କ୍ଲାଡ୍ରିବାଇନ

କ୍ଲାଡ୍ରିବାଇନ
Clinical data
Trade names	Leustatin, Mavenclad, others
Synonyms	2-chlorodeoxyadenosine
AHFS/Drugs.com	Injectable: monograph; By mouth: monograph
MedlinePlus	a693015
data	EU EMA: yes; US DailyMed: Cladribine;
Pregnancy; category	AU: D ; US: D (Evidence of risk) ; ;
Routes of; administration	Intravenous, subcutaneous (liquid), by mouth (tablet)
Legal status
Legal status	AU: S4 (Prescription only) ; CA: ℞-only ; UK: POM (Prescription only) ; US: ℞-only ;
Pharmacokinetic data
Bioavailability	100% (i.v.); 37 to 51% (by mouth)
Protein binding	25% (range 5-50%); up to 20% (by mouth)
Metabolism	Mostly via intracellular kinases; 15-18% is excreted unchanged IV and SQ bolus: 15-18% is excreted unchanged By mouth, 25% (±21%) of dose is excreted unchanged in urine and 3.8% as a metabolite
Elimination half-life	~10 hours IV and SQ and 18.4 to 19.7 hours after by mouth
Excretion	Urinary
Identifiers
	IUPAC name 5-(6-Amino-2-chloro-purin-9-yl)-2-(hydroxymethyl)oxolan-3-ol;
ECHA InfoCard	100.164.726
Chemical and physical data
Formula	C10H12ClN5O3
Molar mass	୨୮୫.୬୯ g·mol−1
3D model (JSmol)	Interactive image;
	SMILES Clc1nc(c2ncn(c2n1)[C@@H]3O[C@@H]([C@@H](O)C3)CO)N;
	InChI InChI=1S/C10H12ClN5O3/c11-10-14-8(12)7-9(15-10)16(3-13-7)6-1-4(18)5(2-17)19-6/h3-6,17-18H,1-2H2,(H2,12,14,15)/t4-,5+,6+/m0/s1 ; Key:PTOAARAWEBMLNO-KVQBGUIXSA-N ;
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କ୍ଲାଡ୍ରିବାଇନ, ଅନ୍ୟମାନଙ୍କ ମଧ୍ୟରେ ଏକ ବେପାର ନାମ ଲେଷ୍ଟାଟିନ୍, ହେଉଛି ଏକ ଔଷଧ ଯାହାକି ଲୋମଶ ଜୀବକୋଷ ଲିଉକେମିଆ, କ୍ରନିକ ଲିମ୍ଫୋସାଇଟିକ ଲ୍ୟୁକେମିଆ, ନନ୍-ହଜକିନ୍ସ ଲିମ୍ଫୋମା ଏବଂ ଚର୍ମ ଟି-ଜୀବକୋଷ ଲିମ୍ଫୋମା ରୋଗମାନଙ୍କର ଚିକିତ୍ସା ପାଇଁ ବ୍ୟବହୃତ ହୁଏ ।^[୫] ଏହା ଆରୋଗ୍ୟ-ପୁନଃପୌନିକ ଏକାଧିକ ସ୍କ୍ଲେରୋସିସ ପାଇଁ ମଧ୍ୟ ବ୍ୟବହୃତ ହୁଏ | ^[୬] ଏହା ପାଟିରେ କିମ୍ବା ଇଞ୍ଜେକ୍ସନଦ୍ୱାରା ଶିରାଭ୍ୟନ୍ତରରେ କିମ୍ବା ଚର୍ମ ତଳେ ଦିଆଯାଏ ।^[୬]

ସାଧାରଣ ପାର୍ଶ୍ୱ ପ୍ରତିକ୍ରିୟାରେ ସଂକ୍ରମଣ, ଉଦ୍‌ବେଗ, କେଶହାନୀ, ଅନିୟମିତ ହୃତ୍ ସ୍ପନ୍ଦନ, ତରଳ ଝାଡ଼ା, ଜ୍ୱର, ମାଂସପେଶୀ ଯନ୍ତ୍ରଣା, ରାସ ଏବଂ ରକ୍ତସ୍ରାବ ହୋଇପାରେ ।^[୬] ଅନ୍ୟାନ୍ୟ ପାର୍ଶ୍ୱ ପ୍ରତିକ୍ରିୟାରେ ଅସ୍ଥି ମଜ୍ଜା ଦମନ, ପ୍ରଗତିଶୀଳ ମଲ୍ଟିଫୋକାଲ୍ ଏନସେଫାଲୋପାଥି (PML), ଟ୍ୟୁମର୍ ଲାଇସିସ୍ ସିଣ୍ଡ୍ରୋମ ଏବଂ ସ୍ନାୟୁ କ୍ଷତି ଅନ୍ତର୍ଭୁକ୍ତ ହୋଇପାରେ ।^[୬] ଗର୍ଭାବସ୍ଥାରେ ବ୍ୟବହାର କଲେ ଶିଶୁର କ୍ଷତି ହୋଇପାରେ ।^[୬] ଏହା ଏକ ଆଣ୍ଟିମେଟାବୋଲାଇଟ୍, ବିଶେଷ ଭାବରେ ଏକ ପ୍ୟୁରିନ୍ ଆନାଲଗ ଯାହା ଲିମ୍ଫୋସାଇଟ‌ଦ୍ୱାରା ନୂତନ ଡିଏନଏ ଉତ୍ପାଦନରେ ବାଧା ସୃଷ୍ଟି କରିଥାଏ ।^[୭]

