PERNOB Injection 100 milligrams (Polynate Calcium)

Adult dosage

1. Standard methotrexate therapy: Inject 6-12 mg of Polynate intramuscularly every 6 hours for a total of 4 times a day. 2. Rescue therapy with methotrexate and Polynate: Starting 3 hours after stopping methotrexate, administer 15 mg of Polynate intravenously every 3 hours for a total of 9 doses, followed by intravenous or intramuscular injections every 6 hours for a total of 8 doses. 3. In combination with 5-Fluorouracil (5-FU) for metastatic colon cancer

This medication is not suitable for treating malignant anemia or megaloblastic anemia caused by vitamin B12 deficiency. Caution is required, as blood conditions may improve even while neurological symptoms are progressing. When using the injectable form, care must be taken to avoid glass shards if the ampule is broken, especially when administering to children or the elderly. Women who are pregnant or breastfeeding should not receive this medication in combination with 5-FU. Caution is necessary when this medication is used by pregnant or breastfeeding women for the purpose of reducing toxicity of folate antagonists. This medication may cause allergic reactions, hives, injection site pain, fever, central nervous system symptoms (such as paralysis, agitation, depression), and other side effects. When used in combination with 5-FU, diarrhea, skin reactions, stomatitis, and hematological toxicity may occur, so if severe symptoms arise, dosage adjustment of 5-FU may be required. This medication must be used under the direction of a physician experienced in chemotherapy, in conjunction with methotrexate, and the treatment duration and dosage should be determined by monitoring plasma methotrexate levels. If there is ascites, renal function impairment, or abnormal fluid status, drug elimination may be delayed, and high doses should be administered intravenously. This medication uses a transporter similar to methotrexate, so effectiveness may diminish in cases of resistance. If the patient is poorly absorbing the medication or experiencing severe vomiting, it is preferable to administer it via injection instead of orally. In patients with central nervous system tumors, repeated administration may lead to drug accumulation and decreased antitumor effectiveness, so overdose should be avoided. This medication is not used for the treatment of erythrocytosis due to specific DNA synthesis inhibitors. It is ineffective against some side effects such as nephrotoxicity caused by methotrexate. This drug increases metabolism in the liver, which may reduce blood levels of certain anticonvulsants, so monitoring and dosage adjustment are necessary. There is a need for caution in combining it with 5-FU as it may increase the effectiveness and side effects of 5-FU. Consideration for the risks and benefits to the fetus is necessary when administering to pregnant women, and caution is also needed when administering to breastfeeding women. Elderly or frail patients are at higher risk of gastrointestinal toxicity and should be treated with particular caution. This medication should not be administered intrathecally, and due to its calcium content, the intravenous administration rate must be limited.

Serious side effects

Hives, anaphylactic reactions (including severe swelling, chest tightness, difficulty breathing, cold sweat, and pallor)

Mild side effects

Vascular pain, transient pain, fever, agitation, depression, diarrhea, skin reactions, dry skin, stomatitis, conjunctivitis, mucositis, mild hematological toxicity, leukopenia, central nervous system disorders (excluding paralysis disorders), hypersensitivity, hives

This medication is sensitive to light, so it should be stored in a light-resistant container. Additionally, avoid storing it in excessively hot or cold places; it is advisable to store it at room temperature.

Appearance

A clear injectable solution that is colorless to light yellow, contained in a brown ampule

Package unit

10 mL - 10 ampules per box