Omacetaxine mepesuccinate

Add 1 mL of NaCl 0.9% to a vial labelled as containing 3.5 mg. Swirl gently until a clear solution is obtained.

Pregnancy.

Patient with diabetes or risk factors for diabetes. Lactation.

Significant: Gastrointestinal haemorrhage, glucose intolerance, hyperglycaemia.
Blood and lymphatic system disorders: Lymphopenia, bone marrow failure, febrile neutropenia.
Gastrointestinal disorders: Diarrhoea, nausea, vomiting, constipation, abdominal pain.
General disorders and administration site conditions: Asthenia, fatigue, pyrexia, injection site reactions.
Metabolism and nutrition disorders: Anorexia, peripheral oedema.
Musculoskeletal and connective tissue disorders: Arthralgia, back pain, myalgia, pain in extremity.
Nervous system disorders: Headache.
Psychiatric disorders: Insomnia.
Respiratory, thoracic and mediastinal disorders: Cough, epistaxis.
Skin and subcutaneous tissue disorders: Alopecia, rash.
Potentially Fatal: Severe anaemia, neutropenia, and thrombocytopenia; cerebral haemorrhage.

Parenteral/SC: Z (Contraindicated due to risk of teratogenicity.)

This drug may cause fatigue, if affected, do not drive or operate machinery.

Monitor CBC during induction and initial maintenance therapy then every 2 weeks thereafter or as clinically indicated; blood glucose frequently; signs of bleeding or infection.

Symptoms: Gastrointestinal disorders, gingival haemorrhage, alopecia, neutropenia, thrombocytopenia. Management: Supportive treatment.

Increased risk of haemorrhage with anticoagulants, aspirin, and other NSAIDS.

Description:
Mechanism of Action: Omacetaxine mepesuccinate is a semisynthetic formulation of homoharringtonine, an alkaloid derived from Cephalotaxus harringtonia. It reversibly inhibits protein synthesis by binding to the A-site cleft of the ribosomal subunit.
Synonym: homoharringtonine.
Pharmacokinetics:
Absorption: Rapidly absorbed. Time to peak plasma concentration: Approx 30 minutes.
Distribution: Plasma protein binding: ≤50%.
Metabolism: Hydrolysed by plasma esterases to 4’-DMHHT. Minimal hepatic microsomal oxidative or esterase-mediated metabolism.
Excretion: Via urine (approx 37%) and faeces (approx 44%). Terminal elimination half-life: 14.6 hours.

Source: National Center for Biotechnology Information. PubChem Database. Omacetaxine mepesuccinate, CID=285033, https://pubchem.ncbi.nlm.nih.gov/compound/Omacetaxine-mepesuccinate (accessed on Jan. 22, 2020)

Store between 20-25°C. Protect from light.
This is a cytotoxic drug. Follow applicable procedures for receiving, handling, administration, and disposal.

Cytotoxic Chemotherapy

L01XX40 - omacetaxine mepesuccinate ; Belongs to the class of other antineoplastic agents. Used in the treatment of cancer.

Anon. Omacetaxine Mepesuccinate. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 04/05/2018.

Anon. Omacetaxine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/05/2018.

Buckingham R (ed). Omacetaxine Mepesuccinate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/05/2018.

Synribo Injection, Powder, Lyophilized, for Solution (Cephalon, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/05/2018.