Description
DK
Dr. Daria Kwaśniewska
ESMO Certified Consultant Medical Oncologist
Reviewed June 2026
⚠ Prescription required. For informational purposes only. Meds For Cancer is a Named Patient Program facilitator — not a retail pharmacy. A valid oncologist prescription is mandatory before any order is processed.
Is Azarest 300 mg right for your situation?
Review these criteria with your oncologist before enquiring✔ You may be a candidate if
- ✓Myelodysplastic syndromes (MDS) of any FAB subtype, including refractory anaemia and CMML
- ✓Newly diagnosed AML with 20–30% bone marrow blasts and multi-lineage dysplasia (per WHO classification)
- ✓Already established on injectable azacitidine and being considered for oral switch
- ✓Need a WHO-GMP generic alternative to Onureg® (Bristol Myers Squibb)
✖ May NOT be suitable if
- ✗Newly diagnosed AML requiring intensive induction chemotherapy (oral azacitidine is for maintenance, not induction)
- ✗Active severe gastrointestinal disease affecting drug absorption
- ✗Pregnant, planning pregnancy, or breastfeeding
- ✗Severe pre-existing bone marrow failure without monitoring capability
Check Availability & Pricing
Prescription required · Named Patient Program · Worldwide shipping
🛡 WHO-GMP Certified · Prescription verified · Express dispatch
What is Azarest 300 mg?
Azarest 300 mg is a generic oral formulation of Azacitidine — a hypomethylating agent — manufactured by Everest Pharmaceuticals Ltd. under WHO-GMP certified conditions in Bangladesh. Each tablet contains 300 mg of azacitidine and is dispensed under the Named Patient Program as an affordable, quality-assured alternative.
Important: Oral azacitidine (this tablet) is not interchangeable with injectable (subcutaneous or intravenous) azacitidine — the two have different dosing schedules, indications, and bioavailability. The oral formulation is specifically approved for continued maintenance therapy in AML after initial response to chemotherapy, not as a substitute for injectable azacitidine in MDS.
| Generic name | Azacitidine |
| Reference brand | Onureg® (oral) / Vidaza® (injectable) |
| Manufacturer | Everest Pharmaceuticals Ltd. |
| Standard | WHO-GMP Certified |
| Drug class | Hypomethylating Agent (Nucleoside Analogue) |
| Dosage form | Tablet — 300 mg |
| Pack size | 14 tablets per pack |
| Route | Oral · once daily, 14 days of a 28-day cycle |
| Prescription | Required — oncologist only |
How Azacitidine Works
In MDS and AML, abnormal blood-forming cells often carry excessive DNA methylation that silences tumour-suppressor genes — genes that would normally control or stop abnormal cell growth. Azacitidine is incorporated into DNA and RNA during cell division and inhibits DNA methyltransferase, the enzyme responsible for this abnormal methylation.
By reducing aberrant DNA methylation, azacitidine reactivates silenced tumour-suppressor genes, restoring more normal regulation of blood cell growth and promoting healthier differentiation of bone marrow cells. This is distinct from traditional cytotoxic chemotherapy — azacitidine works at an epigenetic level rather than directly damaging DNA strands. NCCN guidelines include azacitidine-based regimens for MDS across risk categories and as continued therapy for AML in appropriate patients. View NCCN MDS Guidelines →
What to Expect: First 30 Days
Azacitidine follows a 28-day cycle pattern — understanding this rhythm helps you anticipate blood test schedules and symptom timing.
- Days 1–14: Daily dosing begins. Gastrointestinal symptoms — nausea, diarrhoea, or constipation — are common in this active dosing window. Your oncologist may prescribe anti-nausea medication proactively.
- Days 15–28 (off period): The remaining two weeks of the cycle are dosing-free, allowing the bone marrow and blood counts to recover. Blood tests continue during this window to monitor counts.
- Cycle 1 completion: Response to azacitidine is gradual — unlike fast-acting chemotherapy, hypomethylating agents often take 4–6 cycles (roughly 4–6 months) before full benefit is seen. Your oncologist will assess response through repeat blood counts and bone marrow biopsy at intervals.
Side Effects
Most side effects relate to gastrointestinal symptoms and blood count suppression, both common with hypomethylating agents and generally manageable with supportive care.
