Cytofos

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Cytofos uses



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DESCRIPTION

Cytofos (amifostine) is an organic thiophosphate cytoprotective agent known chemically as 2-[(3-aminopropyl)amino]ethanethiol dihydrogen phosphate (ester) and has the following structural formula:

H 2 N(CH 2 ) 3 NH(CH 2 ) 2 S-PO 3 H 2

Cytofos is a white crystalline powder which is freely soluble in water. Its empirical formula is C5H15N2O3PS and it has a molecular weight of 214.22.

Cytofos is the trihydrate form of Cytofos and is supplied as a sterile lyophilized powder requiring reconstitution for intravenous infusion. Each single-use 10 mL vial contains 500 mg of Cytofos on the anhydrous basis.

CLINICAL PHARMACOLOGY

Cytofos is a prodrug that is dephosphorylated by alkaline phosphatase in tissues to a pharmacologically active free thiol metabolite. This metabolite is believed to be responsible for the reduction of the cumulative renal toxicity of cisplatin and for the reduction of the toxic effects of radiation on normal oral tissues. The ability of Cytofos to differentially protect normal tissues is attributed to the higher capillary alkaline phosphatase activity, higher pH and better vascularity of normal tissues relative to tumor tissue, which results in a more rapid generation of the active thiol metabolite as well as a higher rate constant for uptake into cells. The higher concentration of the thiol metabolite in normal tissues is available to bind to, and thereby detoxify, reactive metabolites of cisplatin. This thiol metabolite can also scavenge reactive oxygen species generated by exposure to either cisplatin or radiation.

Pharmacokinetics:

Clinical pharmacokinetic studies show that Cytofos is rapidly cleared from the plasma with a distribution half-life of < 1 minute and an elimination half-life of approximately 8 minutes. Less than 10% of Cytofos remains in the plasma 6 minutes after drug administration. Cytofos is rapidly metabolized to an active free thiol metabolite. A disulfide metabolite is produced subsequently and is less active than the free thiol. After a 10-second bolus dose of 150 mg/m2 of Cytofos, renal excretion of the parent drug and its two metabolites was low during the hour following drug administration, averaging 0.69%, 2.64% and 2.22% of the administered dose for the parent, thiol and disulfide, respectively. Measurable levels of the free thiol metabolite have been found in bone marrow cells 5-8 minutes after intravenous infusion of ETHYOL. Pretreatment with dexamethasone or metoclopramide has no effect on Cytofos pharmacokinetics.

Clinical Studies

Chemotherapy for Ovarian Cancer. A randomized controlled trial compared six cycles of cyclophosphamide 1000 mg/m2, and cisplatin 100 mg/m2 with or without Cytofos pretreatment at 910 mg/m2, in two successive cohorts of 121 patients with advanced ovarian cancer. In both cohorts, after multiple cycles of chemotherapy, pretreatment with Cytofos significantly reduced the cumulative renal toxicity associated with cisplatin as assessed by the proportion of patients who had ≥40% decrease in creatinine clearance from pretreatment values, protracted elevations in serum creatinine (>1.5 mg/dL), or severe hypomagnesemia. Subgroup analyses suggested that the effect of Cytofos was present in patients who had received nephrotoxic antibiotics, or who had preexisting diabetes or hypertension (and thus may have been at increased risk for significant nephrotoxicity), as well as in patients who lacked these risks. Selected analyses of the effects of Cytofos in reducing the cumulative renal toxicity of cisplatin in the randomized ovarian cancer study are provided in TABLES 1 and 2, below.

