Lenaldocapsule 15mg (Lenalidomide)

Adult dosage

1. Multiple Myeloma 1) In combination with dexamethasone for the treatment of patients who have received at least one prior therapy Treatment should not be initiated if the absolute neutrophil count is <1,000/㎕ and/or the platelet count is <75,000/㎕. The recommended starting dose is 25mg once daily. Take 25mg capsules on Days 1–21 of each 28-day cycle. The recommended dose of dexamethasone, based on a 28-day cycle, is 40mg once daily on Days 1–4, 9–12, and 17–20 during the first 4 cycles. After 4 cycles, administer 40mg once daily only on Days 1–4 of each 28-day cycle. Dose adjustments during treatment ① Dose adjustment based on platelet count If the count decreases to <30,000/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧30,000/㎕: Resume at 15mg once daily For each subsequent decrease to <30,000/㎕: Interrupt treatment When the count recovers to ≧30,000/㎕: Resume at a dose reduced by 5mg from the dose being given. Do not reduce the dose to less than 5mg once daily. ② Dose adjustment based on absolute neutrophil count (Absolute Neutrophil Count: ANC) If the count decreases to <1,000/㎕: Interrupt treatment, add G-CSF, and monitor complete blood counts weekly When the count recovers to ≧1,000/㎕ and neutropenia is the only toxicity: Resume at 25mg once daily When the count recovers to ≧1,000/㎕ and other toxicities occur: Resume at 15mg once daily For each subsequent decrease to <1,000/㎕: Interrupt treatment When the count recovers to ≧1,000/㎕: Resume at a dose reduced by 5mg from the dose being given. Do not reduce the dose to less than 5mg once daily. 2) In combination with dexamethasone for the treatment of newly diagnosed patients who are ineligible for transplantation Treatment should not be initiated if the absolute neutrophil count is <1,000/㎕ and/or the platelet count is <50,000/㎕. The recommended starting dose is 25mg once daily. Take 25 mg capsules on Days 1–21 of each 28-day cycle. The recommended dose of dexamethasone, based on a 28-day cycle, is 40mg once daily on Days 1, 8, 15, and 22. For patients aged 75 years or older, the recommended dose of dexamethasone, based on a 28-day cycle, is 20mg once daily on Days 1, 8, 15, and 22. <Dose reduction levels> Starting dose: this drug 25 mg, dexamethasone 40 mg 1st dose reduction: this drug 20 mg, dexamethasone 20 mg 2nd dose reduction: this drug 15 mg, dexamethasone 12 mg 3rd dose reduction: this drug 10 mg, dexamethasone 8 mg 4th dose reduction: this drug 5 mg, dexamethasone 4 mg 5th dose reduction: this drug 2.5 mg, dexamethasone N/A ① Dose adjustment based on platelet count If the count decreases to <25,000/㎕: Interrupt this drug and dexamethasone and monitor complete blood counts weekly When the count recovers to ≧50,000/㎕: Resume at one dose level below the dose being given ② Dose adjustment based on absolute neutrophil count (Absolute Neutrophil Count: ANC) If the count decreases to <500/㎕: Interrupt this drug and dexamethasone and monitor complete blood counts weekly When the count recovers to ≧1,000/㎕ and neutropenia is the only toxicity: Resume at the starting dose When the count recovers to ≧500/㎕ and dose-dependent hematologic toxicity other than neutropenia occurs: Resume at one dose level below the dose being given For each subsequent decrease to <500/㎕: Interrupt this drug and dexamethasone When the count recovers to ≧500/㎕: Resume at one dose level below the dose being given ③ Dose adjustment for febrile neutropenia (fever ≥38.5℃ and ANC<1,000/㎕): Interrupt treatment and monitor complete blood counts weekly. On the start date of the next treatment cycle, if neutropenia is the only dose-limiting toxicity, resume treatment at the dose being given, continuing growth factor use if needed. Otherwise, resume treatment at one dose level below the dose being given. 