: In March 2020, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was declared Citation: Kotfis, K.; Lechowicz, K.; a global pandemic by the World Health Organization (WHO). The clinical course of the disease is Drozd˙ zal,˙ S.; Nied´zwiedzka-Rystwej, unpredictable but may lead to severe acute respiratory infection (SARI) and pneumonia leading to P.; Wojdacz, T.K.; Grywalska, E.; acute respiratory distress syndrome (ARDS). -
Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals
Journal of Clinical Medicine Review Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals Carlotta Cocchetti 1, Jiska Ristori 1, Alessia Romani 1, Mario Maggi 2 and Alessandra Daphne Fisher 1,* 1 Andrology, Women’s Endocrinology and Gender Incongruence Unit, Florence University Hospital, 50139 Florence, Italy; [email protected] (C.C); jiska.ristori@unifi.it (J.R.); [email protected] (A.R.) 2 Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, 50139 Florence, Italy; [email protected]fi.it * Correspondence: fi[email protected] Received: 16 April 2020; Accepted: 18 May 2020; Published: 26 May 2020 Abstract: Introduction: To date no standardized hormonal treatment protocols for non-binary transgender individuals have been described in the literature and there is a lack of data regarding their efficacy and safety. Objectives: To suggest possible treatment strategies for non-binary transgender individuals with non-standardized requests and to emphasize the importance of a personalized clinical approach. Methods: A narrative review of pertinent literature on gender-affirming hormonal treatment in transgender persons was performed using PubMed. Results: New hormonal treatment regimens outside those reported in current guidelines should be considered for non-binary transgender individuals, in order to improve psychological well-being and quality of life. In the present review we suggested the use of hormonal and non-hormonal compounds, which—based on their mechanism of action—could be used in these cases depending on clients’ requests. Conclusion: Requests for an individualized hormonal treatment in non-binary transgender individuals represent a future challenge for professionals managing transgender health care. For each case, clinicians should balance the benefits and risks of a personalized non-standardized treatment, actively involving the person in decisions regarding hormonal treatment. -
Epigenetic Therapy with Panobinostat Combined with Bicalutamide Rechallenge in Castration- Resistant Prostate Cancer Anna C
Published OnlineFirst January 3, 2019; DOI: 10.1158/1078-0432.CCR-18-1589 Clinical Trials: Targeted Therapy Clinical Cancer Research Epigenetic Therapy with Panobinostat Combined with Bicalutamide Rechallenge in Castration- Resistant Prostate Cancer Anna C. Ferrari1, Joshi J. Alumkal2, Mark N. Stein3, Mary-Ellen Taplin4, James Babb5, Ethan S. Barnett6, Alejandro Gomez-Pinillos5, Xiaomei Liu5, Dirk Moore6, Robert DiPaola7, and Tomasz M. Beer2 Abstract Purpose: This study assesses the action of panobino- Results: In the model, panobinostat/bicalutamide demon- stat, a histone deacetylase inhibitor (HDACI), in restor- strated synergistic antitumor effect while reducing AR activity. ing sensitivity to bicalutamide in a castration-resistant The dose-limiting toxicity was not reached. The probabilities of prostate cancer (CRPC) model and the efficacy and safety remaining rPF were 47.5% in the A arm and 38.5% in the B arm, of the panobinostat/bicalutamide combination in CRPC exceeding the protocol-specified threshold of 35%. The A arm patients resistant to second-line antiandrogen therapy but not the B arm exceeded expectations for times (medians) to (2ndLAARx). rP (33.9 and 10 weeks), and from PSA progression to rP (24 and Patients and Methods: The CWR22PC xenograft and 5.9 weeks). A arm/B arm events included: adverse events (AE), isogenic cell line were tested for drug interactions on 62%/19%; treatment stopped for AEs, 27.5%/11.5%; dose tumor cell growth and on the androgen receptor (AR), reduction required, 41%/4%. The principal A-arm grade 3 AR-splice variant7, and AR targets. A phase I trial had a AEs were thrombocytopenia (31%) and fatigue (14%). -
Feminizing Hormone Therapy