Cytofos + CP CP p-value

(2-sided)

All Patients 16/122 (13%) 36/120 (30%) 0.001
First Cohort 10/63 20/58 0.018
Second Cohort 6/59 16/62 0.026
NCI-CTC Grade:

(mEq/L)

0

>1.4

1

≤1.4->1.1

2

≤1.1->0.8

3

≤0.8->0.5

4

≤0.5

p-value Based on 2-sided Mantel-Haenszel Chi-Square statistic.
All Patien ts

ETHYOL+CP

CP

92

73

13

18

3

7

0

5

0

1

0.001

First Cohort

ETHYOL+CP

CP

49

35

10

8

3

6

0

3

0

1

0.017

Second Cohort

ETHYOL+CP

CP

43

38

3

10

0

1

0

2

0

0

0.012


In the randomized ovarian cancer study, Cytofos had no detectable effect on the antitumor efficacy of cisplatin-cyclophosphamide chemotherapy. Objective response rates (including pathologically confirmed complete remission rates), time to progression, and survival duration were all similar in the Cytofos and control study groups. The table below summarizes the principal efficacy findings of the randomized ovarian cancer study.

Cytofos + CP CP
Complete pathologic tumor

response rate

21.3% 15.8%
Time to progression (months)
Median (± 95% CI) 15.8 (13.2, 25.1) 18.1 (12.5, 20.4)
Mean (± Std error) 19.8 (±1.04) 19.1 (±1.58)
Hazard ratio

(95% Confidence Interval)

.98 (.64, 1.4)
Survival (months)
Median (± 95% CI) 31.3 (28.3, 38.2) 31.8 (26.3, 39.8)
Mean (± Std error) 33.7 (±2.03) 34.3 (±2.04)
Hazard ratio

(95% Confidence Interval)

.97 (.69, 1.32)

Radiotherapy for Head and Neck Cancer. A randomized controlled trial of standard fractionated radiation (1.8 Gy - 2.0 Gy/day for 5 days/week for 5-7 weeks) with or without Cytofos, administered at 200 mg/m2 as a 3 minute i.v. infusion 15-30 minutes prior to each fraction of radiation, was conducted in 315 patients with head and neck cancer. Patients were required to have at least 75% of both parotid glands in the radiation field. The incidence of Grade 2 or higher acute (90 days or less from start of radiation) and late xerostomia (9-12 months following radiation) as assessed by RTOG Acute and Late Morbidity Scoring Criteria, was significantly reduced in patients receiving Cytofos (TABLE 4).

Cytofos + RT RT p-value
Acute

(≤90 days from

start of radiation)

51% (75/148)

78% (120/153)

p<0.0001

Late Based on the number of patients for whom actual data were available.

(9-12 months

post radiation)

35% (36/103)

57% (63/111)

p=0.0016


At one year following radiation, whole saliva collection following radiation showed that more patients given Cytofos produced >0.1 gm of saliva (72% vs. 49%). In addition, the median saliva production at one year was higher in those patients who received Cytofos (0.26 gm vs. 0.1 gm). Stimulated saliva collections did not show a difference between treatment arms. These improvements in saliva production were supported by the patients' subjective responses to a questionnaire regarding oral dryness.

In the randomized head and neck cancer study, locoregional control, disease-free survival and overall survival were all comparable in the two treatment groups after one year of follow-up.

Cytofos + RT RT
Locoregional Control Rate 1 year rates estimated using Kaplan-Meier method

76.1% 75.0%
Hazard RatioHazard ratio >1.0 is in favor of the Cytofos + RT arm 1.013
95% Confidence Interval (0.671, 1.530)
Disease-Free Survival Rate 74.6% 70.4%
Hazard Ratio 1.035
95% Confidence Interval (0.702, 1.528)
Overall Survival Rate 89.4% 82.4%
Hazard Ratio 1.585
95% Confidence Interval (0.961, 2.613)
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INDICATIONS AND USAGE

Cytofos (amifostine) is indicated to reduce the cumulative renal toxicity associated with repeated administration of cisplatin in patient s with advanced ovarian cancer.

Cytofos is indicated to reduce the incidence of moderate to severe xerostomia in patients undergoing post-operative radiation treatment for head and neck cancer, where the radiation port includes a substantial portion of the parotid glands (see Clinical Studies ).

For the approved indications, the clinical data do not suggest that the effectiveness of cisplatin based chemotherapy regimens or radiation therapy is altered by Cytofos. There are at present only limited data on the effects of Cytofos on the efficacy of chemotherapy or radiotherapy in other settings. Cytofos should not be administered to patients in other settings where chemotherapy can produce a significant survival benefit or cure, or in patients receiving definitive radiotherapy, except in the context of a clinical study.