ଚିକିତ୍ସା କ୍ଷେତ୍ରରେ ୧୯୮୦ ଦଶକରୁ କ୍ଲାଡ୍ରିବାଇନ୍ ବ୍ୟବହାର ହୋଇଆସୁଛି ଓ ୧୯୯୩ ପରଠାରୁ ୟୁରୋପର କିଛି ଅଂଶରେ ବ୍ୟବହାର କରାଯାଉଛି ।^[୭] ୧୯୯୩ରୁ ଯୁକ୍ତରାଷ୍ଟ୍ରରେ ଚିକିତ୍ସା କ୍ଷେତ୍ରରେ ବ୍ୟବହାର ପାଇଁ ଏହା ମଧ୍ୟ ଅନୁମୋଦିତ ହୋଇଥିଲା ।^[୫] ଏହା ବିଶ୍ୱ ସ୍ୱାସ୍ଥ୍ୟ ସଂଗଠନର ଜରୁରୀ ଔଷଧ ତାଲିକାରେ ଅଛି ।^[୮] ମୂଳ ନାମରେ ମଧ୍ୟ କେତେକ ସାଧାରଣ ଔଷଧ ଭାବରେ ଉପଲବ୍ଧ ।^[୫] ଯୁକ୍ତରାଜ୍ୟରେ 10 ମିଗ୍ରା ଇଞ୍ଜେକ୍ସନ ପାଇଁ ମୂଲ୍ୟ ପ୍ରାୟ ୧୬୦ ପାଉଣ୍ଡ ଥିବାବେଳେ ୨୦୨୧ ସୁଦ୍ଧା ୧୦ ମିଗ୍ରା ବଟିକା ମୂଲ୍ୟ ୨୦୫୦ ପାଉଣ୍ଡ ଖର୍ଚ୍ଚ ହୋଇଥାଏ ।^[୬] ଯୁକ୍ତରାଷ୍ଟ୍ରରେ ଏହି ରାଶି ଯଥାକ୍ରମେ ୩୭୦ ଡଲାର ଏବଂ ୯,୦୦୦ ଡଲାର ଖର୍ଚ୍ଚ ହୋଇଥାଏ ।^[୯] ^[୧୦]

ଆଧାର ସମ୍ପାଦନା

↑ "Cladribine". Drugs.com. 28 February 2020. Archived from the original on 4 March 2016. Retrieved 4 March 2020.
↑ ^୨.୦ ^୨.୧ ^୨.୨ ^୨.୩ "PRODUCT INFORMATION LITAK© 2 mg/mL solution for injection" (PDF). TGA eBusiness Services. St Leonards, Australia: Orphan Australia Pty. Ltd. 10 May 2010. Archived from the original on 11 September 2016. Retrieved 27 November 2014.
↑ ^୩.୦ ^୩.୧ Giovannoni, G (2017). "Cladribine to Treat Relapsing Forms of Multiple Sclerosis". Neurotherapeutics. 14 (4): 874–887. doi:10.1007/s13311-017-0573-4. PMC 5722776. PMID 29168160.
↑ Liliemark J (February 1997). "The clinical pharmacokinetics of cladribine". Clinical Pharmacokinetics. 32 (2): 120–31. doi:10.2165/00003088-199732020-00003. PMID 9068927. S2CID 32926069.
↑ ^୫.୦ ^୫.୧ ^୫.୨ "Cladribine Monograph for Professionals". Drugs.com (in ଇଂରାଜୀ). Archived from the original on 5 March 2021. Retrieved 5 January 2022.
↑ ^୬.୦ ^୬.୧ ^୬.୨ ^୬.୩ ^୬.୪ ^୬.୫ BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 952. ISBN 978-0857114105.
↑ ^୭.୦ ^୭.୧ "Litak". Archived from the original on 16 April 2021. Retrieved 5 January 2022.
↑ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
↑ "Cladribine Prices, Coupons & Patient Assistance Programs". Drugs.com (in ଇଂରାଜୀ). Archived from the original on 20 April 2021. Retrieved 5 January 2022.
↑ "Mavenclad Prices, Coupons & Patient Assistance Programs". Drugs.com (in ଇଂରାଜୀ). Archived from the original on 22 January 2021. Retrieved 5 January 2022.

