Why is this medication prescribed?

Cosela (Trilaciclib Injection) is prescribed primarily to reduce the frequency of chemotherapy-induced myelosuppression in adult patients with extensive-stage small cell lung cancer (ES-SCLC). Myelosuppression refers to a decrease in bone marrow activity leading to reduced production of blood cells (such as white blood cells, red blood cells, and platelets), which is a common side effect of chemotherapy.

How should this medicine be used?

Here are some general guidelines for using Cosela:

• Administration: Cosela is administered intravenously (IV) by a healthcare professional in a clinical setting, typically before each cycle of chemotherapy.
• Timing: It is recommended to administer Cosela approximately 30 minutes before starting chemotherapy each cycle.
• Dosage: The recommended dosage of Cosela is based on the patient’s body surface area (BSA) and should be calculated prior to each administration.
• Preparation: The vial should be inspected visually for particulate matter and discoloration prior to administration. It should be diluted in 0.9% sodium chloride injection, USP, to a final concentration of 0.2 to 2.0 mg/mL before use.
• Storage: Cosela should be stored refrigerated at 2°C to 8°C (36°F to 46°F) and protected from light. It should not be frozen.
• Monitoring: Patients should be monitored closely during and after administration of Cosela for any signs of hypersensitivity reactions or other adverse effects.
• Chemotherapy Administration: Chemotherapy may be administered as prescribed after Cosela administration according to the standard protocols.

It’s crucial for patients to follow their healthcare provider’s instructions precisely regarding the timing and dosage of Cosela administration to ensure optimal effectiveness in managing chemotherapy-induced myelosuppression.

Other uses for this medicine

Cosela (Trilaciclib Injection) is specifically approved for reducing chemotherapy-induced myelosuppression in adult patients with extensive-stage small cell lung cancer (ES-SCLC). Currently, its use is limited to this indication, and there are no other approved uses for Cosela.

What special precautions should I follow?

Special Precautions for Cosela:

• Hypersensitivity Reactions: Patients should be monitored for signs of hypersensitivity reactions during and after administration of Cosela. Immediate medical attention should be sought if any symptoms such as rash, itching, swelling, dizziness, or difficulty breathing occur.
• Potential Interactions: Cosela may interact with other medications. Patients should inform their healthcare provider about all medications, vitamins, and supplements they are taking before starting Cosela.
• Pregnancy and Breastfeeding: The safety of Cosela in pregnant women has not been established. It is advised to avoid using Cosela during pregnancy unless clearly necessary. It is also not known whether Cosela is excreted in human milk; breastfeeding should be avoided during treatment with Cosela.
• Liver or Kidney Impairment: Patients with severe liver or kidney impairment may require dose adjustments or monitoring while receiving Cosela. Consultation with a healthcare provider is essential in these cases.
• Monitoring: Regular monitoring of blood counts (such as white blood cells, red blood cells, and platelets) is recommended during chemotherapy cycles to assess the effectiveness of Cosela in reducing myelosuppression.
• Administration Precautions: Cosela should only be administered under the supervision of a healthcare professional experienced in the use of cytotoxic chemotherapy agents and in a clinical setting equipped to manage potential adverse reactions.
• Storage: Proper storage conditions (refrigeration at 2°C to 8°C) should be strictly followed to maintain the stability of Cosela before use.

Always follow the specific guidance provided by your healthcare provider regarding precautions, dosage, and administration of Cosela to ensure safe and effective treatment.

What special dietary instructions should I follow?

There are no specific dietary instructions associated with Cosela. However, it’s generally recommended to maintain a balanced diet and adequate hydration during chemotherapy treatment. Discuss any specific dietary concerns or restrictions with your healthcare provider.

What should I do if I forget a dose?

Since Cosela is typically administered in a clinical setting by healthcare professionals before each cycle of chemotherapy, the likelihood of a patient forgetting a dose is low. However, if a dose is missed or delayed, it’s crucial to consult with your healthcare provider immediately. They will provide guidance on whether the dose can be administered at a later time or if any adjustments are necessary.

What side effects can this medication cause?

Cosela (trilaciclib) is generally well-tolerated, but like any medication, it can cause side effects. Here are some of the common side effects associated with Cosela:

• Fatigue: Feeling tired or weak is a common side effect of Cosela.
• Headache: Some people may experience headaches while taking Cosela.
• Hypocalcemia: Low levels of calcium in the blood can occur with Cosela treatment. This may cause symptoms like numbness or tingling around the mouth or in the hands and feet, muscle cramps, or seizures.
• Nausea and Vomiting: These gastrointestinal symptoms can occur in some patients.
• Diarrhea: Changes in bowel habits, including diarrhea, may occur.
• Constipation: Conversely, some patients may experience constipation.
• Increased Liver Enzymes: Cosela may cause temporary increases in certain liver enzymes, which can be monitored by your healthcare provider through blood tests.
• Allergic Reactions: Although rare, allergic reactions such as rash, itching, swelling, or difficulty breathing may occur.
• Other Effects: Other less common side effects may include dizziness, decreased appetite, muscle pain, and changes in taste.

It’s important to note that not all individuals will experience these side effects, and some may experience none at all. If you notice any unusual symptoms while taking Cosela, it’s essential to inform your healthcare provider promptly. They can help manage these side effects or adjust your treatment regimen if necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Cosela:

• Storage Conditions:
  • Cosela should be stored at room temperature between 20°C to 25°C (68°F to 77°F).
  • It should be kept in its original packaging to protect from light.
  • Avoid storing it in humid places like bathrooms.
• Disposal:
  • Unused or expired Cosela should be disposed of properly.
  • Follow specific disposal instructions provided by your pharmacist or local waste disposal company.
  • Do not dispose of it in household trash unless instructed to do so.

In case of emergency/overdose

• Emergency Contact: In case of overdose or emergency, contact your healthcare provider, local poison control center, or emergency room immediately.
• Symptoms of Overdose: Symptoms of overdose may include severe side effects such as increased risk of infection, bleeding, or other serious complications related to bone marrow suppression. Your healthcare provider will assess and manage any symptoms of overdose as appropriate.

What other information should I know?

• Administration: Cosela is typically administered as an intravenous infusion. It is given before certain chemotherapy regimens to help protect bone marrow from the toxic effects of chemotherapy.
• Monitoring: Your healthcare provider will monitor your blood counts and overall health closely during treatment with Cosela. This monitoring helps manage any potential side effects or complications.
• Side Effects: Common side effects of Cosela include fatigue, low blood calcium levels (hypocalcemia), headache, and others. Report any unusual or severe symptoms to your healthcare provider promptly.
• Interactions: Inform your healthcare provider about all medications you are taking, including prescription, over-the-counter, vitamins, and herbal supplements. Certain medications may interact with Cosela, affecting how it works or increasing the risk of side effects.
• Pregnancy and Breastfeeding: Discuss with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. Cosela’s effects during pregnancy and breastfeeding are not well studied, so caution is advised.
• Follow-up: Attend all scheduled appointments with your healthcare provider as they are crucial for monitoring your response to treatment and managing any side effects.

Always follow your healthcare provider’s instructions and ask any questions you have about Cosela or its use. They can provide personalized guidance based on your specific medical history and needs.