About

Certican (everolimus) is an immunosuppressant medication belonging to the class of mTOR inhibitors. It works by inhibiting the mammalian target of rapamycin (mTOR), a key protein involved in cell growth, proliferation, and angiogenesis. In the context of organ transplantation, everolimus helps prevent rejection by suppressing the immune system's response to the transplanted organ. It reduces the proliferation of T-cells and B-cells, which are crucial components of the immune response. This action helps maintain the transplanted organ's viability and function, reducing the risk of acute and chronic rejection episodes.

Everolimus is often used in combination with other immunosuppressants, such as calcineurin inhibitors and corticosteroids, to achieve optimal immune suppression while minimizing the toxicity associated with higher doses of individual agents. Its unique mechanism of action also lends it to applications in certain advanced cancers, where its anti-proliferative effects are beneficial.

Uses

Prevention of organ rejection in kidney transplant recipients.
Prevention of organ rejection in heart transplant recipients.
Prevention of organ rejection in liver transplant recipients.
Treatment of certain advanced cancers (e.g., renal cell carcinoma).

Directions For Use

Take orally once daily, consistently at the same time each day, with or without food.

Do not crush or chew the tablet; swallow whole with water.

Benefits

Effectively prevents organ transplant rejection.
Reduces the need for calcineurin inhibitors in some protocols.
Offers a steroid-sparing option in immunosuppression.
Improves long-term graft survival rates.
Has anti-proliferative effects beneficial in certain cancers.
Provides a targeted immunosuppressive mechanism.

Side Effects

Increased risk of infection.
Anemia.
Leukopenia (low white blood cell count).
Thrombocytopenia (low platelet count).
Hyperlipidemia (high cholesterol/triglycerides).
Hypertension (high blood pressure).
Peripheral edema.
Proteinuria (protein in urine).
Oral ulceration/stomatitis.
Diarrhea.
Nausea.
Rash.

Safety Measures

Alcohol - Avoid or limit alcohol consumption as it may exacerbate certain side effects like liver issues or gastrointestinal upset. Alcohol can also interact with other medications often co-administered.
Pregnancy - Contraindicated during pregnancy due to potential fetal harm. Women of childbearing potential must use effective contraception during treatment and for 8 weeks after the last dose.
Breastfeeding - Not recommended during breastfeeding as everolimus may pass into breast milk and harm the infant. A decision should be made to discontinue nursing or the drug.
Liver - Use with caution in patients with impaired liver function. Dose adjustments may be necessary as everolimus is primarily metabolized by the liver. Close monitoring of drug levels is essential.
Kidney - Generally well-tolerated in patients with kidney conditions, but close monitoring of renal function is important, especially when used with nephrotoxic agents. No specific dose adjustment for mild to moderate impairment.
Lung - Can cause interstitial lung disease (ILD) or pneumonitis, a serious side effect. Patients should be monitored for new or worsening respiratory symptoms like cough, dyspnea, or fever.

Disclaimer

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