FEMINIZING HORMONE THERAPY Julie Thompson, PA-C Medical Director of Trans Health, Fenway Health April 2020 fenwayhealth.org GOALS AND OBJECTIVES 1. Review process of initiating hormone therapy through the informed consent model 2. Provide an overview of feminizing hormone therapy 3. Review realistic expectations and benefits of hormone therapy vs their associated risks 4. Discuss recommendations for monitoring fenwayhealth.org PROTOCOLS AND STANDARDS OF CARE fenwayhealth.org WPATH STANDARDS OF CARE, 2011 The criteria for hormone therapy are as follows: 1. Well-documented, persistent (at least 6mo) gender dysphoria 2. Capacity to make a fully informed decision and to consent for treatment 3. Age of majority in a given country 4. If significant medical or mental health concerns are present, they must be reasonably well controlled fenwayhealth.org INFORMED CONSENT MODEL ▪ Requires healthcare provider to ▪ Effectively communicate benefits, risks and alternatives of treatment to patient ▪ Assess that the patient is able to understand and consent to the treatment ▪ Informed consent model does not preclude mental health care! ▪ Recognizes that prescribing decision ultimately rests with clinical judgment of provider working together with the patient ▪ Recognizes patient autonomy and empowers self-agency ▪ Decreases barriers to medically necessary care fenwayhealth.org INITIAL VISITS ▪ Review history of gender experience and patient’s goals ▪ Document prior hormone use ▪ Assess appropriateness for gender affirming medical treatment ▪ WPATH criteria -
Pizotifen Activates ERK and Provides Neuroprotection in Vitro and in Vivo in Models of Huntington’S Disease
Journal of Huntington’s Disease 1 (2012) 195–210 195 DOI 10.3233/JHD-120033 IOS Press Research Report Pizotifen Activates ERK and Provides Neuroprotection in vitro and in vivo in Models of Huntington’s Disease Melissa R. Sarantos1, Theodora Papanikolaou1, Lisa M. Ellerby∗ and Robert E. Hughes∗ The Buck Institute for Research on Aging, Novato, CA, USA Abstract. Background: Huntington’s disease (HD) is a dominantly inherited neurodegenerative condition characterized by dysfunction in striatal and cortical neurons. There are currently no approved drugs known to slow the progression of HD. Objective: To facilitate the development of therapies for HD, we identified approved drugs that can ameliorate mutant huntingtin- induced toxicity in experimental models of HD. Methods: A chemical screen was performed in a mouse HdhQ111/Q111 striatal cell model of HD. This screen identified a set of structurally related approved drugs (pizotifen, cyproheptadine, and loxapine) that rescued cell death in this model. Pizotifen was subsequently evaluated in the R6/2 HD mouse model. Results: We found that in striatal HdhQ111/Q111 cells, pizotifen treatment caused transient ERK activation and inhibition of ERK activation prevented rescue of cell death in this model. In the R6/2 HD mouse model, treatment with pizotifen activated ERK in the striatum, reduced neurodegeneration and significantly enhanced motor performance. Conclusions: These results suggest that pizotifen and related approved drugs may provide a basis for developing disease modifying therapeutic interventions for HD. Keywords: Huntington’s disease, Drug screening, Pizotifen, ERK Pathway, R6/2 HD mouse model ABBREVIATIONS of mutant huntingtin (Htt) protein containing an expanded polyglutamine tract. -
Minutes of PRAC Meeting on 09-12 July 2018
6 September 2018 EMA/PRAC/576790/2018 Inspections, Human Medicines Pharmacovigilance and Committees Division Pharmacovigilance Risk Assessment Committee (PRAC) Minutes of the meeting on 09-12 July 2018 Chair: June Raine – Vice-Chair: Almath Spooner Health and safety information In accordance with the Agency’s health and safety policy, delegates were briefed on health, safety and emergency information and procedures prior to the start of the meeting. Disclaimers Some of the information contained in the minutes is considered commercially confidential or sensitive and therefore not disclosed. With regard to intended therapeutic indications or procedure scope listed against products, it must be noted that these may not reflect the full wording proposed by applicants and may also change during the course of the review. Additional details on some of these procedures will be published in the PRAC meeting highlights once the procedures are finalised. Of note, the minutes are a working document primarily designed for PRAC members and the work the Committee undertakes. Note on access to documents Some documents mentioned in the minutes cannot be released at present following a request for access to documents within the framework of Regulation (EC) No 1049/2001 as they are subject to on- going procedures for which a final decision has not yet been adopted. They will become public when adopted or considered public according to the principles stated in the Agency policy on access to documents (EMA/127362/2006, Rev. 1). 30 Churchill Place ● Canary Wharf ● London E14 5EU ● United Kingdom Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact An agency of the European Union © European Medicines Agency, 2018. -
