Cancer therapy with Xeloda

Xeloda is a cancer (chemotherapeutic) medication. Xeloda interferes with the growth of cancer cells and slows their growth and spread in the body.

Xeloda is used in the treatment of some types of breast and colorectal cancers.

Xeloda may also be used for purposes other than those listed in this medication guide.

                        Xeloda should only be prescribed by a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

Talk to your doctor if you are taking the blood thinner warfarin (Coumadin). In some cases, severe bleeding and death have resulted when these medications were taken together, or when treatment with warfarin (Coumadin) was started in the month following treatment with Xeloda. If treatment with both medications is determined by your doctor to be necessary, special monitoring will be required.

If the dose of Xeloda prescribed for you requires a combination of different strength tablets, it is very important that you correctly identify the tablets to ensure the correct dose. Contact your doctor or pharmacist if you have questions regarding a dose.

Stop taking Xeloda and notify your doctor immediately if you experience any of the following side effects: more than 4 bowel movements per day or diarrhea at night; vomiting more than once in a 24-hour period; the amount of food you eat each day is much less than usual or if you are only able to eat at certain times; pain, redness, swelling, or sores in or around the mouth; tingling, numbness, pain, swelling, or redness of the hands and/or feet (hand-and-foot syndrome); or fever (temperature greater than 100.5 degrees) or other evidence of infection.

                      Do not take Xeloda without first talking to your doctor if you are allergic to fluorouracil (Adrucil).

Before taking Xeloda, tell your doctor if you

    * have liver disease or a history of liver problems;

    * have kidney disease;

      have heart or coronary artery disease; or

      are taking any other medicines especially warfarin (Coumadin), phenytoin (Dilantin), folic acid (found in some vitamins), or leucovorin (Wellcovorin).

You may not be able to take Xeloda, or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.

Do not take this medication if you are pregnant or could become pregnant during treatment. Xeloda is in the FDA pregnancy category D. This means that it is known to cause birth defects in an unborn baby. Contraceptive measures are recommended for both men and women during treatment with Xeloda. It is not known whether Xeloda will harm a nursing infant. Do not take Xeloda without first talking to your doctor if you are breast-feeding. The safety and effectiveness of Xeloda in patients younger than 18 years of age have not been established. If you are over the age of 80, you may be more likely to experience side effects from Xeloda.

                         Xeloda should only be prescribed by a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

Take Xeloda exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Each dose of Xeloda should be swallowed with water. Take Xeloda within 30 minutes after the end of a meal (usually breakfast and dinner).

If the dose of Xeloda prescribed for you requires a combination of different strength tablets, it is very important that you correctly identify the tablets to ensure the correct dose. Contact your doctor or pharmacist if you have questions regarding a dose.

Xeloda is usually taken for 14 days followed by a 7 day rest period (no drug given), in a 21 day cycle. Follow your doctor's instructions.

Take all of the Xeloda that has been prescribed for you. Store Xeloda at room temperature away from moisture and heat.

                              Capecitabine is available with a prescription under the brand name Xeloda. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

      Xeloda 150 mg - oblong light peach-colored tablets

      Xeloda 500 mg - oblong peach-colored tablets

Salagen

Salagen is used for:

Treating dry mouth associated with radiation treatment for cancer or Sjogren syndrome. It may also be used for other conditions as determined by your doctor.

Salagen is a cholinergic agent. It works by increasing the secretion of saliva from the salivary glands, which helps to relieve dry mouth.

Use Salagen as directed by your doctor. Check the label on the medicine for exact dosing instructions.

* Take Salagen by mouth with or without food.

* Drinking extra fluids while you are taking Salagen is recommended. Check with your doctor for instructions.

* If you miss a dose of Salagen , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Salagen .

* Salagen may cause blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Salagen with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

* It may take 12 weeks for Salagen to work.

* Salagen should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.

* PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Salagen while you are pregnant. It is not known if Salagen is found in breast milk. Do not breast-feed while taking Salagen .

Store Salagen at room temperature, up to 77 degrees F (25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Keep Salagen out of the reach of children and away from pets.

Paclitaxel

Paclitaxel must be administered in an appropriate medical setting. Serious allergic reactions, some fatal, have occurred with use of Paclitaxel . DO NOT use Paclitaxel again if you have experienced a severe allergic reaction to it. Stop using Paclitaxel and notify your doctor immediately if you develop signs of an allergic reaction, such as rash; itching; severe dizziness; swelling of hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness. Certain patients with solid tumors or AIDS-related Kaposi sarcoma should not use Paclitaxel . Frequent blood tests should be performed while you are using Paclitaxel because of the risk of bone marrow suppression and serious infection.