CONTRAINDICATIONS

Cytofos is contraindicated in patients with known hypersensitivity to aminothiol compounds.

WARNINGS

1. Effectiveness of the Cytotoxic Regimen

Limited data are currently available regarding the preservation of antitumor efficacy when Cytofos is administered prior to cisplatin therapy in settings other than advanced ovarian cancer. Although some animal data suggest interference is possible, in most tumor models the antitumor effects of chemotherapy are not altered by Cytofos. Cytofos should not be used in patients receiving chemotherapy for other malignancies in which chemotherapy can produce a significant survival benefit or cure (e.g., certain malignancies of germ cell origin), except in the context of a clinical study.

2. Effectiveness of Radiotherapy

Cytofos should not be administered in patients receiving definitive radiotherapy, except in the context of a clinical trial, since there are at present insufficient data to exclude a tumor-protective effect in this setting. Cytofos was studied only with standard fractionated radiotherapy and only when ≥75% of both parotid glands were exposed to radiation. The effects of Cytofos on the incidence of xerostomia and on toxicity in the setting of combined chemotherapy and radiotherapy and in the setting of accelerated and hyperfractionated therapy have not been systematically studied.

3. Hypotension

Patients who are hypotensive or in a state of dehydration should not receive Cytofos. Patients receiving Cytofos at doses recommended for chemotherapy should have antihypertensive therapy interrupted 24 hours preceding administration of Cytofos. Patients receiving Cytofos at doses recommended for chemotherapy who are taking antihypertensive therapy that cannot be stopped for 24 hours preceding Cytofos treatment, should not receive Cytofos.

Prior to Cytofos infusion patients should be adequately hydrated. During Cytofos infusion patients should be kept in a supine position. Blood pressure should be monitored every 5 minutes during the infusion, and thereafter as clinically indicated. It is important that the duration of the 910 mg/m2 infusion not exceed 15 minutes, as administration of Cytofos as a longer infusion is associated with a higher incidence of side effects. For infusion durations less than 5 minutes, blood pressure should be monitored at least before and immediately after the infusion, and thereafter as clinically indicated. If hypotension occurs, patients should be placed in the Trendelenburg position and be given an infusion of normal saline using a separate i.v. line. During and after Cytofos infusion, care should be taken to monitor the blood pressure of patients whose antihypertensive medication has been interrupted since hypertension may be exacerbated by discontinuation of antihypertensive medication and other causes such as i.v. hydration.

Guidelines for interrupting and restarting Cytofos infusion if a decrease in systolic blood pressure should occur are provided in the DOSAGE AND ADMINISTRATION section. Hypotension may occur during or shortly after Cytofos infusion, despite adequate hydration and positioning of the patient. Hypotension has been reported to be associated with dyspnea, apnea, hypoxia, and in rare cases seizures, unconsciousness, respiratory arrest and renal failure.

4. Cutaneous Reactions

Fatal and serious cutaneous reactions have been reported with Cytofos treatment, including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, toxicoderma, exfoliative dermatitis and drug reaction with biopsy-confirmed eosinophilia and systemic symptoms (DRESS). These reactions have been reported more frequently when Cytofos is used as a radioprotectant. Serious cutaneous reactions may develop weeks after initiation of Cytofos administration. Monitor patients carefully prior to, during and after Cytofos administration. Discontinue Cytofos for cutaneous reactions or mucosal lesions appearing outside of the injection site or radiation port and for erythematous, edematous or bullous lesions on the palms or soles.

5. Hypersensitivity

Allergic manifestations including anaphylaxis and severe cutaneous reactions have been associated with Cytofos administration.

6. Nausea and Vomiting

Antiemetic medication should be administered prior to and in conjunction with Cytofos. When Cytofos is administered with highly emetogenic chemotherapy, the fluid balance of the patient should be carefully monitored.

7. Hypocalcemia

Serum calcium levels should be monitored in patients at risk of hypocalcemia, such as those with nephrotic syndrome or patients receiving multiple doses of Cytofos. If necessary, calcium supplements can be administered.