Solubility of Bicalutamide, Megestrol Acetate, Prednisolone
Article pubs.acs.org/jced Solubility of Bicalutamide, Megestrol Acetate, Prednisolone, Beclomethasone Dipropionate, and Clarithromycin in Subcritical Water at Different Temperatures from 383.15 to 443.15 K † ⊥ ‡ † ⊥ † † † Yuan Pu, , Fuhong Cai, Dan Wang,*, , Yinhua Li, Xiaoyuan Chen, Amadou G. Maimouna, † † † ⊥ † § Zhengxiang Wu, Xiaofei Wen, Jian-Feng Chen, , and Neil R. Foster , † Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic−Inorganic Composites, Beijing University of Chemical Technology, Beijing 100029, China ‡ College of Mechanical and Electrical Engineering, Hainan University, Haikou 570228, China § Department of Chemical Engineering, Curtin University, Perth, Western Australia 6102, Australia ⊥ Research Center of the Ministry of Education for High Gravity Engineering and Technology, Beijing University of Chemical Technology, Beijing 100029, China ABSTRACT: The solubility of bicalutamide, megestrol acetate, prednisolone, beclomethasone dipropionate, and clarithromycin in subcritical water (SBCW) at the temperature range from 383.15 to 443.15 K and constant pressure of 5.5 MPa were measured using a modified solvent−antisolvent method combined with SBCW technology. The chemical structures of these five kinds of solutes were stable after processed in SBCW at up to 443.15 K, which was demonstrated by Fourier transformed infrared analysis. The solubility of selected solutes increased exponentially as the temperature of the SBCW increased from 383.15 to 443.15 K. The obtained -
Long Term Hormone Treatment
Long Term Hormone Treatment Your hospital doctor has recommended that you have treatment using hormones. Please follow the following guidelines: Collect your tablets and first injection from the hospital pharmacy. Make an appointment at your GP surgery to have the first injection, called *Zoladex or Decapeptyl, for 2 weeks after you have started taking the tablets. Take the tablets, for 4 weeks in total, 2 weeks before the first injection continuing for 2 weeks after the first injection, and then stop – this will be Bicalutamide, 1 tablet each day or Cyproterone acetate (CPA) 1 tablet 3 times a day. You should also take the Bicalutamide or Cyproterone Acetate tablet on the day of your first injection. Arrange to have the second Zoladex injection at your GP surgery 4 weeks after the first injection. Subsequent injections can be given at 12 week intervals using the long acting Zoladex or Decapeptyl injection. Continue all your other medications unless the hospital doctor or your GP advises otherwise. If you are unsure about the tablets or injections either ask your GP for advice or telephone the specialist nurses, Jane Thacker, on 01284 712735 or Oncology CNS on 01284 713212 (or 01284 713000 bleep 874) for guidance. Please have a PSA (Prostate Specific Antigen) blood test done at your GP surgery a Source: Oncology Reference No: 5161-4 Issue date: 17/01/18 Review date: 17/01/20 Page 1 of 2 week before each visit to the hospital urology or oncology clinic. Week 1 Bicalutamide or CPA Week 2 Bicalutamide or CPA First Injection Week 3 Bicalutamide or CPA Week 4 Bicalutamide or CPA Week 6 Injection every 12 weeks *Zoladex is the trade name for Goserelin If you would like any information regarding access to the West Suffolk Hospital and its facilities please visit the disabledgo website link below: http://www.disabledgo.com/organisations/west-suffolk-nhs-foundation-trust/main © West Suffolk NHS Foundation Trust Paddock House, Eye 0333 321 8604 Bluebird Lodge, Ipswich . -
A Small Molecular Activator of Cardiac Hypertrophy Uncovered in a Chemical Screen for Modifiers of the Calcineurin Signaling Pathway
