Certican
Generic Name
Everolimus
Manufacturer
Novartis Pharma AG
Country
Switzerland
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| certican 025 mg tablet | ৳ 125.00 | ৳ 1,250.00 |
Description
Overview of the medicine
Certican (Everolimus) is an immunosuppressant medication used to prevent organ rejection in adult kidney and heart transplant recipients, and sometimes liver transplant. It is also used in combination with cyclosporine.
Uses & Indications
Dosage
Adults
Initial dose of 0.75 mg twice daily (total 1.5 mg/day) in combination with cyclosporine. Dose adjusted based on therapeutic drug monitoring (TDM) to achieve target trough levels (3-8 ng/mL).
Elderly
No specific dose adjustment required, but monitor closely due to potential for decreased hepatic, renal, or cardiac function.
Renal_impairment
No dose adjustment for mild to moderate renal impairment. For severe impairment, monitor trough levels closely.
How to Take
Oral. Administer consistently either with or without food. Swallow tablets whole, do not crush or chew. Take at the same time each day, preferably in the morning and evening.
Mechanism of Action
Everolimus is an mTOR (mammalian target of rapamycin) inhibitor. It binds to the cytoplasmic protein FKBP-12, forming a complex that inhibits mTOR. Inhibition of mTOR blocks cell cycle progression and T-lymphocyte activation and proliferation, thus exerting immunosuppressive effects.
Pharmacokinetics
Onset
Immunosuppressive effects begin shortly after consistent dosing.
Excretion
Primarily in feces (80%), with a small amount in urine (5%).
Half life
Approximately 28-35 hours (mean elimination half-life).
Absorption
Rapidly absorbed, peak concentrations reached within 1-2 hours. High-fat meals decrease AUC and Cmax.
Metabolism
Primarily hepatic via CYP3A4.
Side Effects
Contraindications
- •Hypersensitivity to everolimus, sirolimus, or any excipients of the formulation.
- •Pregnancy (relative contraindication for transplant, benefits versus risks).
Drug Interactions
Live vaccines
Avoid.
ACE inhibitors
Increased risk of angioedema.
Strong CYP3A4 inducers
Significantly decrease everolimus levels. Avoid concurrent use or increase everolimus dose with careful monitoring.
Strong CYP3A4 inhibitors
Significantly increase everolimus levels. Avoid concurrent use or reduce everolimus dose with careful monitoring.
Calcineurin Inhibitors (e.g., cyclosporine, tacrolimus)
Increased risk of nephrotoxicity with cyclosporine. Monitor kidney function and everolimus trough levels.
Storage
Store at room temperature (below 30°C). Protect from light and moisture. Keep out of reach of children.
Overdose
Limited experience with overdose. General supportive measures should be initiated. Everolimus is not dialyzable to a significant extent.
Pregnancy & Lactation
Pregnancy: Category C. May cause fetal harm. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Effective contraception is required for women of childbearing potential. Lactation: Excreted in breast milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 36 months
Availability
Available in pharmacies, hospitals, and specialized transplant centers.
Approval Status
Approved by FDA/DGDA
Patent Status
Patent expired for original indications, generic versions available.
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