Paclitaxel is used for:

Treating ovary and breast cancer. It may be used for other types of cancer as determined by your doctor, which may not be listed in the professional package insert.

Paclitaxel is a chemotherapy medicine. It works by slowing or stopping cancer cells from dividing and growing, so they eventually die.

Use Paclitaxel as directed by your doctor. Check the label on the medicine for exact dosing instructions.

* Paclitaxel may come with an additional patient leaflet. Read it carefully and reread it each time you get Paclitaxel refilled.

* Paclitaxel is usually administered as an injection at your doctor's office, hospital, or clinic. Ask your doctor or pharmacist any questions that you may have about Paclitaxel .

* If nausea, vomiting, diarrhea, or loss of appetite occurs, do not discontinue your medicine. Ask your doctor or pharmacist for ways to lessen these effects.

* Wear gloves while handling Paclitaxel .

* If you get Paclitaxel on your skin, rinse the area thoroughly with soap and water. If you get Paclitaxel in your eyes, nose, or mouth, flush the area thoroughly with water.

* If you miss a dose of Paclitaxel , contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Paclitaxel .

* Serious allergic reactions, some fatal, have occurred with use of Paclitaxel . You will need to take certain other medicines before using Paclitaxel in order to lessen the risk of allergic reaction. Stop using Paclitaxel and notify your doctor immediately if you develop signs of an allergic reaction, such as rash; itching; severe dizziness; swelling of hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.

* Some patients develop redness or sores in the mouth or on the lips. These symptoms may occur a few days after treatment with Paclitaxel and usually decrease or disappear in 1 week. Talk with your doctor about proper mouth care and other ways to prevent or reduce this side effect.

* Paclitaxel may cause dizziness or vision changes. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Paclitaxel . Using Paclitaxel alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.

* Paclitaxel contains alcohol, which may interact with the effects of other medicines. Alcohol in other beverages or medicines may increase this effect. Before you begin taking any new prescription or over-the-counter medicine, read the ingredients to see if it also contains alcohol. If it does or if you are uncertain, contact your doctor or pharmacist.

* Paclitaxel may lower your body's ability to fight infection. Prevent infection by avoiding contact with people with colds or other infections. Notify your doctor of any signs of infection, including fever, sore throat, rashes, or chills. Also, do not touch your eyes or the inside of your nose unless you have thoroughly washed your hands first.

* Paclitaxel may reduce the number of blood cells that are needed for clotting. Report any unusual bleeding, bruising, blood in the stool, or dark, tarry stools immediately to your doctor.

* If you have not had chickenpox or measles, avoid contact with anyone who has either of these diseases or shingles.

* Check with your doctor before having immunizations (vaccinations).

* Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Paclitaxel .

* LAB TESTS, including blood counts, vital signs (such as pulse and blood pressure), and liver function tests, will be required to monitor your progress and check for side effects. Be sure to keep all doctor and lab appointments.

* Caution is advised when using Paclitaxel in the ELDERLY because they may be more sensitive to the effects of Paclitaxel , especially effects on the bone marrow (myelosuppression).

* Paclitaxel is not recommended for use in CHILDREN. Safety and effectiveness in this age group have not been confirmed.

* Women of childbearing age should use an effective form of birth control (eg, condoms) while using Paclitaxel .

* PREGNANCY AND BREAST-FEEDING: Paclitaxel has been shown to cause harm to the fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Paclitaxel during pregnancy. It is unknown if Paclitaxel is excreted in breast milk. Do not breast-feed while using Paclitaxel .

Store Paclitaxel as directed on the prescription label. Keep Paclitaxel out of the reach of children and away from pets.

Dactinomycin

Dactinomycin is very toxic. Do not inhale the dust or vapors of Dactinomycin . Do not get Dactinomycin in your eyes, nose, mouth, or onto your skin. Do not come into contact with Dactinomycin if you are pregnant. Dactinomycin is given through a vein. If Dactinomycin leaks out of the vein (extravasation), severe damage to the area around the injection site will occur. Tell your doctor or health care provider immediately if you notice any discomfort, pain, or redness at the injection site.

Dactinomycin is used for:

Treating certain types of cancer. It may be used alone or with other medicines.

Dactinomycin is an antineoplastic. It works by killing certain cancer cells.

Do NOT use Dactinomycin if:

* you are allergic to any ingredient in Dactinomycin

* you have chickenpox (varicella infection), or shingles (herpes zoster infection), or if you have had either of these infections recently

Contact your doctor or health care provider right away if any of these apply to you.

Use Dactinomycin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

* Dactinomycin is usually given as an injection at your doctor's office, hospital, or clinic. Ask your doctor or pharmacist any questions you may have about Dactinomycin .

