Azashine 300 mg contains Azacitidine, a chemical analogue of cytidine, classified under hypomethylating agents and antimetabolite chemotherapy. It is primarily used in the treatment of myelodysplastic syndromes (MDS) and certain types of leukemia, particularly in older adults or those not suitable for intensive chemotherapy.

Azacitidine helps improve blood cell production in the bone marrow and slows or halts the growth of abnormal cells. Azashine is generally administered as a subcutaneous injection or intravenous infusion, and the dosage of 300 mg is adjusted according to body surface area and clinical condition.

Mechanism of Action

Azacitidine acts in a dual capacity — altering gene expression and directly targeting abnormal cells:

1. DNA Hypomethylation:

   • Azacitidine gets incorporated into DNA and inhibits DNA methyltransferase, leading to hypomethylation.

   • This can reactivate tumor suppressor genes that were previously silenced, promoting normal cell growth and function.

2. Cytotoxic Activity:

   • Azacitidine also incorporates into RNA, disturbing RNA processing and protein synthesis.

   • This causes apoptosis (cell death) in rapidly dividing abnormal cells in the bone marrow.

     Uses / Indications

     Azashine (Azacitidine) is indicated for:

     1. Myelodysplastic Syndromes (MDS):

        • Including refractory anemia, RAEB, RARS, and CMML.

        • Improves blood counts and reduces the need for transfusions.

     2. Acute Myeloid Leukemia (AML):

        • Especially in patients who are not candidates for intensive chemotherapy.

        • Helps slow progression and maintain quality of life.

     3. Chronic Myelomonocytic Leukemia (CMML):

        • Reduces abnormal monocyte proliferation and supports marrow function.

          Adverse Effects

          While Azashine offers life-extending benefits, like most chemotherapeutic agents, it may also produce side effects:

          Common Side Effects:

          • Nausea, vomiting

          • Diarrhea or constipation

          • Weakness or fatigue

          • Injection site redness or irritation

          • Loss of appetite

          • Low-grade fever