3) In combination with melphalan and prednisolone for the treatment of newly diagnosed patients who are ineligible for transplantation Treatment should not be initiated if the absolute neutrophil count is <1,500/㎕ and/or the platelet count is <75,000/㎕. The recommended starting dose is 10mg once daily. Take 10 mg capsules on Days 1–21 of each 28-day cycle. Through Cycle 9, administer melphalan orally at a dose of 0.18mg/kg on Days 1–4 of each 28-day cycle, and administer prednisolone orally at a dose of 2mg/kg on Days 1–4 of each 28-day cycle. For patients who have completed 9 cycles or cannot complete combination therapy because of intolerance, administer this drug alone at 10mg once daily on Days 1–21 of each 28-day cycle until disease progression. <Dose reduction levels> Starting dose: this drug 10 mg, melphalan 0.18 mg/kg, prednisolone 2 mg/kg 1st dose reduction: this drug 7.5 mg, melphalan 0.14 mg/kg, prednisolone 1 mg/kg 2nd dose reduction: this drug 5 mg, melphalan 0.10 mg/kg, prednisolone 0.5 mg/kg 3rd dose reduction: this drug 2.5 mg, melphalan N/A, prednisolone 0.25 mg/kg ① Dose adjustment based on platelet count If the count decreases to <25,000/㎕: Interrupt this drug, melphalan, and prednisolone and monitor complete blood counts weekly When the count recovers to ≧25,000/㎕: Resume this drug and melphalan at doses reduced by one dose level For each subsequent decrease to <30,000/㎕: Interrupt this drug, melphalan, and prednisolone When the count recovers to ≧30,000/㎕: Resume this drug and melphalan at doses reduced by one dose level from the doses being given ② Dose adjustment based on absolute neutrophil count (Absolute Neutrophil Count: ANC) If the count decreases to <500/㎕: Interrupt this drug, melphalan, and prednisolone and monitor complete blood counts weekly When the count recovers to ≧500/㎕ and neutropenia is the only toxicity: Resume at the starting dose When the count recovers to ≧500/㎕ and dose-dependent hematologic toxicity other than neutropenia occurs: Resume this drug and melphalan at doses reduced by one dose level For each subsequent decrease to <500/㎕: Interrupt this drug, melphalan, and prednisolone When the count recovers to ≧500/㎕: Resume this drug and melphalan at doses reduced by one dose level from the doses being given ③ Dose adjustment for febrile neutropenia (fever≥38.5℃ and ANC<1,000/㎕): Interrupt this drug, melphalan, and prednisolone and monitor complete blood counts weekly. On the start date of the next treatment cycle, if neutropenia is the only dose-limiting toxicity, resume treatment at the dose being given, continuing growth factor use if needed. Otherwise, resume treatment at one dose level below the dose being given. 4) In combination with bortezomib and dexamethasone for the treatment of newly diagnosed patients (1) In combination with bortezomib and dexamethasone for the treatment of newly diagnosed patients who are ineligible for transplantation Treatment should not be initiated if the absolute neutrophil count is <1,000/㎕ and/or the platelet count is <80,000/㎕. The recommended starting dose of this drug is 25mg once daily, taken on Days 1–14 of each 21-day cycle. Administer bortezomib by subcutaneous injection at a dose of 1.3mg/m2 per body surface area on Days 1, 4, 8, and 11 of each 21-day cycle. The recommended dose of dexamethasone is 20mg once daily, taken on Days 1, 2, 4, 5, 8, 9, 11, and 12 of each 21-day cycle. Patients should receive treatment for 8 cycles (total 24 weeks) as initial therapy. After initial therapy, take this drug 25mg once daily in combination with dexamethasone on Days 1–21 of each 28-day cycle. The recommended dosage regimen for dexamethasone is 40mg once daily on Days 1, 8, 15, and 22 of each 28-day cycle. For patients aged 75 years or older, the starting dose of dexamethasone is 20mg once daily on Days 1, 8, 15, and 22 of each 28-day cycle. (2) Induction therapy with dexamethasone and bortezomib for the treatment of newly diagnosed patients who are eligible for transplantation Treatment should not be initiated if the absolute neutrophil count is <1,000/㎕ and/or the platelet count is <80,000/㎕. The recommended starting dose of this drug is 25mg once daily, taken on Days 1–21 of each 28-day cycle. Administer bortezomib by subcutaneous injection at a dose of 1.3mg/m2 per body surface area on Days 1, 4, 8, and 11 of each 28-day cycle. The recommended dose of dexamethasone is 40mg once daily, taken on Days 1–4 and 9–12 of each 28-day cycle. Patients should receive treatment for 6 cycles (total 24 weeks) as induction therapy. <Dose reduction levels> Starting dose 25 mg; 1st dose reduction 20 mg; 2nd dose reduction 15 mg; 3rd dose reduction 10 mg; 4th dose reduction 5 mg; 5th dose reduction 2.5 mg If the platelet count decreases to <30,000/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧50,000/㎕: Resume at one dose level below the dose being given For each subsequent decrease to <30,000/㎕: Interrupt