Evergraf 0.5mg (Everolimus )

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  • Brand: Panacea Biotec Ltd
  • Trade name Evergraf 0.5mg
  • Substance Everolimus
  • Manufacturer Panacea Biotech Ltd
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Evergraf 0.5mg containing an active ingredient known as Everolimus which is intercedes with cancer cell growth and slows down its process.

Evergraf 0.5mg tablets are not used as curable medicine, which is used to slow their spreading in to the body.


Evergraf 0.5mg tablets are mainly indicated in;

Renal carcinoma

Breast carcinoma

Brain carcinoma

Everolimus is also used in various advanced stage cancer in stomach, intestines or pancreas.


Everolimus is an mTOR prohibitor, binds at high compatibility to FK506 binding protein 12, through producing drug complex that prohibits the effective of mTOR.

This prohibition decreases the activity of effectors downstream, which may causes blockage of cell progression from G1 into S phase, subsequently causes cell growth arrest and apoptosis

Absorption: The peak plasma concentration time of Everolimus reaches within 1 to 2 hours.

The effect of food with Evergraf is given below; With heavy meal: Reduction of systemic exposure to Evergraf, and the peak blood plasma concentration by 54%.

Distribution: The blood plasma ratio of Evergraf with the range of 5 to 5000ng/ml is 17% to 73%. Evergrafhuman plasma protein bound with the range of 74%.


The metabolism of Everolimus is occurred in liver, which is a substrate of CYP3A4.

The metabolites of Everolimus;

 Three monohydroxylated metabolite,

Two hydrolytic rings opened products, &

 Phosphatidylcholine conjugate of Everolimus.

Excretion: The terminal half-life period of Everolimus is relatively 30 hours

The major route of elimination;

5% in urine; the parent compound has been detected in urine or feces.


In breast cancer, renal cell cancer, pancreatic cancer, Neuro endocrine cancer:

The recommended dosage is 10mg should be taken as a single dose.

In Brain or intracranial cancer

The recommended dosage of Evergraf is 4.5mg/m2 orally as a single dose.

In pediatric

The usual pediatric dosage of Evergraf in brain or intracranial tumor is 4.5mg/m2 should be taken orally as a single dose. 

Evergraf tablets should be administered with or without food.


The over dosage of Everolimus is rarely occur, in case of over dosage patient must be provide with supportive measures. The acute toxicity of Everolimus over dosage should be monitored.


  • Hypersensitivity reactions
  • Lymphomas & other malignancy
  • Serious infections
  • Kidney graft thrombosis
  • Hepatic artery thrombosis
  • Nephrotoxicity
  • Hyperlipemia
  • Angioedema
  • Interstitial lung disease
  • Thrombocytopenia
  • Male infertility
  • Proteinuria
  • New commencement of diabetes


  • Evergraf 0.5mg is metabolized hepatically, a substrate of CYP3A4.
  • Evergraf 0.5mg combined with strong inhibitor of CYP3A4, or P-gp, leads to cause decreasing the efflux of Everolimus and increase the plasma concentration of Everolimus.
  • Evergraf 0.5mg with strong CYP3A4 inducers, causes increasing the exposure of Everolimus.
  • Co administration of Evergraf 0.5mg with cyclosporine causes increasing the AUC level of Everolimus frequently.
  • Evergraf 0.5mg tablet is combined with ketaconazole or other CYP3A4 inhibitors causes increasing the plasma concentration and AUC of Everolimus.
  • Concomitant of Evergraf 0.5mg with erythromycin causes increasing in AUC of Everolimus.
  • Co administration of Evergraf 0.5mg with verapamil leads to increasing the plasma concentration of Everolimus.
  • Co administration of Evergraf 0.5mg with Atorvastatin or pravastatin causes rhabdomyolysis, due to increasing concentration of lipid lowering agents.


Some anaphylactic reaction occurs, if patients are contraindicated to the components present in the Evergraf 0.5mg tablets.



Increased exposure of skin cancers, patient may protect from UV light

Serious infections

Patients receiving Evergraf 0.5mg have high risk of acquiring various infections related to bacteria, virus, and fungi.

Anti-microbial agents are preferred for the suspected patients.

Hepatic artery thrombosis

In liver transplant patients, Evergraf 0.5mg therapy should not be recommended.


Renal function should be monitored frequently; caution should be taken while using Evergraf 0.5mg in renal impaired patients.


This may have occurred in the patients receiving concomitantly Evergraf 0.5mg with Angiotensin converting enzyme agents


Patient getting Evergraf 0.5mg with lipid lowering drugs causes increasing in plasma concentration of these drugs causes hyperlipidemia

Interstitial lung disease: Occurred in Evergraf 0.5mg therapy

Thrombocytopenia: Using Evergraf 0.5mg with cyclosporine causes thrombocytopenia

Outbreak of diabetes: Blood glucose level should be monitored

Embryo fetal toxicity: Causes fetal damage using Evergraf 0.5mg in pregnancy condition

Immunization: Using live vaccines in Evergraf 0.5mg therapy

Hereditary disorders: In the conditions like galactose intolerance, glucose-galactose malabsorption, Evergraf 0.5mg should not be used may results in diarrhea & malabsorption.

Interact with grape juice: Causes increasing blood levels of Everolimus; avoid these concomitants.


Pregnancy category of Everolimus C

Evergraf 0.5mg is used only by the patients after knowing the benefits to the mother outweighs the risk to fetus.

Breast feeding should not be suggested


Evergraf 0.5mg tablet should be kept at 25oC

Keep the tablet away from moisture, heat and light


In case of missed dose, patients must consult with medical practitioner and follow the instructions given by them.

On the other hand, the missed dose should be avoiding and follow the regular dosing schedule.


The over dosage of Everolimus is rarely occur, in case of over dosage patient must be provide with supportive measures. The acute toxicity of Everolimus over dosage should be monitored.

  • Trade name Evergraf 0.5mg
  • Substance Everolimus
  • Manufacturer Panacea Biotech Ltd
  • Packaging 10 tablets
  • Country of origin India
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