Melphalan refers to alkylating agents. They damage DNA, have a cytotoxic, mutagenic and carcinogenic effect.
Form release, composition and packaging
Produced in two forms:
- Tablets of 2 and 5 mg. In each blister for 20 pcs. In a cardboard box there can be from 1 to 3 plates.
- Powder for the preparation of injection solutions in vials of 50 mg in a kit with a solvent.
Manufacturer
SC Balkan Pharmaceuticals SRL( Balkan Pharmaceuticals) Republic of Moldova.
Indications for use
The drug is used for chemotherapy of myeloma, in conjunction with prednisolone. Effective in the treatment of ovarian cancer and melanoma. It was originally created to treat skin cancer, but did not show significant efficacy.
Assigned for the treatment of retinoblastoma of the eye, a frequent malignant tumor of childhood, and also with:
- soft tissue sarcoma of the extremities,
- oncology of the breast,
- neuroblastoma.
Contraindications
Do not use the drug for individual intolerance, with depressed bone marrow function, during pregnancy and lactation.
With caution is prescribed for infections, severe concomitant ailments, bone marrow infiltration by malignant cells, children and the elderly.
Pharmacological action of
Melphalan causes damage to macromolecules of DNA, stops protein synthesis. Cytotoxicity is associated with blockade of interchain cross-links in the DNA molecule. It is active against any tumor cells.
Has a high selectivity of activity in relation to cells of oncological formations and lymph nodes.
In the process of treatment, the number of abnormal young cells produced by the bone marrow is decreasing. After discontinuation of reception peripheral blood values quickly come back to normal.
The severity of the cytotoxic effect is dose dependent. With complete destruction of tumor cells in vital organs, irreversible changes are not detected.
Instructions for Use Melphalan
The drug is given intravenously for 20 minutes. Intraarterial, intraperitoneal, intrapleural perfusion can be performed. The dose is selected individually. It can vary depending on the effect and side effects.
This approach is appropriate if the treatment is in combination with cytostatics.16 mg / sq.m. 1 time every four weeks with monotherapy. The average duration of treatment is 1 month.
If the kidney function is impaired, the dose is reduced by half. A full dose is prescribed only at a certain level of white blood cells and platelets.
Side effects of
Side effects may have different manifestations
| Localization: | Manifestations: |
|---|---|
| Blood | Anemia, thrombocytopenia, neutropenia. |
| Respiratory function | Pulmonary fibrosis. |
| Digestive organs | Nausea, vomiting, mucositis, ulcers, impaired liver function. |
| Skin | Damage to the dermis, soft tissue, vasculitis, alopecia, skin necrosis. |
| Allergy | Anaphylactic shock. |
| Reproductive organs | Amenorrhea, azoospermia. Effects depend on the dose and can be irreversible. |
| Mutagenicity | Secondary malignant tumors. The association with imunnosupressivnym action is not exact, but the risk is increased with prolonged use. |
| Other | Hepatitis, an increase in urine of 5-hydroxyindoleacetic acid. |
Overdose of
At elevated doses of the drug,
- anemia, colitis,
- swallowing difficulty,
- nausea and vomiting may develop.
An infection may join these symptoms. Then there is a rise in body temperature, cough, low back pain, difficulty urinating.
One of the manifestations of overdose is the appearance of ulcers on the oral mucosa.
There is no antidote, hemodialysis and hemoperfusion do not help to remove excess. Therefore, peripheral blood values are monitored for 3-6 weeks.
Specific instructions for
When handling Mefalan, it is important to follow the rules for handling skin irritants and toxic substances.
During the treatment, a blood test is performed to detect bone marrow aplasia and myelosuppression in a timely manner. Leukopenia and thrombocytopenia are exacerbated after discontinuation of treatment.
Therefore, with abnormal decrease in platelets or white blood cells, treatment is interrupted.
There are cases of acute leukemia, which occurred after long-term treatment of these drugs. However, there is no information that would confirm the presence of the drug teratogenic properties.
Drug Interaction
This substance can not be used with dextrose solutions. It weakens immunization with the use of vaccines with live viruses. There is an increase in viral replication and side effects from vaccination.
Reviews
Most patients have weakness, regular dizziness. In most cases, the medicine has allowed to get rid of the disease, but the recovery period after taking is long enough.
In many cases, the medication is combined with prednisolone, which enhances the action of Melfalan.
Price
In Moscow the cost of a powder for the preparation of a solution in a 50 mg bottle varies from 8,300 to 15,000 rubles. The cost of 25 tablets starts from 3700 to 4000 rubles.
Analogues of Melphalan
L-Sarcoslysin, L-PAM, L-phenylalanine mustarfl L-sarcolysin, Melphalan.
Synonyms for
Alkeran.
Conditions for dispensing from pharmacies
Sold exclusively by prescription
Storage conditions and shelf life
Powder for the preparation of the solution has a shelf life of 3 years, and tablets - 24 months. Storage is possible at a temperature of 15-25 degrees in a place protected from the sun and children.
Video about tablets and injections of Alkera( Melphalan):