treatment When the count recovers to ≧50,000/㎕: Resume at one dose level below the dose being given If the neutrophil count decreases to <500/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧1,000/㎕ and neutropenia is the only toxicity: Resume at the starting dose When the count recovers to ≧500/㎕ and dose-dependent hematologic toxicity other than neutropenia occurs: Resume at one dose level below the dose being given For each subsequent decrease to <500/㎕: Interrupt treatment When the count recovers to ≧500/㎕: Resume at one dose level below the dose being given 5) Maintenance therapy in patients who have undergone autologous hematopoietic stem cell transplantation after newly diagnosed disease Treatment should not be initiated if the absolute neutrophil count is <1,000/㎕ and/or the platelet count is <75,000/㎕. The recommended starting dose is 10mg once daily. Take 10 mg capsules on Days 1–28 of each 28-day cycle until intolerance or disease progression occurs. After 3 cycles of maintenance therapy with this drug, the dose may be increased to 15mg once daily if tolerated. Dose reduction levels: From the starting dose (10mg), 1st dose reduction 5 mg, 2nd dose reduction 5mg (Days 1–21 of each 28-day cycle); if the dose has been increased (15mg), 1st dose reduction 10 mg, 2nd dose reduction 5 mg, 3rd dose reduction 5mg (Days 1–21 of each 28-day cycle). Do not reduce below 5mg (Days 1–21 of each 28-day cycle). If the platelet count decreases to <30,000/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧30,000/㎕: Resume at a dose reduced by one dose level For each subsequent decrease to <30,000/㎕: Interrupt treatment When the count recovers to ≧30,000/㎕: Resume at a dose reduced by one dose level from the dose being given If the absolute neutrophil count decreases to <500/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧500/㎕: Resume at a dose reduced by one dose level For each subsequent decrease to <500/㎕: Interrupt treatment When the count recovers to ≧500/㎕: Resume at a dose reduced by one dose level from the dose being given 2. Myelodysplastic Syndromes Treatment should not be initiated if the absolute neutrophil count is <500/㎕ and/or the platelet count is <25,000/㎕. The recommended starting dose is 10mg once daily. Take 10 mg capsules on Days 1–21 of each 28-day cycle. Dose reduction levels: Starting dose 10 mg once daily on Days 1–21 of each 28-day cycle; 1st dose reduction 5 mg once daily on Days 1–28 of each 28-day cycle; 2nd dose reduction 2.5 mg once daily on Days 1–28 of each 28-day cycle; 3rd dose reduction 2.5 mg every other day on Days 1–28 of each 28-day cycle. If the platelet count decreases to <25,000/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧50,000/㎕, or recovers to ≧25,000/㎕ to <50,000/㎕ on at least 2 occasions over 7 days or longer: Resume at one dose level below the dose being given If the absolute neutrophil count decreases to <500/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧500/㎕: Resume at one dose level below the dose being given Treatment with this drug should be discontinued in patients who have not had at least a minor erythroid response within 4 months after starting treatment (demonstrated by at least a 50% reduction in transfusion requirements or, if no transfusions were given, a 1g/dl increase in hemoglobin level). 3. Mantle Cell Lymphoma The recommended starting dose is 25mg once daily. Take 25mg capsules on Days 1–21 of each 28-day cycle. Dose reduction levels: Starting dose 25mg once daily on Days 1–21 of each 28-day cycle; 1st dose reduction 20mg once daily on Days 1–21 of each 28-day cycle; 2nd dose reduction 15mg once daily on Days 1–21 of each 28-day cycle; 3rd dose reduction 10mg once daily on Days 1–21 of each 28-day cycle; 4th dose reduction 5mg once daily on Days 1–21 of each 28-day cycle; 5th dose reduction 2.5mg once daily on Days 1–21 of each 28-day cycle; 5mg every other day on Days 1–21 of each 28-day cycle. If the platelet count decreases to <50,000/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧60,000/㎕: Resume at one dose level below the dose being given For each subsequent decrease to <50,000/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧60,000/㎕: Resume at one dose level below the dose being given Do not reduce below 2.5mg once daily or 5mg every other day. If the absolute neutrophil count decreases to <1,000/㎕ for at least 7 days, or