Alkeran

Alkeran possesses antitumor and cytostatic activity, which is provided by its alkylating effect, which makes it possible to slow down the replication of atypical neoplastic cells (malignant), which undergo active division.

The drug blocks the processes of cellular mitosis of rapidly multiplying tissues and shows a noticeable selectivity in relation to neoplasms in the lymph region. The drug inhibits tumor growth by stopping the formation of new ones, and the multiplication of already existing atypical cells. [1]

A positive effect on malignant tumors is combined in the drug with a negative effect on hematopoiesis. Recovery of bone marrow activity usually occurs after the end of therapy.

Indications Alkeran

It is used in the case of neuroblastoma in a child, and in addition, with polycythemia of a true nature, affecting the ovaries, adenocarcinoma, myeloma (multiple form), melanoma (localized type), breast carcinoma, as well as sarcoma, which affects soft tissues in the extremities.

Release form

The release of the therapeutic substance is made in tablets with a volume of 2 mg - 25 pieces inside glass bottles. Inside the pack - 1 such bottle.

In addition, it can be produced in powder form - in bottles that contain 50 mg of the drug. The box contains 1 bottle of powder (10 ml) and 1 bottle containing solvent.

Dosing and administration

Alkeran therapy should be carried out under the supervision of an oncologist, from his appointment.

The tablets should be swallowed whole without chewing. The drug effect in each patient develops personally, taking into account the degree of absorption of melphalan. Therefore, the selection of the dosage must be done personally; in the course of therapy, the portion is increased until the therapeutic effect occurs.

A liquid for parenteral administration is prepared before the procedure. A solvent (10 ml), which comes with the medicine, is poured into the bottle with the powder. To completely dissolve the substance, the bottle must be shaken. 1 ml of liquid contains 5 mg of melphalan. The prepared liquid cannot be stored in the refrigerator.

The medication is administered intra-arterially (regional perfusion into the artery region) and intravenously (through a dropper along with saline in the form of infusion). The injection procedure can last for a maximum of 90 minutes. If crystals appear in the liquid or if it becomes cloudy, it is required to dispose of the substance.

Both monotherapy with a drug and its use in combination with cytostatics (among them prednisolone) can be performed.

In the case of multiple myeloma, it is necessary to use tablets in a portion of 0.15 mg / kg per day for 4 days. In this case, the intake of drugs must be divided into several uses. At the end of the 4-day cycle, you must take a break for 1.5 months.

Intravenous use for the above disease (together with cytostatics) is performed at a dosage of 8-30 mg / m2 of the patient's epidermis area. The interval between injections should be equal to 0.5-1.5 months. In the case of monotherapy, the serving size is 0.4 mg / kg, with 1 dose per month. It is necessary to re-enter the medicine after stabilization of the blood test readings. The treatment is considered high-dose in the case of using portions of 0.1-0.2 g / m2. When using doses over 0.14 g / m2, the patient needs to undergo autologous bone marrow transplantation.

In case of problems with renal function, it is necessary to halve the dose of drugs.

For adenocarcinoma affecting the ovaries, orally take 0.2 mg / kg per day for a period of 5 days. The tablets should be used in cycles, between which the 1-2-month intervals are observed. For parenteral use, 1 mg / kg per day (monotherapy) or 0.3-0.4 mg / kg per day (combination with cytostatics) is required. It is necessary to use Alkeran with a 1-1.5 month interval.

With polycythemia of the true nature, oral intake of 6-10 mg of the substance per day (in the period of 5-7 days) is required to stimulate the remission of the disease. At the end of the initial phase of treatment, the tablets are consumed in portions of 2-4 mg per day, 1 time per week.

A child in the case of neuroblastoma (which has a progressive nature) is intravenously used at 0.1-0.24 g / m2 of drugs for a period of 1-3 days.

In the case of melanoma (having a malignant form), the drug is used at the initial stage - intra-arterially, through regional hyperthermic perfusion. The selection of the portion is performed by the treating doctor personally.

For the treatment of sarcoma, intra-arterial injection of drugs in combination with actinomycin D is required, as well as an operation.

Use Alkeran during pregnancy

You can not prescribe medication to pregnant women (especially in the 1st trimester).

When using Alkeran during lactation, it is necessary to cancel HS.

Contraindications

It is contraindicated to prescribe the medicine to persons with allergies in relation to its constituent elements. Large portions of the medication are not used in people with kidney failure.

Side effects Alkeran

With the introduction of the drug, leuko- or thrombocytopenia, stomatitis, nausea, diarrhea, suppression of bone marrow activity, alopecia and a transient increase in blood urea levels are often noted.

After an intravenous injection, you may experience a tingling sensation and a feeling of heat.

Occasionally, when using drugs, pulmonary fibrosis, anemia (having a hemolytic nature) or interstitial pneumonia appear, and in addition, hepatitis, allergies (itching, rashes, anaphylaxis and urticaria), maculopapular rashes, hepatic dysfunction and veno-occlusive pathology.

The medication inhibits the function of the ovaries, therefore it is able to provoke the development of amenorrhea in a woman. Occasionally, the drug affects the processes of spermatogenesis and can provoke permanent or transient sterility in a man.

Overdose

In case of drug poisoning, digestive dysfunction is observed - the appearance of pain in the epigastric zone, nausea and stool disorders. Occasionally, in case of an overdose, hemorrhagic diarrhea develops.

Prolonged administration of large portions of drugs causes suppression of bone marrow activity, in which thrombocyto- or leukopenia and anemia develop.

Interactions with other drugs

After intravenous and intra-arterial use of drugs together with nalidixic acid, the risk of death increases (especially in a child). Among the negative consequences of the combined treatment is the appearance of enterocolitis, which has a hemorrhagic nature.

The use of large portions of Alkeran prior to performing hematopoietic stem cell transplantation, followed by cyclosporine administration, may cause renal dysfunction.

You can not enter the medication with infusion fluids that include glucose. Saline solution (0.9% NaCl) can be used as a basis for drugs.

Storage conditions

Alkeran tablets must be stored in the refrigerator - at temperatures within + 2 / + 8 ° C. The powder can be stored at standard values up to 25 ° C.

Shelf life

Alkeran is allowed to be used within a 36-month term from the date of manufacture of the medicinal product.

Analogs

Analogs of the therapeutic substance are the drugs Alfalan, Cloqueran, Endoxan with Ifomid, Leukeran with Holoxan, and besides this, Bentero, Cyclophosphamide, Ifosfamide with Ifol, Cel and Ifos.