Description

Evermil 10 mg (Everolimus): Dual‑Purpose mTOR Blocker for Oncology & Transplant

Evermil 10 mg is a generic formulation of everolimus, a mammalian target of rapamycin (mTOR) inhibitor and immunosuppressant marketed in India. This once-daily oral tablet is used in post‐transplant rejection prophylaxis for kidney or liver transplants, and as targeted therapy for advanced cancers including hormone receptor–positive breast cancer (with exemestane), renal cell carcinoma (RCC), progressive neuroendocrine tumors (NET), and tuberous sclerosis complex (TSC)-associated renal angiomyolipoma or SEGA. 

🎯 Approved Indications & Typical Dosing

• Advanced HR‑positive, HER2‑negative breast cancer: 10 mg once daily (with exemestane) until disease progression or intolerable side effects. 
• Renal cell carcinoma after VEGF therapy: 10 mg daily similarly until progression.
• Progressive NET (pancreatic, GI/lung): 10 mg once daily.
• TSC-associated renal angiomyolipoma or SEGA: In adults, 10 mg once daily; pediatric SEGA dose based on body surface area. 
• Kidney transplant rejection prophylaxis: Initiate 0.75–1 mg twice daily starting at least 30 days post-transplant alongside reduced-dose cyclosporine and steroids; titrate using therapeutic drug monitoring.

⚙️ Mechanism of Action

Everolimus binds FKBP‑12 and inhibits the mTORC1 complex, suppressing downstream cell growth, protein synthesis, and lymphocyte activation. It selectively spares mTORC2, offering better metabolic and safety profiles compared to sirolimus. 

⚠️ Common Side Effects

• . _Stomatitis / aphthous ulcers_ (≥ 30 %)—managed proactively with alcohol-free dexamethasone mouthwash. 
• Infections—especially upper respiratory; risk increases with transplant-related therapy. 
• Fatigue, rash, diarrhea, peripheral edema, nausea, decreased appetite, headache. 
• Lab abnormalities (≥ 30 %): hyperglycemia, hyperlipidemia, anemia, lymphopenia, elevated AST/ALT and triglycerides. 
• Non-infectious pneumonitis, renal impairment, impaired wound healing—especially when used perioperatively; monitor closely. 

🧪 Safety Monitoring & Interactions

• Baseline and periodic labs: CBC, LFTs, renal function, fasting lipids/glucose. 
• Due to risk of pneumonitis—evaluate for new respiratory symptoms and perform imaging if needed. 
• Avoid live vaccines during and for months after therapy. 
• Potent CYP3A4 or P‑gp inhibitors (e.g. ketoconazole, grapefruit juice) may increase exposure—avoid. Inducers (e.g. rifampin) reduce levels and may require dose adjustment. 

📈 Advantages of Evermil 10 mg

• Provides dual-use across transplant and oncology indications in a standardized once-daily 10 mg strength.
• More cost-effective than brand-name options—Glenmark formulation appears priced 30–70% lower than branded Afinitor. 
• Pill simplicity enhances outpatient adherence in long-term treatment.

❓ Frequently Asked Questions (FAQs)

1. Can Evermil be taken with food?

Yes—take Evermil at the same time each day, with or without food. Swallow tablets whole—do not crush, chew, or split. 

2. What if a dose is missed?

If missed by < 8 hours, take immediately. Otherwise, skip and take the next dose at usual time. Do not double dose. 

3. How long is this treatment generally continued?

For cancer, therapy continues until disease progression or unacceptable toxicity. In post-transplant settings, Evermil may be prescribed long-term with dose adjustments based on drug levels and organ function. 

4. Is Evermil safe during pregnancy or breastfeeding?

No—moderately to severely teratogenic. Effective contraception is required during treatment and for several months after; breastfeeding is contraindicated. 

5. When should Evermil be withheld for surgery?

Stop Evermil at least 1 week before elective surgery and resume only after full wound healing, per transplant or oncologist’s instructions.