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Indications for using of Alkeran-50.
Alkeran – 50 is in ampoules. It is intended for the treatment of neuroblastoma in children, ovarian adenocarcinoma, true polycythemia, localized melanoma, multiple myeloma, mammary carcinoma and soft tissue sarcoma of the extremities.
Method of application of Alkeran-50.
Treatment with Alkeran – 50 should be carried out according to the purpose and under the supervision of an oncologist.
A solution of Alkeran – 50 is prepared before using. In the vial with lyophilizate 10 ml of solvent is added, which is enclosed in the package. For complete dissolution, the vial is vigorously shaken. In 1 ml of the solution contains 5 mg of Melphalan. It is forbidden to store the prepared solution in the refrigerator.
Alkeran – 50 is indicated for intravenous and intraarterial administration with regional arterial perfusion. The remedy is administered intravenously drip in combination with infusion saline. The introduction of Alkeran – 50 should last no longer than 1.5 hours. If the prepared solution is cloudy or crystals begin to form in it, it must be destroyed.
Treatment with medication can be done independently and with cytotoxic remedies, incl. Prednisolone.
Intravenously Alkeran – 50 with multiple myeloma in combination with cytostatics, 8-30 mg / m2 of the skin of the patient should be administered. The interval between injections should be 2-6 weeks. With monotherapy, the dose of the remedy is 0.4 mg / kg of the patient’s weight once a month. Repeated administration of the remedy should be carried out after normalization of laboratory blood parameters. High-dosage therapy is considered when using Alkeran at 100-200 mg / m2. After the administration of 140 mg / m2, the patient needs to undergo an autologous bone marrow transplant.
In the pathology of kidneys, the dose of Alkeran – 50 should be reduced by half.
Adenocarcinoma of the ovaries is treated with the application of the remedy inside 0.2 mg / kg / day for 5 days. Parenteral administration of Alkeran – 50 at 1 mg / kg 1 day with monotherapy, with cytostatics – 0.3-0.4 mg / kg 1 day was shown. The remedy should be administered at intervals of 4 to 6 weeks.
The true polycythemia is treated with Alkeran – 50 ingestion at 6-10 mg / day for 5-7 days, stimulating the development of remission of the disease.
Children with progressing neuroblastoma need intravenous administration 100-240 mg / m2 of Alkeran – 50 for 1-3 days.
The remedy for malignant melanoma is introduced in the early stages with the help of hyperthermic regional perfusion intraarterially. The dose of the remedy is determined individually by the treating doctor.
With sarcoma, Alkeran – 50 should be administered intraarterially with actinomycin D and surgical intervention.
Treatment with Alkeran – 50 is often accompanied by bone marrow depression, leukopenia, thrombocytopenia, nausea, diarrhea, stomatitis, alopecia, transient increase in urea levels in the blood, and alopecia.
The patient can feel heat and tingling with intravenously administration of the remedy.
Rarely, Alkeran – 50 provokes the development of hemolytic anemia, allergies (rash, urticaria, pruritus, anaphylactic shock), interstitial pneumonia, pulmonary fibrosis, impaired liver function, hepatitis, veno-occlusive disease, maculopapular rash.
The remedy suppresses the work of the ovaries and can cause amenorrhea in women. Rarely, Alkeran – 50 affects spermatogenesis and can cause temporary or permanent sterility in men.
It is forbidden to use Alkeran – 50 for people with allergies to its ingredients. High doses of the remedy are contraindicated in renal failure.