Common · Usually Manageable
- Nausea and vomiting
- Diarrhoea or constipation
- Fatigue
- Decreased appetite
- Muscle or joint pain
- Dizziness
- Mild injection-site-like skin reactions (rare with oral form)
Serious · Report Immediately
- Severe neutropenia (low white blood cells) with infection risk
- Thrombocytopenia (low platelets) with bleeding risk
- Severe anaemia
- Renal toxicity
- Tumour lysis syndrome (rare, in high-burden disease)
⚠ Call your doctor immediately if you experience:
- Fever of 38°C (100.4°F) or higher, especially with low white blood cell counts
- Unusual bruising, bleeding gums, or blood in stool or urine
- Severe or persistent vomiting/diarrhoea leading to dehydration
How to Take Azarest 300 mg
Standard dose: 1 tablet (300 mg) once daily for 14 consecutive days, followed by 14 days off — a complete 28-day cycle. With or without food.
- 1Once daily for 14 days, then 14 days off — track this carefully on a calendar; the dosing schedule is distinct from injectable azacitidine cycles.
- 2Same time each day, with or without food, for consistency.
- 3Swallow tablet whole with water. Do not crush or split.
- 4If you miss a dose, take it as soon as you remember the same day. If a full day has passed, skip the missed dose and resume your normal schedule — do not double up.
- 5Storage: at room temperature, in original packaging, away from moisture and light.
Caregiver Guidance
- ♥Track the 14-days-on/14-days-off cycle — mark dosing days clearly on a calendar to avoid confusion, especially since this differs from many other oral cancer medications.
- ♥Watch for fever and unusual bleeding — blood counts drop predictably during and shortly after the dosing window. Report fever or bleeding signs immediately.
- ♥Support nausea management — encourage small, frequent meals and ensure any prescribed anti-nausea medication is taken as directed during the active dosing days.
If the Medicine Stops Working
Resistance or loss of response to azacitidine can develop over time, sometimes presenting as worsening blood counts or disease progression on repeat bone marrow assessment. When this occurs, your oncologist will reassess the treatment plan — options may include a different hypomethylating agent, combination with venetoclax (in AML), allogeneic stem cell transplant evaluation if the patient is a candidate, or enrolment in a clinical trial. Regular bone marrow monitoring is essential to detect changes in disease status early.
Frequently Asked Questions
Is Azarest the same as injectable azacitidine?
No. Azarest is the oral tablet formulation of azacitidine, which has a different dosing schedule, indication, and bioavailability compared to injectable (subcutaneous or intravenous) azacitidine used for MDS. The oral form is specifically approved for continued AML treatment after response to induction chemotherapy. Do not substitute one for the other without your oncologist’s explicit instruction.
How long until I see results from Azarest?
Hypomethylating agents like azacitidine typically work gradually. Many patients require 4–6 treatment cycles (roughly 4–6 months) before the full clinical benefit becomes apparent on blood tests and bone marrow assessment. Early discontinuation before completing several cycles, unless medically necessary, may prevent the medication from showing its full effect.
Why is the dosing schedule 14 days on, 14 days off?
This cycle structure allows the bone marrow to recover between active treatment periods while maintaining sustained drug exposure during the 14 dosing days. The off-period is built into the regimen specifically to manage blood count suppression — it should not be skipped or extended without your oncologist’s guidance.
What blood tests will I need during treatment?
Complete blood counts are typically checked at the start of each cycle and periodically during the dosing window to monitor for neutropenia, thrombocytopenia, and anaemia. Liver and kidney function tests are also monitored periodically. Your oncologist will determine the exact monitoring schedule based on your specific situation.
Can Azarest be combined with other medications?
Azacitidine is sometimes used in combination regimens, particularly with venetoclax in AML treatment protocols. Always provide your oncologist and pharmacist with your complete medication list, as dose adjustments or monitoring changes may be needed depending on combination therapy.
How do I order Azarest through Meds For Cancer?
Contact us via WhatsApp (+880 130 449 8958) or email (info@medsforcancer.com) with your oncologist’s prescription. Our team will verify the prescription, confirm availability and pricing for your country, and arrange secure international shipping under the Named Patient Program.
🛡 Named Patient Program — Regulatory Framework
Meds For Cancer operates as a Named Patient Program (NPP) facilitator. Under this framework, WHO-GMP certified medicines are made available to individual patients with a confirmed medical need and a valid oncologist prescription, in countries where the branded product is unavailable or unaffordable.
This service does not constitute retail pharmacy dispensing. A prescription review is mandatory before any order is processed.
Clinical References
- Wei AH, et al. Oral azacitidine maintenance therapy for acute myeloid leukaemia in first remission (QUAZAR AML-001). NEJM 2020;383:2526–2537.
- Fenaux P, et al. Efficacy of azacitidine compared with conventional care in higher-risk MDS. Lancet Oncol 2009;10:223–232.
- NCCN Clinical Practice Guidelines in Oncology: Myelodysplastic Syndromes. V1.2026.
- NCCN Clinical Practice Guidelines in Oncology: Acute Myeloid Leukemia. V3.2026.
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