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PRECAUTIONS

General

Patients should be adequately hydrated prior to the Cytofos infusion and blood pressure should be monitored.

The safety of Cytofos administration has not been established in elderly patients, or in patients with preexisting cardiovascular or cerebrovascular conditions such as ischemic heart disease, arrhythmias, congestive heart failure, or history of stroke or transient ischemic attacks. Cytofos should be used with particular care in these and other patients in whom the common Cytofos adverse effects of nausea/vomiting and hypotension may be more likely to have serious consequences.

Prior to chemotherapy, Cytofos should be administered as a 15-minute infusion. Blood pressure should be monitored every 5 minutes during the infusion, and thereafter as clinically indicated.

Prior to radiation therapy, Cytofos should be administered as a 3-minute infusion. Blood pressure should be monitored at least before and immediately after the infusion, and thereafter as clinically indicated.

Allergic Reactions

In case of severe acute allergic reactions Cytofos should be immediately and permanently discontinued. Epinephrine and other appropriate measures should be available for treatment of serious allergic events such as anaphylaxis.

Drug Interactions

Special consideration should be given to the administration of Cytofos in patients receiving anti-hypertensive medications or other drugs that could cause or potentiate hypotension.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No long term animal studies have been performed to evaluate the carcinogenic potential of Cytofos. Cytofos was negative in the Ames test and in the mouse micronucleus test. The free thiol metabolite was positive in the Ames test with S9 microsomal fraction in the TA1535 Salmonella typhimurium strain and at the TK locus in the mouse L5178Y cell assay. The metabolite was negative in the mouse micronucleus test and negative for clastogenicity in human lymphocytes.

Pregnancy

Cytofos has been shown to be embryotoxic in rabbits at doses of 50 mg/kg, approximately sixty percent of the recommended dose in humans on a body surface area basis. There are no adequate and well-controlled studies in pregnant women. Cytofos should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers

No information is available on the excretion of Cytofos or its metabolites into human milk. Because many drugs are excreted in human milk and because of the potential for adverse reactions in nursing infants, it is recommended that breast feeding be discontinued if the mother is treated with Cytofos.

Pediatric Use

The safety and effectiveness in pediatric patients have not been established therefore Cytofos is not recommended for use in the pediatric population.

Geriatric Use

The clinical studies did not include sufficient number of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy in elderly patients.

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ADVERSE REACTIONS

Controlled Trials

In the randomized study of patients with ovarian cancer given Cytofos at a dose of 910 mg/m2 prior to chemotherapy, transient hypotension was observed in 62% of patients treated. The mean time of onset was 14 minutes into the 15-minute period of Cytofos infusion, and the mean duration was 6 minutes. In some cases, the infusion had to be prematurely terminated due to a more pronounced drop in systolic blood pressure. In general, the blood pressure returned to normal within 5-15 minutes. Fewer than 3% of patients discontinued Cytofos due to blood pressure reductions. In the randomized study of patients with head and neck cancer given Cytofos at a dose of 200 mg/m2 prior to radiotherapy, hypotension was observed in 15% of patients treated.

Phase III Ovarian Cancer

Trial (WR-1)

910 mg/m 2

Phase III Head and

Neck Cancer Trial (WR-38)

200 mg/m 2

Per Patient Per Infusion Per Patient Per Infusion
Nausea/Vomiting
≥Grade 3 36/122 (30%) 53/592 (9%) 12/150 (8%) 13/4314 (<1%)
All Grades 117/122 (96%) 520/592 (88%) 80/150 (53%) 233/4314 (5%)
Hypotension
≥Grade 3According to protocol-defined criteria. WR-1: requiring interruption of infusion; WR-38: drop of >20mm Hg. 10/122 (8%) 4/150 (3%)
All Grades 75/122 (61%) 159/592 (27%) 22/150 (15%) 46/4314 (1%)

In the randomized study of patients with head and neck cancer, 17% (26/150) discontinued Cytofos due to adverse events. All but one of these patients continued to receive radiation treatment until completion.