* If you get Dactinomycin in your eyes or on your skin, rinse the area with water for 15 minutes. Remove any contaminated clothing and do not reuse. Contaminated shoes must be cleaned completely before reuse.

* If you miss a dose of Dactinomycin , contact your doctor right away.

Ask your health care provider any questions you may have about how to use Dactinomycin .

Dactinomycin is usually handled and stored by a health care provider. If you are using Dactinomycin at home, store Dactinomycin as directed by your pharmacist or health care provider.

Quadramet

Samarium Sm 153 lexidronam (sa-MARE-ee-um lex-ID-roe-nam) is a radiopharmaceutical ((ray-dee-oh-far-ma-SOO-ti-kal)) . Radiopharmaceuticals are radioactive agents that may be used to diagnose some diseases by studying the function of the body's organs or to treat certain diseases.

Samarium Sm 153 lexidronam is used to help relieve the bone pain that may occur with certain kinds of cancer. The radioactive samarium is taken up in the bone cancer area and gives off radiation that helps provide relief of pain.

Samarium Sm 153 lexidronam is to be given only by or under the direct supervision of a doctor with specialized training in nuclear medicine or radiation oncology.

In deciding to use a medicine, the risks of receiving the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For samarium Sm 153 lexidronam, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to bone tumor-seeking medicines, like samarium Sm 153 lexidronam, or bone-imaging radiopharmaceuticals. Also tell your doctor if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in either humans or animals. However, to avoid exposing the fetus to radiation, samarium Sm 153 lexidronam is not recommended for use during pregnancy. Be sure you have discussed this with your doctor.

Breast-feeding—Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. Because samarium Sm 153 lexidronam may cause serious side effects, breast-feeding is generally not recommended while you are receiving this medicine.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of samarium Sm 153 lexidronam in children with use in other age groups.

Older adults—Samarium Sm 153 lexidronam has been used in older people and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In other cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving samarium Sm 153 lexidronam, it is especially important that your doctor know the following:

* If you have ever received radiation therapy or anticancer medicines—Anticancer medicines or radiation therapy may increase the harmful effects of samarium Sm 153 lexidronam on the bone marrow

* Etidronate (e.g., Didronel)—This medicine may prevent samarium Sm 153 lexidronam from working properly

Other medical problems—The presence of other medical problems may affect the use of samarium Sm 153 lexidronam. Make sure you tell your doctor if you have any other medical problems.

Your doctor may have special instructions for you to follow to get ready for your treatment. If you do not understand them or if you have not received such instructions, check with your doctor in advance.

This radiopharmaceutical may accumulate in your bladder. Therefore, to increase the flow of urine and lessen the amount of radiation to your bladder your doctor may instruct you to drink plenty of liquids before receiving samarium Sm 153 lexidronam and urinate often afterwards.

If you have a problem controlling your bladder, tell your doctor before receiving samarium Sm 153 lexidronam. Special precautions will need to be taken to prevent radiation contamination of clothing, bed linens, and the environment.

Dosing—The doses of radiopharmaceuticals will be different for different patients and for the different types of treatment. The amount of radioactivity of a radiopharmaceutical is expressed in units called becquerels or curies. The usual adult dose of samarium Sm 153 lexidronam is 37 megabecquerels (1 millicurie) per kg (16.8 megabecquerels [0.45 millicurie] per pound) of body weight. The dose you receive depends on your body size. The amount of radiation received from this medicine by specific areas of the body to treat a disease is many times higher than that from any diagnostic test, such as x-rays and nuclear medicine scans. Repeated doses may be necessary, depending on the kind of disease you have and how your body is responding to treatment.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects. You may need to have blood tests done regularly.

Follow these guidelines for 12 hours after receiving samarium Sm 153 lexidronam, to help reduce the chance of contaminating other persons or the environment with radiation:

* Use a normal toilet, if available, instead of a urinal.

* Samarium Sm 153 lexidronam is passed mainly in the urine. To prevent contamination of your home environment, flush the toilet twice after using.

* Wipe any spilled urine with a tissue and flush it away.

* Wash your hands after using or cleaning the toilet.

* Wash your clothes and bed linens immediately, if they become soiled with your urine or blood. Wash them separately from other clothes.

* If you cut yourself, wash away any spilled blood.

Samarium Sm 153 lexidronam can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If your blood count becomes abnormally low, there are certain precautions you can take to reduce the risk of infection or bleeding, such as:

* With abnormally low white blood cell counts:

o If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

o Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

o Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

* With abnormally low platelet blood counts:

o Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.

o Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.

o Avoid contact sports or other situations where bruising or injury could occur.