decreases to <1,000/㎕ with fever (body temperature≧38.5℃), or decreases to <500/㎕: Interrupt treatment and monitor complete blood counts weekly When the count recovers to ≧1,000/㎕: Resume at one dose level below the dose being given For each subsequent decrease to <1,000/㎕ for at least 7 days, or decrease to <1,000/㎕ with fever (body temperature≧38.5℃), or decrease to <500/㎕: Interrupt treatment. When the count recovers to ≧1,000/㎕: Resume at one dose level below the dose being given Do not reduce below 2.5mg once daily or 5mg every other day. 4. Follicular Lymphoma Treatment should not be initiated if the absolute neutrophil count is <1,000/㎕ and/or the platelet count is <50,000/㎕ (except in cases secondary to lymphoma infiltration of the bone marrow). The recommended starting dose is 20mg once daily. Take 20mg capsules on Days 1–21 of each 28-day cycle. Take for a maximum of 12 treatment cycles. The recommended starting dose of rituximab is based on a 28-day cycle: administer 375 mg/m2 intravenously weekly during Cycle 1 (Days 1, 8, 15, and 22). During Cycles 2–5, administer 375 mg/m2 intravenously only on Day 1 of each 28-day cycle. Dose reduction levels: Starting dose 20mg once daily on Days 1–21 of each 28-day cycle; 1st dose reduction 15mg once daily on Days 1–21 of each 28-day cycle; 2nd dose reduction 10mg once daily on Days 1–21 of each 28-day cycle; 3rd dose reduction 5mg once daily on Days 1–21 of each 28-day cycle. If the platelet count decreases to <50,000/㎕: Interrupt this drug and monitor complete blood counts weekly When the count recovers to ≥50,000/㎕: Resume at one dose level below the dose being given For each subsequent decrease to <50,000/㎕: Interrupt this drug and monitor complete blood counts weekly When the count recovers to ≥50,000/㎕: Resume at one dose level below the dose being given Do not reduce below 5mg once daily. If the absolute neutrophil count decreases to <1,000/㎕ for at least 7 days, or decreases to <1,000/㎕ with fever (body temperature≥38.5°C), or decreases to <500/㎕: Interrupt this drug and monitor complete blood counts weekly When the count recovers to ≥1,000/㎕: Resume at one dose level below the dose being given For each subsequent decrease to <1,000/㎕ for at least 7 days, or decrease to <1,000/㎕ with fever (body temperature≥38.5°C), or decrease to <500/㎕: Interrupt this drug and monitor complete blood counts weekly When the count recovers to ≥1,000/㎕: Resume at one dose level below the dose being given Do not reduce below 5mg once daily. Mantle Cell Lymphoma or Follicular Lymphoma Tumor lysis syndrome (Tumor lysis syndrome, TLS): For patients with laboratory tumor lysis syndrome (laboratory TLS) or Grade 1 clinical tumor lysis syndrome (clinical TLS), this drug may be continued at the same dose or, at the physician's discretion, continued at a dose reduced by one dose level. For patients with Grade 2–4 clinical tumor lysis syndrome, interrupt this drug. Once tumor lysis syndrome improves to Grade 0, resume treatment at a dose one level lower, at the physician's discretion. Tumor flare reaction (tumor flare reaction, TFR): For patients with Grade 1/2 tumor flare reaction, this drug may be continued without interruption or dose reduction, at the prescriber's discretion. For patients with Grade 3/4 tumor flare reaction, interrupt this drug. When the reaction recovers to Grade 1 or lower, resume treatment at the same dose for the remainder of the cycle. 5. Dose adjustment for other Grade 3/4 toxicities If other Grade 3/4 toxicities related to this drug occur, interrupt treatment; when the toxicity resolves to Grade 2 or lower, resume treatment at a dose reduced by one dose level from the dose being given, at the prescriber's discretion. 7. Dose in patients with renal impairment Patients with creatinine clearance below 11 mL/min who are not on dialysis and patients with creatinine clearance below 7 mL/min have not been studied. Table 15. Starting dose in patients with renal impairment_Multiple myeloma or mantle cell lymphoma Moderate renal impairment, 30 ≤ CLcr <50mL/min: Dose adjustment for multiple myeloma/mantle cell lymphoma 10mg once daily*; dose adjustment for post-transplant maintenance therapy 5mg once daily Severe renal impairment, CLcr <30mL/min (patients not on dialysis): Dose adjustment for multiple myeloma/mantle cell lymphoma 7.5mg once daily or 15mg every other day; dose adjustment