[drugs.comINT-1] "Cladribine". Drugs.com. 28 February 2020. Archived from the original on 4 March 2016. Retrieved 4 March 2020.

[TGA-2] ୨.୦ ^୨.୧ ^୨.୨ ^୨.୩ "PRODUCT INFORMATION LITAK© 2 mg/mL solution for injection" (PDF). TGA eBusiness Services. St Leonards, Australia: Orphan Australia Pty. Ltd. 10 May 2010. Archived from the original on 11 September 2016. Retrieved 27 November 2014.

[Giovannoni_Neurotherapeutics-3] ୩.୦ ^୩.୧ Giovannoni, G (2017). "Cladribine to Treat Relapsing Forms of Multiple Sclerosis". Neurotherapeutics. 14 (4): 874–887. doi:10.1007/s13311-017-0573-4. PMC 5722776. PMID 29168160.

[4] Liliemark J (February 1997). "The clinical pharmacokinetics of cladribine". Clinical Pharmacokinetics. 32 (2): 120–31. doi:10.2165/00003088-199732020-00003. PMID 9068927. S2CID 32926069.

[AHFS2022-5] ୫.୦ ^୫.୧ ^୫.୨ "Cladribine Monograph for Professionals". Drugs.com (in ଇଂରାଜୀ). Archived from the original on 5 March 2021. Retrieved 5 January 2022.

[BNF81-6] ୬.୦ ^୬.୧ ^୬.୨ ^୬.୩ ^୬.୪ ^୬.୫ BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 952. ISBN 978-0857114105.

[EPAR2022-7] ୭.୦ ^୭.୧ "Litak". Archived from the original on 16 April 2021. Retrieved 5 January 2022.

[WHO23rd-8] World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.

[9] "Cladribine Prices, Coupons & Patient Assistance Programs". Drugs.com (in ଇଂରାଜୀ). Archived from the original on 20 April 2021. Retrieved 5 January 2022.

[10] "Mavenclad Prices, Coupons & Patient Assistance Programs". Drugs.com (in ଇଂରାଜୀ). Archived from the original on 22 January 2021. Retrieved 5 January 2022.

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Clinical data

Trade names	Leustatin, Mavenclad, others^[୧]
Synonyms	2-chlorodeoxyadenosine
AHFS/Drugs.com	Injectable: monograph By mouth: monograph
MedlinePlus	a693015
data	EU EMA: yes US DailyMed: Cladribine
Pregnancy category	AU: D US: D (Evidence of risk)
Routes of administration	Intravenous, subcutaneous (liquid), by mouth (tablet)
Legal status
Legal status	AU: S4 (Prescription only) CA: ℞-only UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability	100% (i.v.); 37 to 51% (by mouth)^[୪]
Protein binding	25% (range 5-50%);^[୨] up to 20% (by mouth) ^[୩]
Metabolism	Mostly via intracellular kinases; 15-18% is excreted unchanged^[୨] IV and SQ bolus: 15-18% is excreted unchanged By mouth, 25% (±21%) of dose is excreted unchanged in urine and 3.8% as a metabolite^[୩]
Elimination half-life	~10 hours IV and SQ^[୨] and 18.4 to 19.7 hours after by mouth
Excretion	Urinary^[୨]
Identifiers
IUPAC name 5-(6-Amino-2-chloro-purin-9-yl)-2-(hydroxymethyl)oxolan-3-ol
ECHA InfoCard	100.164.726
Chemical and physical data
Formula	C₁₀H₁₂ClN₅O₃
Molar mass	୨୮୫.୬୯ g·mol⁻¹
3D model (JSmol)	Interactive image
SMILES Clc1nc(c2ncn(c2n1)[C@@H]3O[C@@H]([C@@H](O)C3)CO)N
InChI InChI=1S/C10H12ClN5O3/c11-10-14-8(12)7-9(15-10)16(3-13-7)6-1-4(18)5(2-17)19-6/h3-6,17-18H,1-2H2,(H2,12,14,15)/t4-,5+,6+/m0/s1^Y Key:PTOAARAWEBMLNO-KVQBGUIXSA-N^Y
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