Hypotension that requires interruption of the Cytofos infusion should be treated with fluid infusion and postural management of the patient (supine or Trendelenburg position). If the blood pressure returns to normal within 5 minutes and the patient is asymptomatic, the infusion may be restarted, so that the full dose of Cytofos can be administered. Short term, reversible syncope (loss of consciousness) has been reported rarely.

Nausea and/or vomiting occur frequently after Cytofos infusion and may be severe. In the ovarian cancer randomized study, the incidence of severe nausea/vomiting on day 1 of cyclophosphamide-cisplatin chemotherapy was 10% in patients who did not receive Cytofos, and 19% in patients who did receive Cytofos. In the randomized study of patients with head and neck cancer, the incidence of severe nausea/vomiting was 8% in patients who received Cytofos and 1% in patients who did not receive Cytofos.

Decrease in serum calcium concentrations is a known pharmacological effect of Cytofos. At the recommended doses, clinically significant hypocalcemia was reported in 1% of patients in the randomized head and neck cancer study.

Other effects, which have been described during or following Cytofos infusion are flushing/feeling of warmth, chills/feeling of coldness, malaise, pyrexia, rash, dizziness, somnolence, hiccups, diarrhea, sneezing, diplopia and blurred vision. These effects have not generally precluded the completion of therapy.

Injection site reactions (including rash/erythema, pruritus, urticaria, pain, inflammation, bruising and local swelling) were also observed.

Clinical Trials and Pharmacovigilance Reports

Hypersensitivity and anaphylactic reactions characterized by one or more of the following manifestations have been observed during or after Cytofos administration: hypotension, pyrexia, chills/rigors, dyspnea, hypoxia, chest discomfort, cutaneous eruptions, pruritus, urticaria and laryngeal edema. Cutaneous eruptions have been commonly reported during clinical trials and were generally non-serious. Serious, sometimes fatal skin reactions including erythema multiforme, and in rare cases exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis have also occurred. The reported incidence of serious skin reactions associated with Cytofos is higher in patients receiving Cytofos as a radioprotectant than in patients receiving Cytofos as a chemoprotectant. Rare anaphylactoid reactions and cardiac arrest have also been reported.

Hypotension, usually brief systolic and diastolic, has been associated with one or more of the following adverse events: apnea, dyspnea, hypoxia, tachycardia, bradycardia, extrasystoles, chest pain, myocardial ischemia and seizure. Rare cases of renal failure, myocardial infarction, respiratory and cardiac arrest have been observed during or after hypotension.

Rare cases of arrhythmias such as atrial fibrillation/flutter and supraventricular tachycardia have been reported. These are sometimes associated with hypotension or allergic reactions.

Transient hypertension and exacerbations of preexisting hypertension have been observed rarely after Cytofos administration.

Seizures and syncope (loss of consciousness) have been reported rarely.

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OVERDOSAGE

In clinical trials, the maximum single dose of Cytofos was 1300 mg/m2. No information is available on single doses higher than this in adults. In the setting of a clinical trial, pediatric patients have received single Cytofos doses of up to 2700 mg/m2. At the higher doses, anxiety and reversible urinary retention occurred.

Administration of Cytofos at 2 and 4 hours after the initial dose has not led to increased nausea and vomiting or hypotension. The most likely symptom of overdosage is hypotension, which should be managed by infusion of normal saline and other supportive measures, as clinically indicated.

DOSAGE AND ADMINISTRATION

For Reduction of Cumulative Renal Toxicity with Chemotherapy:

The recommended starting dose of Cytofos is 910 mg/m2 administered once daily as a 15-minute i.v. infusion, starting 30 minutes prior to chemotherapy.

The 15-minute infusion is better tolerated than more extended infusions. Further reductions in infusion times for chemotherapy regimens have not been systematically investigated.

Patients should be adequately hydrated prior to Cytofos infusion and kept in a supine position during the infusion. Blood pressure should be monitored every 5 minutes during the infusion, and thereafter as clinically indicated.

