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► Alkeran (melphalan) - Practical Medicine

Alkeran (melphalan) - coated tablets

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Alkeran coated tablets; 2 mg; 25 tables Aspen Pharma 326.81 0.00
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Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:melphalan

The drug is available on prescription

What is Alkeran?

It is an anticancer drug used in cancer chemotherapy.

What does Alkeran contain and how does it work?

The active substance of the preparation is melphalan. It is an organic compound used as an anticancer drug. It has an alkylating effect on biological macromolecules, in particular DNA, which leads to their chemical modification. Alkylation causes the formation of abnormal bonds in the DNA molecule, disturbances in the synthesis of nucleic acids (DNA and RNA) and proteins and leads to cell death. The cytotoxic activity of the preparation concerns especially the rapidly dividing cells (in which DNA repair mechanisms are insufficient), which are cancer cells. Melphalan is used orally primarily in chemotherapy of hematopoietic tumors.

When to use Alkeran?

The preparation is indicated for the treatment of multiple myeloma.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients. Avoid use during pregnancy, especially in the first trimester. The use of the preparation is contraindicated during breast-feeding.

When should you exercise extreme caution when using Alkeran?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In certain situations, it may be necessary to carry out specific check-ups. The preparation is a cytotoxic drug. Treatment may only be carried out under the supervision of an oncologist who has experience in the use of cancer chemotherapy.
In immunocompromised patients, live vaccines should not be used because of the risk of generalized post-vaccination disease that can cause death. The immune response to other vaccinations may be impaired.
The preparation is cytotoxic and you should follow the guidelines for the use of cytotoxic drugs. Contact with the tablets does not pose a hazard unless the outer coating layer has been disturbed. The tablets should not be divided.
During your treatment your doctor will recommend regular haematological tests (blood counts) due to the likelihood of bone marrow suppression, which may sometimes be irreversible. There is a risk of leukopenia (reduction in the number of white blood cells [leukocytes] in blood counts), neutropenia (decrease in neutrophil counts in blood counts) and thrombocytopenia (decrease in platelet counts) and anemia. If the first symptoms of haematological disorders occur, your doctor may recommend a periodic discontinuation of treatment because the number of white blood cells and platelets may continue to decrease after the last dose. Caution should be exercised when treating patients after previous (recent) radiotherapy or chemotherapy because the toxic effects of the preparation on the bone marrow may be exacerbated.
Patients with impaired renal function require close medical observation and regular laboratory tests.They are particularly exposed to azotemia (a condition in which the concentration of nitrogen-containing compounds in the blood is increased as a result of renal failure) bone marrow suppression.
The use of the preparation is associated with the risk of secondary tumors (especially leukemia), especially in the case of long-term treatment. Because the use of the preparation is associated with the risk of acute leukemia, the physician will consider the risk of acute leukemia to the expected benefits before prescribing the product, in each case individually.
Treatment may result in ovarian suppression (which may be manifested by lack of menstruation) and impaired spermatogenesis.
People treated with the preparation (both men and women) should absolutely consult a doctor about the use of effective contraception to prevent pregnancy.

Does this preparation affect the ability to drive vehicles?
There are no data on the effects of the preparation on the ability to drive vehicles and use machines / devices. Be careful.

Dosage of Alkeran

The preparation is in the form of coated tablets for oral use. The tablets should be taken before eating, swallowed whole with water. Do not divide the tablets. If you have any doubts regarding the use of the preparation, consult a physician. The doctor will determine the duration of treatment and will select the dosage individually depending on the indication, the expected result, the clinical situation, and whether the preparation will be used as a monotherapy or as part of a multi-drug chemotherapy. During treatment, the doctor will adjust the dosage depending on the results of hematology (white blood cell count) and depending on the severity of side effects.
Multiple myeloma:
Adults: there are many different dosing regimens, usually a prednisone combination therapy is used that is more effective than monotherapy; usual: 0.15 mg / kg body weight per day in divided doses for 4 days, the cycle is repeated every 6 weeks.
Older people usually use standard dosage, however care should be taken; there are no general recommendations regarding the dosage in this age group.
Children: the product is very rarely indicated for use in children; there are no detailed guidelines on the dosage of the drug in children.
If you have kidney problems, your doctor will consider starting treatment with reduced doses.

Can I use Alkeran during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine. Also, see the warnings in the "Take special care with the preparation" section.
If possible, do not use the preparation during pregnancy, especially in the first trimester. In each case, an individual doctor will consider the benefit to the mother in relation to the risk to the fetus.
The preparation is contraindicated during breast-feeding.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
In immunocompromised patients, live vaccines should not be used because of the risk of generalized post-vaccination disease that can cause death. The immune response to other vaccinations may be impaired.
Nalidixic acid (a quinolone antibiotic) used in parallel with high doses of intravenous melphalan may cause death in children due to hemorrhagic colitis.
The preparation used with cyclosporin may cause renal dysfunction (especially in patients after bone marrow transplantation).

What side effects can occur?

Like all medicines, Alkeran can also cause side effects, although it will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.The severity of the side effects of the preparation may be greater if it is given in combination with other chemotherapeutics.
Very often, possible bone marrow suppression and hematological disorders: leukopenia (reduction in the number of white blood cells [leukocytes] in blood counts), neutropenia (decrease in neutrophil counts in blood counts), thrombocytopenia, anemia. Very common: nausea and vomiting, diarrhea, inflammation and sore mouth, baldness. Frequent transient increase in blood urea in patients with impaired renal function. Uncommon or rare: hepatic impairment (increased bilirubin, increased liver enzymes, hepatitis, jaundice), haemolytic anemia, hypersensitivity reactions (rash, urticaria, angioneurotic edema, life-threatening anaphylactic shock and cardiac arrest), rash maculopapular, interstitial pneumonitis, pulmonary fibrosis (sometimes fatal).