A small molecular activator of cardiac hypertrophy uncovered in a chemical screen for modifiers of the calcineurin signaling pathway Erik Bush*†, Jens Fielitz‡, Lawrence Melvin*, Michael Martinez-Arnold‡, Timothy A. McKinsey*, Ryan Plichta*, and Eric N. Olson†‡ *Myogen, Incorporated, Westminster, CO 80021; and ‡Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9148 Contributed by Eric N. Olson, January 5, 2004 The calcium, calmodulin-dependent phosphatase calcineurin, regu- ative roles for these proteins in the control of calcineurin activity. lates growth and gene expression of striated muscles. The activity of Overexpression of MCIP1 (also called Down syndrome critical calcineurin is modulated by a family of cofactors, referred to as region 1), for example, suppresses calcineurin signaling (12). In modulatory calcineurin-interacting proteins (MCIPs). In the heart, the contrast, MCIP1 also seems to potentiate calcineurin signaling, MCIP1 gene is activated by calcineurin and has been proposed to as demonstrated by the diminution of calcineurin activity in the fulfill a negative feedback loop that restrains potentially pathological hearts of MCIP1 knockout mice (13). Intriguingly, the MCIP1 calcineurin signaling, which would otherwise lead to abnormal car- gene is a target of NFAT and is up-regulated in response to diac growth. In a high-throughput screen for small molecules capable calcineurin signaling (15), which has been proposed to create a of regulating MCIP1 expression in muscle cells, we identified a unique negative feedback loop that dampens calcineurin activity, which 4-aminopyridine derivative exhibiting an embedded partial structural would otherwise lead to abnormal cardiac growth. motif of serotonin (5-hydroxytryptamine, 5-HT). -
Aetna Formulary Exclusions Drug List
Covered and non-covered drugs Drugs not covered – and their covered alternatives 2020 Advanced Control Plan – Aetna Formulary Exclusions Drug List 05.03.525.1B (7/20) Below is a list of medications that will not be covered without a Key prior authorization for medical necessity. If you continue using one of these drugs without prior approval, you may be required UPPERCASE Brand-name medicine to pay the full cost. Ask your doctor to choose one of the generic lowercase italics Generic medicine or brand formulary options listed below. Preferred Options For Excluded Medications1 Excluded drug name(s) Preferred option(s) ABILIFY aripiprazole, clozapine, olanzapine, quetiapine, quetiapine ext-rel, risperidone, ziprasidone, VRAYLAR ABSORICA isotretinoin ACANYA adapalene, benzoyl peroxide, clindamycin gel (except NDC^ 68682046275), clindamycin solution, clindamycin-benzoyl peroxide, erythromycin solution, erythromycin-benzoyl peroxide, tretinoin, EPIDUO, ONEXTON, TAZORAC ACIPHEX, esomeprazole, lansoprazole, omeprazole, pantoprazole, DEXILANT ACIPHEX SPRINKLE ACTICLATE doxycycline hyclate capsule, doxycycline hyclate tablet (except doxycycline hyclate tablet 50 mg [NDC^ 72143021160 only], 75 mg, 150 mg), minocycline, tetracycline ACTOS pioglitazone ACUVAIL bromfenac, diclofenac, ketorolac, PROLENSA acyclovir cream acyclovir (except acyclovir cream), valacyclovir ADCIRCA sildenafil, tadalafil ADZENYS XR-ODT amphetamine-dextroamphetamine mixed salts ext-rel†, dexmethylphenidate ext-rel, dextroamphetamine ext-rel, methylphenidate ext-rel†, MYDAYIS, -
Lack of Correlation Between in Vitro and in Vivo Studies on the Inhibitory Effects Of
pharmaceutics Article Lack of Correlation between In Vitro and In Vivo Studies on the Inhibitory Effects of (-)-Sophoranone on CYP2C9 Is Attributable to Low Oral Absorption and Extensive Plasma Protein Binding of (-)-Sophoranone 1, 2,3, 3 3 3 Yu Fen Zheng y, Soo Hyeon Bae y , Zhouchi Huang , Soon Uk Chae , Seong Jun Jo , Hyung Joon Shim 3, Chae Bin Lee 3, Doyun Kim 3,4, Hunseung Yoo 4 and Soo Kyung Bae 3,* 1 School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 639 Longmian Road, Jiangning District, Nanjing 211198, China; [email protected] 2 Q-fitter, Inc., Seoul 06578, Korea; sh.bae@qfitter.com 3 College of Pharmacy and Integrated Research Institute of Pharmaceutical Sciences, The Catholic University, Korea, Bucheon 14662, Korea; [email protected] (Z.H.); [email protected] (S.U.C.); [email protected] (S.J.J.); [email protected] (H.J.S.); [email protected] (C.B.L.); [email protected] (D.K.) 4 Life Science R&D Center, SK Chemicals, 310 Pangyo-ro, Sungnam 13494, Korea; [email protected] * Correspondence: [email protected]; Tel.: +82-2-2164-4054 These authors contributed equally to this work. y Received: 8 March 2020; Accepted: 5 April 2020; Published: 7 April 2020 Abstract: (-)-Sophoranone (SPN) is a bioactive component of Sophora tonkinensis with various pharmacological activities. This study aims to evaluate its in vitro and in vivo inhibitory potential against the nine major CYP enzymes. Of the nine tested CYPs, it exerted the strongest inhibitory effect on CYP2C9-mediated tolbutamide 4-hydroxylation with the lowest IC50 (Ki) value of 0.966 0.149 µM (0.503 0.0383 µM), in a competitive manner.