The infusion of Cytofos should be interrupted if the systolic blood pressure decreases significantly from the baseline value as listed in the guideline below:

Baseline Systolic Blood Pressure
<100 100-119 120-139 140-179 ≥180
Decrease in systolic blood pressure during infusion of Cytofos (mm Hg) 20 25 30 40 50

If the blood pressure returns to normal within 5 minutes and the patient is asymptomatic, the infusion may be restarted so that the full dose of Cytofos may be administered. If the full dose of Cytofos cannot be administered, the dose of Cytofos for subsequent chemotherapy cycles should be 740 mg/m2.

It is recommended that antiemetic medication, including dexamethasone 20 mg i.v. and a serotonin 5HT3 receptor antagonist, be administered prior to and in conjunction with Cytofos. Additional antiemetics may be required based on the chemotherapy drugs administered.

For Reduction of Moderate to Severe Xerostomia from Radiation of the Head and Neck:

The recommended dose of Cytofos is 200 mg/m2 administered once daily as a 3-minute i.v. infusion, starting 15-30 minutes prior to standard fraction radiation therapy (1.8-2.0 Gy).

Patients should be adequately hydrated prior to Cytofos infusion. Blood pressure should be monitored at least before and immediately after the infusion, and thereafter as clinically indicated.

It is recommended that antiemetic medication be administered prior to and in conjunction with Cytofos. Oral 5HT3 receptor antagonists, alone or in combination with other antiemetics, have been used effectively in the radiotherapy setting.

Reconstitution

Cytofos (amifostine) for Injection is supplied as a sterile lyophilized powder requiring reconstitution for intravenous infusion. Each single-use vial contains 500 mg of Cytofos on the anhydrous basis.

Prior to intravenous injection, Cytofos is reconstituted with 9.7 mL of sterile 0.9% Sodium Chloride Injection, USP. The reconstituted solution (500 mg amifostine/10 mL) is chemically stable for up to 5 hours at room temperature (approximately 25°C) or up to 24 hours under refrigeration (2°C to 8°C).

Cytofos prepared in polyvinylchloride (PVC) bags at concentrations ranging from 5 mg/mL to 40 mg/mL is chemically stable for up to 5 hours when stored at room temperature (approximately 25°C) or up to 24 hours when stored under refrigeration (2°C to 8°C).

CAUTION: Parenteral products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Do not use if cloudiness or precipitate is observed.

Incompatibilities

The compatibility of Cytofos with solutions other than 0.9% Sodium Chloride for Injection, or Sodium Chloride solutions with other additives, has not been examined. The use of other solutions is not recommended.

HOW SUPPLIED

Cytofos (amifostine) for Injection is supplied as a sterile lyophilized powder in 10 mL single-use vials (NDC 66220-017-03). Each single-use vial contains 500 mg of Cytofos on the anhydrous basis. The vials are available packaged as follows:

3 pack - 3 vials per carton (NDC 66220-017-03)

Store the lyophilized dosage form at Controlled Room Temperature 20°-25°C (68°-77°F).

U.S. Patent 5,994,409

Manufactured for:

Cumberland Pharmaceuticals Inc.

Nashville, TN 37203

Cytofos is a registered trademark owned by the Clinigen Group.

For product information, please call Cumberland Pharmaceuticals Inc. Medical Information at 1 877 484 2700.

Revision Date 05/2017

Cumberland Logo Clinigen Logo

Cytofos pharmaceutical active ingredients containing related brand and generic drugs:

Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


Cytofos available forms, composition, doses:

Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


Cytofos destination | category:

Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


Cytofos Anatomical Therapeutic Chemical codes:

A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


Cytofos pharmaceutical companies:

Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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References

  1. Dailymed."ETHYOL (AMIFOSTINE) INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION [CUMBERLAND PHARMACEUTICALS INC.]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  2. Dailymed."AMIFOSTINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
  3. "amifostine". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).

Frequently asked Questions

Can i drive or operate heavy machine after consuming Cytofos?

Depending on the reaction of the Cytofos after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Cytofos not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

Is Cytofos addictive or habit forming?

Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.

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Review

sdrugs.com conducted a study on Cytofos, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Cytofos consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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The information was verified by Dr. Rachana Salvi, MD Pharmacology

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