Clomipramine Hydrochloride and Gemcitabine Hydrochloride

• Generic Name: clomipramine
• Dosage Forms: n.a.
• Other Brand Names: Anafranil

Among the drugs of choice for the management of OCD.

Reduces but does not completely eliminate obsessions and compulsions.

Has been used effectively for the management of panic disorder with or without agoraphobia.

Has been used effectively for the management of major depressive disorder.

Despite comparable efficacy, the adverse effect profile (e.g., anticholinergic effects) of clomipramine may limit its usefulness relative to other antidepressants (e.g., TCAs, SSRIs).

Effective antidepressant when obsessive manifestations accompany episode of major depressive disorder.

Has been used for the management of chronic pain (e.g., central pain, idiopathic pain disorder, tension headache, diabetic peripheral neuropathy, cancer pain) alone or as adjunct to conventional analgesics.

Has been used for the symptomatic management of cataplexy in a limited number of patients with cataplexy and associated narcolepsy.

Has been used for the management of repetitive and obsessive-compulsive behaviors and hyperactivity associated with autistic disorder; does not treat core symptoms of autistic disorder.

Has been used for the management of trichotillomania (an urge to pull out one’s hair) in a limited number of patients with the disorder; relapse reported in some patients receiving long-term therapy.

Has been used for the management of severe onychophagia (nail biting) without a history of OCD.

Associated with relatively high dropout rate because of adverse effects and drug intolerance; not considered first-line therapy in most patients with onychophagia.

Has been used for the management of anorexia nervosa in a limited number of patients with the disorder.

Initial therapeutic effects (e.g., improved eating behavior, weight gain) not sustained with long-term therapy (e.g., ≥8 weeks).

Avoid use in underweight individuals and in those exhibiting suicidal ideation.

Has been used for the management of premature ejaculation.

Has been used for the management of premenstrual syndrome.

• Generic Name: gemcitabine
• Dosage Forms: n.a.
• Other Brand Names: Gemzar, Infugem

Used in combination with paclitaxel as first-line therapy for metastatic breast cancer in patients who did not respond to previous anthracycline-containing chemotherapy or in whom such chemotherapy was contraindicated.

Used for initial treatment in patients with inoperable, locally advanced (stage IIIA or IIIB) or metastatic (stage IV) non-small cell lung cancer in combination with cisplatin.

Used as monotherapy for advanced non-small cell lung cancer in patients with relapsed or refractory advanced non-small cell lung cancer who previously were treated with platinum-containing chemotherapy regimens or in those who have not received prior chemotherapy.

Use of chemotherapy generally is advised only in patients with good performance status (ECOG performance status of 0 or 1, and 2 in selected patients) and evaluable lesions so that treatment can be discontinued if the disease does not respond. Individualize decision to use chemotherapy according to several factors, including patient preference, toxicity, survival benefit, quality of life, and cost of treatment.

Used as first-line therapy for the palliative treatment of locally advanced (nonresectable stage II or III) or metastatic (stage IV) adenocarcinoma of the pancreas.

Also used as second-line therapy in patients previously treated with fluorouracil.

Used alone or in combination therapy (i.e., cisplatin) for the treatment of advanced or metastatic bladder cancer.

Objective responses to gemcitabine have been observed in patients with metastatic bladder cancer that did not respond to previous treatment with cisplatin-based regimens, including some patients with hepatic metastases.

Currently being investigated for use in the treatment of advanced epithelial ovarian cancer.

Use in combination with cisplatin is recommended (accepted) for the treatment of unresectable locally advanced or metastatic biliary tract cancer (intrahepatic or extrahepatic cholangiocarcinoma, gallbladder cancer, or ampullary cancer), including unresectable recurrent disease following surgical resection, in patients with good performance status (ECOG performance status of 0 or 1).