Along with its needed effects, a medicine may cause some unwanted effects. Blood problems, such as a decrease in the number of white blood cells or platelets, may occur in some patients using samarium Sm 153 lexidronam.

Check with your doctor immediately if any of the following side effects occur:

Black, tarry stools; blood in urine or stools; cough or hoarseness; fever or chills; lower back or side pain; painful or difficult urination; pinpoint red spots on skin; unusual bleeding or bruising

Also, check with your doctor as soon as possible if you notice the following side effect:

Irregular heartbeat

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Increase in bone pain (transient); nausea and vomiting

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Octeotride

Octreotide is used for:
Treatment of severe diarrhea caused by certain types of cancer. It is also used to treat acromegaly in certain patients. It may also be used for other conditions as determined by your doctor.
Octreotide is a somatostatic agent. It works by reducing blood levels of a variety of hormones (eg, growth hormone) and chemical messengers (eg, gastrin, vasoactive intestinal peptide), which cause disease symptoms.
Use Octreotide as directed by your doctor. Check the label on the medicine for exact dosing instructions.
* Octreotide is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Octreotide at home, a health care provider will teach you how to use it. Be sure you understand how to use Octreotide . Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
* Do not use Octreotide if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
* Allow Octreotide to come to room temperature before using. Do not warm or thaw Octreotide with hot water or by placing in the microwave.
* Rotate injection sites to avoid using the same injection site within several days.
* Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
* If you miss a dose of Octreotide , use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once. If more than one dose is missed, contact your doctor or pharmacist.
Ask your health care provider any questions you may have about how to use Octreotide .
* Octreotide may cause dizziness, drowsiness, or vision changes. These effects may be worse if you take it with alcohol or certain medicines. Use Octreotide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
* Diabetes patients - Octreotide may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
* Octreotide may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
* Octreotide may also sometimes lower blood sugar in some patients. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
* Lab tests, including blood sugar levels, growth hormone levels, and thyroid function tests, may be performed while you use Octreotide . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
* Use Octreotide with caution in the ELDERLY; they may be more sensitive to its effects.
* Caution is advised when using Octreotide in CHILDREN; they may be more sensitive to it its effects, especially gallbladder problems.
* Octreotide may restore fertility in some women with acromegaly who were unable to become pregnant. If you wish to avoid pregnancy, you should use effective birth control while you use Octreotide .
* PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Octreotide while you are pregnant. It is not known if Octreotide is found in breast milk. If you are or will be breast-feeding while you use Octreotide , check with your doctor. Discuss any possible risks to your baby.
Store Octreotide in the refrigerator between 36 and 46 degrees F (2 and 8 degrees C). Do not freeze. Octreotide may also be stored at room temperature between 70 and 86 degrees F (20 and 30 degrees C) for up to 14 days if protected from light. Throw away multiple-dose vials within 14 days after opening. Open single-dose vials just before use and throw away any unused portion. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Octreotide , as well as syringes and needles, out of the reach of children and away from pets.

Dacarbazine treating hodgkin's disease

Treating certain cancers (eg, advanced skin cancer) and Hodgkin disease. It may be used with other medicines. It may also be used for other conditions as determined by your doctor. Dacarbazine is an anti neoplastic agent. It is not known exactly how Dacarbazine works. It may block the growth of cancer cells. do not use dacarbazine if you are an allergic to any ingredient in that or if you are suffering from chicken pox.
Some medical conditions may interact with Dacarbazine . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

* if you are pregnant, planning to become pregnant, or are breast-feeding
* if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
* if you have allergies to medicines, foods, or other substances
* if you have a blood disease, an infection, or liver or kidney problems

Some MEDICINES MAY INTERACT with Dacarbazine . However, no specific interactions with Dacarbazine are known at this time.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Dacarbazine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Use Dacarbazine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

* Dacarbazine will be administered as an injection at your doctor's office, hospital, or clinic.
* If Dacarbazine contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
* If nausea, vomiting, or loss of appetite occurs, ask your doctor or pharmacist for ways to lessen these effects.
* Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
* If you miss a dose of Dacarbazine , contact your doctor immediately.
Ask your health care provider any questions you may have about how to use Dacarbazine .
Dacarbazine may lower your body's ability to fight infection. Prevent infection by avoiding contact with people with colds or other infections. Notify your doctor of any signs of infection, including fever, sore throat, rashes, or chills. Dacarbazine may reduce the number of clot-forming cells (platelets) in your blood. To prevent bleeding, avoid situations in which bruising or injury may occur. Report any unusual bleeding, bruising, blood in stools, or dark, tarry stools to your doctor.