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Enzamide 40mg tablets are majorly indicated for prostate carcinoma, which contains Enzalutamide, as an active component considered as non-steroidal anti-androgen medication.
Enzamide 40mg is a prescription medicine, which can be used under the guidance of medical practitioners.
The primary usage of Enzamide 40mg tablet is contains in the specific treatment of metastatic castration resistant prostate cancer (mCRPC), taken orally.
The anti-androgen effect exhibits by obstruct the testosterone production by interfere with androgen synthesis, the hormone which is responsible for tumor cell growth.
Enzamide 40mg is majorly used to treat prostate cancer in men.
The usual prescribed dosage of Enzamide is 160mg as a single dose by taking with or without food.
Enzamide is available in the strength of 40mg; four tablets of Enzamide should be administered at a same time.
Enzamide tablet should not crush, not chew taken with glass of water.
In patients with ≥ grade III toxicity: Enzamide 40mg therapy should be refuse for one week or the symptoms should be reduced to grade II, then restart with same dose or decreased to 80mg or 120mg
Strong CYP2C8 inhibitors: While combining with Enzamide tablet, the dosage should be modified by reducing to 80mg as a single dose or avoid this combination.
Strong CYP3A4 inducers: Co administration of Enzamide with Strong CYP3A4 inducers, the dosage of Enzamide tablet increased up to 240mg or stop this combination.
In the case of over dosage of Enzamide tablets, causes severe seizures.
If over dosage is occurring, immediately stop the therapy and maintain the safety measures.
In dose acceleration study, seizure does not occur at ≤ 240mg daily.
Seizures may report in the dose of 360mg, 480mg & 600mg at high risk
Prostate carcinoma is developed by using male hormone known as androgen.
Testosterone is the one of the major hormones secreted by testes and adrenal glands
Enzamide containing Enzalutamide will interfere with testosterone production, causes tumor cell growth depletion.
Enzamide interfere with androgen receptor signaling transduction and leads to cancer cell lysis
After receiving 160mg of Enzamide for mCRPC, from median time to attain peak plasma concentration time at 1 hour (variation with 0.5 to 3 hours).
Food does not cause any alteration in absorption of Enzamide tablets.
Maximum plasma protein bounding capacity of Enzamide tablets is occurs as 97% to 98%
Two most prominent cytochrome isoenzymes are involved in metabolism of Enzamide tablets;
The isoenzymes like CYP2C8 & CYP3A4; whereas CYP2C8 is essential for production of N-desmethyl Enzalutamide which is an active metabolite of Enzalutamide.
Enzamide tablets go through elimination by hepatic metabolism
Major route of elimination;
71% in urine; 14% in feces
The terminal half-life period of Enzamide tablets is 5.8 days (range at 2.8 to 10.2 days); N-desmethyl Enzalutamide has half-life period of relatively 7.8 to 8.6 days.
Some side effects during the therapy using with Enzamide,
Hypertension & hot flush, Dizziness, headache, Asthenia conditions, Peripheral edema, Spinal cord compression, paresthesia, Mental impairment, Hypesthesia, Respiratory tract infections, Hematuria, Pollakiuria, Dry skin, Back pain, Arthralgia, Muscular weakness, pain, Diarrhea, Pruritus, Neutropenia, Thrombocytopenia, Increasing bilirubin level, Epistaxis, Infections like sepsis, Fall associated injuries like fractures, joint injury, and hematomas, Hallucinations.
Enzamide tablets are contraindicated to pregnancy condition, which may cause fetal harm leads to death.
An Anaphylactic reaction happens, if patients are contraindicated to the ingredient present in Enzamide tablets.
Enzamide tablet container should be stored at the temperature of 20oC to 25oC (68oF to 77oF).
Keep the container in cool and dry place
Protect from light.
During the treatment with Enzamide tablets, patient may suffer with some adverse effects like;
Posterior reversible encephalopathy syndrome
In PRES, some neurological disorders occur in patients. It may overcome by providing safety measures or discontinue the therapy as soon as possible.
PRES is recognized by using MRI
In seizures, patient must counsel about this adverse reaction before starting the therapy. Stop the therapy if possible.
Spermatogenesis occurs which may interfere with male fertility leads to hypo spermatogenesis.
In androgen depletion therapy, may have increase exposure of cardiovascular disease like worsening hypertension.
Enzamide combined with CYP2C8 strong inhibitors, causes elevation of plasma concentration time curve of Enzalutamide and its active metabolite. So avoid this combination, otherwise dosage of Enzamide should be reduced to 80mg.
Enzamide with CYP2C8 strong inducers causes variation in plasma exposure of Enzamide, to minimize this problem to avoid this concomitant.
Co administration of Enzamide tablets with strong inhibitors or CYP3A4, leads to elevate the AUC of Enzalutamide and its metabolite.
CYP3A4 strong inducers example like; phenytoin, Phenobarbital, carbamazepine etc combines with Enzamide tablets causes depletes the plasma exposure of Enzamide.
Moderate CYP3A4 inducers like Bosentan, efavirenz, modafinil, st Johns wort causes decreasing the plasma concentration of Enzamide tablet.
Enzamide tablets are strong CYP3A4 inducers and moderate CYP2C8 & CYP2C19.
CYP3A4 strong inducers like Midazolam, CYP2C8 inducers like warfarin, & CYP2C19 inducers like Omeprazole with Enzamide causes reducing the plasma risk of Midazolam, warfarin & Omeprazole.
Pregnancy category of Enzamide tablet is D
Enzamide is contraindicated to pregnancy; it may cause fetal harm even to death.
Breast feeding is not suggested, Enzamide is contraindicated in lactation
Enzamide 40mg is a chem. Drug, used in prostate cancer. Enzamide tablet should not be self-medicated, used by the patients only after getting advice from the medical oncologist.
If patient missed a dose, must consult with the physician and follow the instructions as per the guidance of medical adviser, the missed dose should be taken within a time or the missed dose should be avoid and follow the regular schedule.
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