Alkeran 2 mg
Used in oncology
Active ingredient - MELPHALAN 2 mg
Manufacturer - GlaxoSmithKline
Application of Melphalan
- For oral administration: plasmacytoma, polycythaemia vera.
- For injections: plasmacytoma, lymphoepithelial carcinoma (Schmincke), melanoma of the extremities, children’s progressive neuroblastoma, soft tissues sarcoma (including hemangioendothelioma) – partial perfusion.
- Intra-arterial and intraperitoneal administration of relatively high doses: neuroblastoma, melanoma (late stages), colorectal cancer. Refractory hematologic malignancies followed by transplantation of autologous bone marrow.
Hypersensitivity, bone marrow depression (leucocytes decrease below 2•109/l and thrombocytes decrease below 50•109/l).
Limitations of use
Risk versus benefit evaluation is necessary in the following cases: chicken pox, ophthalmic zoster and other system infections, serious concurring diseases, parenchymatous hepatitis, urolithiasis, hyperuricemia, urarthritis, bone marrow infiltration with tumor cells, pre-existing cytotoxic or X-ray therapy (should be prescribed not earlier than in 3-4 weeks), terminal stage of disease, renal compromise, pediatric and geriatric use (safety and effectiveness have not been studied).
Application during pregnancy and breast feeding
Counter indicative during pregnancy (especially in I trimester).
FDA pregnancy risk category – D
Interruption of breast feeding is required for the period of treatment.
Melphalan side effects
- On gastrointestinal organs: anorexia, stomach bleeding, peptic ulcer (risk of these side effects development is significantly higher during combined cytoreduction), stomatitis, nausea, vomit (30%), esophagitis, diarrhea.
- On heart-vascular system and blood (hematosis, hemostasis): myelodepression (leucopenia, thrombocytopenia, anaemia), hemolytic anemia, bleeding and hemorrhaging, vasculitis, venoocclusive disorders, cardiopulmonary arrest.
- On respirator system: coughing, bronchospasm, fibrosis of lung tissues, interstitial pneumonitis.
- On urogenital system: painful urination and stranguria, erythrocyturia, hyperuricemia, nephropathy, oedemata, proteinuria, hypovarianism (especially during the period before menopause), menostasis, azoospermia.
- Allergic reactions: anaphylaxis (2%), anaphylactic shock, Quincke's edema, urticaria fever, exanthema, pruritus.
- Other: CNS dysfunction, pain syndrome (pain in back, side), infections, temperature rise, chill, alopecia, strengthening of 5-hydroxycaproic acid, necrosis of perivascular spaces, fever or pins and needles sensation at the site of injection.
Known as Alphalan, Melphalan tablets, Megval, Afhlan, Evomela, Egymelan
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