for post-transplant maintenance therapy 2.5mg once daily End-stage renal disease, CLcr <30mL/min (patients on dialysis): Dose adjustment for multiple myeloma/mantle cell lymphoma 5mg once daily, administered after dialysis on dialysis days; dose adjustment for post-transplant maintenance therapy 2.5mg once daily, administered after dialysis on dialysis days *After the second treatment cycle, the dose may be increased to 15mg once daily if the patient has not responded to treatment and tolerates it. Table 16. Starting dose in patients with renal impairment_Myelodysplastic syndromes Moderate renal impairment, 30 ≤ CLcr <50mL/min: Starting dose 5mg once daily (Days 1–21 of each 28-day cycle); 1st dose reduction 2.5mg once daily (Days 1–28 of each 28-day cycle); 2nd dose reduction 2.5mg every other day (Days 1–28 of each 28-day cycle) Severe renal impairment, CLcr <30mL/min (patients not on dialysis): Starting dose 2.5mg once daily (Days 1–21 of each 28-day cycle); 1st dose reduction 2.5mg every other day (Days 1–28 of each 28-day cycle); 2nd dose reduction 2.5mg twice a week (Days 1–28 of each 28-day cycle) End-stage renal disease, CLcr <30mL/min (patients on dialysis): Starting dose 2.5mg once daily (Days 1–21 of each 28-day cycle); 1st dose reduction 2.5mg every other day (Days 1–28 of each 28-day cycle); 2nd dose reduction 2.5mg twice a week (Days 1–28 of each 28-day cycle). Administer after dialysis on dialysis days Table 17. Dose in patients with renal impairment_Follicular lymphoma Moderate renal impairment, 30 ≤ CLcr < 60mL/min: 10mg once daily (Days 1–21 of each 28-day cycle) Severe renal impairment, CLcr < 30mL/min (patients not on dialysis): No data End-stage renal disease, CLcr < 30mL/min (patients on dialysis): No data ¹After the second treatment cycle, the dose may be increased to 15mg once daily if the patient tolerates it. 2For patients receiving an initial dose of 10mg, if dose reduction is required due to Grade 3/4 neutropenia or thrombocytopenia, or other Grade 3/4 toxicities considered related to this drug, do not reduce below 5mg every other day or 2.5mg once daily. 8. Take with water. Do not crush, chew, or open the capsules. The dose may be adjusted based on clinical or laboratory test results.

This medication should not be taken during pregnancy, and women of childbearing potential must have a pregnancy test before and during use. This medication can cause severe birth defects, so women of childbearing age must use two forms of contraception for 4 weeks before, during, and 4 weeks after taking it. This medication may decrease white blood cell and platelet counts in the blood, so regular blood tests are necessary to check for abnormalities. There may be an increased risk of heart attacks or thrombosis, so patients with risk factors for cardiovascular disease need to be closely monitored and efforts should be made to reduce risk factors. If signs of thromboembolism, such as shortness of breath, chest pain, or swelling of the arms or legs appear, medical personnel must be notified immediately. Patients taking this medication may experience liver function abnormalities, so regular liver function tests are required, especially for those with a history of liver disease. Patients with impaired kidney function may require dosage adjustments and must continuously monitor kidney function. Tumor lysis syndrome and tumor flare reactions may occur, so adequate hydration and appropriate preventive measures should be taken during the initial treatment or dose increase. The risk of infections may increase, so immediate notification of medical personnel is required if symptoms of infection develop; preventive measures to protect against infections should be taken seriously. This medication carries risks of serious skin reactions, allergic reactions, and pulmonary hypertension, so if any adverse symptoms occur, treatment should be discontinued immediately, and medical personnel should be consulted. This medication should not be administered to patients with certain genetic lactose intolerance. Regular monitoring for various adverse reactions is necessary during treatment, and appropriate measures should be taken if adverse reactions occur. This medication can only be prescribed and dispensed by qualified medical personnel registered in a pregnancy prevention program, so it should be taken according to medical instructions.

