Erbitux
Generic Name
Cetuximab
Manufacturer
Merck KGaA
Country
Germany
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| erbitux 5 mg injection | ৳ 37,223.00 | N/A |
Description
Overview of the medicine
Cetuximab (Erbitux) is a chimeric human-mouse monoclonal antibody that specifically binds to the epidermal growth factor receptor (EGFR) on tumor cells, inhibiting cell growth and proliferation. It is used in the treatment of certain cancers, particularly metastatic colorectal cancer and head and neck cancer.
Uses & Indications
Dosage
Adults
Initial dose: 400 mg/m² as a 120-minute IV infusion. Subsequent doses: 250 mg/m² as a 60-minute IV infusion weekly.
Elderly
No specific dose adjustment generally required, but caution due to age-related decline in organ function.
Renal_impairment
No specific dose adjustment recommended, as cetuximab is not renally eliminated.
How to Take
Intravenous (IV) infusion, typically through a dedicated line, with a filter. Requires premedication (e.g., antihistamines) to prevent infusion reactions.
Mechanism of Action
Cetuximab binds to the extracellular domain of EGFR, blocking the binding of endogenous ligands and inhibiting receptor activation. This leads to inhibition of cell growth, induction of apoptosis, decreased matrix metalloproteinase production, and reduced vascular endothelial growth factor (VEGF) production. It also mediates antibody-dependent cellular cytotoxicity (ADCC).
Pharmacokinetics
Onset
Clinical response varies; dependent on cancer type and patient characteristics.
Excretion
Primarily through catabolism; very little intact antibody is excreted.
Half life
Approximately 76-114 hours (about 3-5 days).
Absorption
Administered intravenously, resulting in 100% bioavailability.
Metabolism
Believed to be catabolized like endogenous IgG, through proteolytic degradation.
Side Effects
Contraindications
- Known severe hypersensitivity to cetuximab.
- Prior severe or life-threatening infusion reaction to cetuximab.
- Combination with oxaliplatin-containing chemotherapy in patients with wild-type RAS mCRC who are also experiencing severe or grade 2-4 rash.
- Patients with KRAS or NRAS mutations in mCRC.
Drug Interactions
Radiation therapy
May enhance adverse events, especially dermatological and mucosal.
Platinum-based chemotherapy
Increased incidence of adverse events, especially dermatological.
Storage
Store refrigerated (2°C to 8°C). Do not freeze. Protect from light.
Overdose
No specific antidote. Management involves supportive care and monitoring for adverse reactions.
Pregnancy & Lactation
Pregnancy: Category C. Use only if potential benefit justifies potential risk to the fetus. Lactation: Unknown if excreted in human milk. Advise mothers to discontinue breastfeeding during treatment and for a period after the last dose.
Side Effects
Contraindications
- Known severe hypersensitivity to cetuximab.
- Prior severe or life-threatening infusion reaction to cetuximab.
- Combination with oxaliplatin-containing chemotherapy in patients with wild-type RAS mCRC who are also experiencing severe or grade 2-4 rash.
- Patients with KRAS or NRAS mutations in mCRC.
Drug Interactions
Radiation therapy
May enhance adverse events, especially dermatological and mucosal.
Platinum-based chemotherapy
Increased incidence of adverse events, especially dermatological.
Storage
Store refrigerated (2°C to 8°C). Do not freeze. Protect from light.
Overdose
No specific antidote. Management involves supportive care and monitoring for adverse reactions.
Pregnancy & Lactation
Pregnancy: Category C. Use only if potential benefit justifies potential risk to the fetus. Lactation: Unknown if excreted in human milk. Advise mothers to discontinue breastfeeding during treatment and for a period after the last dose.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
As per manufacturer's instructions, typically 2-3 years unopened.
Availability
Hospitals, specialized oncology clinics
Approval Status
Approved
Patent Status
Proprietary (Brand name)
Clinical Trials
Ongoing and completed clinical trials for various indications, combinations, and patient populations continue to investigate the efficacy and safety of cetuximab.
Lab Monitoring
- Serum electrolytes (especially magnesium, calcium, potassium) regularly.
- Skin assessments for dermatologic toxicity.
- Infusion reaction monitoring.
Doctor Notes
- Monitor closely for infusion reactions and manage dermatologic side effects aggressively.
- Verify KRAS/NRAS mutation status before initiation in metastatic colorectal cancer patients.
- Ensure appropriate premedication to prevent infusion reactions.
Patient Guidelines
- Report any skin rash, itching, or swelling immediately.
- Stay hydrated.
- Avoid excessive sun exposure.
- Report any breathing difficulties or severe allergic reactions during infusion.
Missed Dose Advice
Contact the healthcare provider for rescheduling. Do not double the next dose.
Driving Precautions
May cause fatigue or vision changes; caution advised until effects are known.
Lifestyle Advice
- Use moisturizers and sunscreen to manage skin dryness and rash.
- Maintain good hygiene.
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