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Levamisole hydrochloride
Levamisole hydrochloride (Ergamisol)
Levamisole hydrochloride
(lee-VAM-ih-sohl)
Pregnancy Category: C
Ergamisol
Novo-Levamisole (Rx)
Classification:
Antineoplastic, adjunct
Action/Kinetics:
Used in combination with fluorouracil; considered to be an immunomodulator. It restores depressed immune function. As such, it stimulates formation of antibodies, stimulates T-cell activation and proliferation, potentiates monocyte and macrophage function (including phagocytosis and chemotaxis), and increases mobility adherence and chemotaxis of neutrophils. Rapidly absorbed from the GI tract. Peak plasma levels: 0.13 mcg/mL after 1.5-2 hr. t1/2: 3-4 hr. Metabolized by the liver and excreted mainly in the urine.
Uses:
In combination with fluorouracil to treat clients with Dukes' stage C colon cancer following surgical resection.
Contraindications:
Lactation.
Special Concerns:
Safety and effectiveness have not been demonstrated in children. Agranulocytosis, caused by levamisole, may be accompanied by a flu-like syndrome, or it may be asymptomatic. Thus, hematologic monitoring is required.
Side Effects:
GI: Commonly nausea and diarrhea; vomiting, stomatitis, anorexia, abdominal pain, constipation, flatulence, dyspepsia. Hematologic: Leukopenia, thrombocytopenia, anemia, granulocytopenia. Dermatologic: Commonly: dermatitis and pruritus; alopecia, skin discoloration. CNS: Dizziness, headache, inability to concentrate, weakness, memory loss, paresthesia, ataxia, somnolence, depression, insomnia, confusion, nervousness, anxiety, forgetfulness. Musculoskeletal: Arthralgia, myalgia. Ophthalmologic: Abnormal tearing, conjunctivitis, blurred vision. Miscellaneous: Fatigue, fever, rigors, chest pain, edema, taste perversion, altered sense of smell, infection, hyperbilirubinemia, epistaxis.
Drug Interactions:
- Ethanol / Disulfiram-like reaction when used with levamisole
- Phenytoin /
 Phenytoin plasma levels
How Supplied:
Tablet: 50 mg
Dosage
•Tablets
Adults, initial: Levamisole, 50 mg q 8 hr for 3 days (starting 7-30 days after surgery) given together with fluorouracil, 450 mg/m2/day by IV push for 5 days (starting 21-34 days after surgery). Maintenance: Levamisole, 50 mg q 8 hr for 3 days q 2 weeks for 1 year; fluorouracil, 450 mg/m2/day by IV push once a week beginning 28 days after the beginning of the 5-day course and continuing for 1 year. |
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