Limb malformation, congenital deformity, miscarriage, neutropenia, thrombocytopenia, febrile reaction, hemorrhage, myocardial infarction, venous thromboembolism, arterial thromboembolism, secondary primary malignant tumors, acute myeloid leukemia, myelodysplastic syndrome, liver failure, acute liver failure, toxic hepatitis, cytolytic hepatitis, cholestatic hepatitis, abnormal liver function tests, vascular edema, anaphylactic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash syndrome with eosinophilia and systemic symptoms, pulmonary hypertension, tumor lysis syndrome, pneumonia, renal failure, diarrhea, fatigue, back pain, weakness, insomnia, rash, loss of appetite, cough, fever, muscle cramps, hypotension, lung infection, dehydration, peripheral neuropathy, cataract, blurred vision, decreased vision, blindness, hearing loss, tinnitus, atrial fibrillation, bradycardia, congestive heart failure, tachycardia, heart failure, myocardial ischemia, arrhythmia, QT prolongation, atrial flutter, ventricular premature contraction, hypertension, petechiae, vasculitis, ischemia, peripheral ischemia, cerebral venous sinus thrombosis, respiratory distress, nosebleed, respiratory impairment, pleuritic pain, hypoxia, speech disorders, abdominal pain, nausea, vomiting, dyspepsia, dry mouth, stomatitis, gastrointestinal bleeding, small bowel obstruction, colitis, appendicitis, elevated alanine aminotransferase, elevated aspartate aminotransferase, hepatotoxicity, hepatocellular damage, hyperbilirubinemia, urticaria, hyperhidrosis, skin dryness, skin hyperpigmentation, eczema, erythema, drug rash, skin depigmentation, photosensitivity, muscle weakness, bone pain, musculoskeletal and connective tissue pain, arthralgia, limb pain, myalgia, joint swelling, renal failure, hematuria, urinary retention, urinary incontinence, acquired Fanconi syndrome, erectile dysfunction, fatigue, edema, weakness, influenza-like symptoms, chest pain, drowsiness, elevated serum alkaline phosphatase, increased C-reactive protein, falls, contusions, pulmonary embolism, pneumonia, septic shock, influenza, bronchitis, sepsis, urinary tract infection, herpes zoster, viral infection, progressive multifocal leukoencephalopathy, papulosquamous rash, hair loss, skin reaction, skin desquamation, subcutaneous hemorrhage, vertebral compression fracture, rib fracture, femoral neck fracture, radiation pneumonitis, spinal injury, spinal fracture, forearm fracture, thoracic spine fracture, acute kidney injury, dysuria, azotemia, insomnia, delirium, bipolar disorder, changes in mental state, papulosquamous rash, urticaria, rash, liver dysfunction, acute cholangitis, acute cholecystitis, bile duct stones, jaundice, adrenal insufficiency, Cushing's syndrome, inappropriate antidiuretic hormone secretion, cervical dysplasia, vaginal discharge, vaginal bleeding, perineal rash, hyperbilirubinemia, flushing, shock, ear discomfort, ear discharge, hearing impairment, splenomegaly, hemolytic uremic syndrome, candidemia

This medication should be stored in a tightly closed container to protect it from air and moisture. Additionally, it is important to store it at room temperature between 15°C to 30°C to maintain its effectiveness.

Appearance

A hard capsule with a blue opaque upper part and a white opaque lower part filled with a white or almost white powder.

Package unit

21 capsules/case (3 capsules/PTPX7)