ALKERAN 2mg Tablets

What is ALKERAN 2mg

Alkeran is the brand name for melphalan, a chemotherapy (anticancer) drug in tablet form.

• Drug class: Alkylating agent (specifically, a nitrogen mustard).
• Main use: Treatment of various cancers such as multiple myeloma, ovarian cancer, lymphomas, leukemias, and certain solid tumors :contentReference[oaicite:1]{index=1}.
• Formulation: Each white tablet contains 2 mg of melphalan hydrochloride, typically supplied in a 25-tablet glass bottle :contentReference[oaicite:2]{index=2}.
• Essential drug: Listed on the WHO’s Essential Medicines as an effective and widely used chemotherapy agent :contentReference[oaicite:3]{index=3}.

In summary: Alkeran is a potent anti-cancer medication used orally to target malignant cells in the blood, bone marrow, and certain solid tumors.

How to use ALKERAN 2mg

Proper usage is crucial to maximize therapeutic effect and minimize risks:

• Administration: Taken orally with a full glass of water. To reduce GI irritation, administer after meals :contentReference[oaicite:4]{index=4}.
• Typical schedules:
  • Multiple myeloma: 6 mg once daily for 2–3 weeks, followed by a 4-week break; then maintenance at 2 mg daily :contentReference[oaicite:5]{index=5}.
  • Ovarian cancer: ~0.2 mg/kg daily over 5 days per cycle, repeated every 4–5 weeks :contentReference[oaicite:6]{index=6}.
  • Malignancies and leukemias: Dosing tailored by body surface area or weight—typically under specialist care :contentReference[oaicite:7]{index=7}.
• Monitoring: Regular blood tests (CBC with differential) prior to therapy start and at intervals during treatment to check for bone marrow suppression :contentReference[oaicite:8]{index=8}.
• Missed dose: Do not double up—skip and continue per schedule. Inform your doctor :contentReference[oaicite:9]{index=9}.
• Precautions: Strict medical supervision with regular lab follow-ups. Avoid pregnancy and exposure to infectious agents during treatment :contentReference[oaicite:10]{index=10}.

Mode of Action ALKERAN 2mg

Melphalan acts by directly damaging cancer cell DNA:

• Alkylation: Melphalan binds to guanine bases in DNA, forming cross-links between strands.
• Cell death induction: These cross-links inhibit both DNA and RNA synthesis, preventing replication and ultimately triggering cell apoptosis—affecting both active and dormant cancer cells :contentReference[oaicite:11]{index=11}.
• Broad-spectrum action: As an alkylating agent, it damages rapidly dividing cells—especially effective in hematologic cancers and certain solid tumors.

This mechanism underpins melphalan’s role in cancer therapy, though it also affects healthy dividing cells, contributing to side effects.

ALKERAN 2mg Interactions ALKERAN 2mg

Melphalan can interact with various drugs and vaccines:

• No classic drug–drug interactions: Oral melphalan lacks direct metabolic interactions, but caution is required :contentReference[oaicite:12]{index=12}.
• With immunosuppressants: Potency increases with agents like tacrolimus, cyclosporine—higher infection and marrow suppression risk :contentReference[oaicite:13]{index=13}.
• With amphotericin B: Higher risk of renal toxicity, hypotension, bronchospasm—monitor closely :contentReference[oaicite:14]{index=14}.
• Live vaccines: Contraindicated during and up to 3 months post-treatment due to immunosuppressive effects :contentReference[oaicite:15]{index=15}.

Always inform physicians and pharmacists about melphalan so monitoring and timing adjustments can be implemented.

Dosage of ALKERAN 2mg

Melphalan dosing varies by indication and patient status:

• Adults (multiple myeloma):
  • 6 mg orally daily for 2–3 weeks → off period.
  • Once blood counts recover, maintain at 2 mg daily :contentReference[oaicite:16]{index=16}.
• Ovarian cancer: ~0.2 mg/kg orally for 5 days, repeated every 4–5 weeks :contentReference[oaicite:17]{index=17}.
• Blood cancers: Dosing based on BSA or weight; supervised by specialists :contentReference[oaicite:18]{index=18}.
• Pediatric use: Not established for routine pediatric patients :contentReference[oaicite:19]{index=19}.
• Modifications: May be adjusted for advanced age, renal or hepatic impairment to prevent toxicity.
• Treatment duration: Cyclic: treatment period, followed by rest and lab monitoring.

Possible side effects of ALKERAN 2mg

Melphalan’s side effects arise mainly from bone marrow suppression and its alkylating action:

• Hematologic (most frequent):
  • Anemia, leukopenia (infection risk), thrombocytopenia (bleeding)—usually reversible if detected early :contentReference[oaicite:20]{index=20}.
• Gastrointestinal: Nausea, vomiting, diarrhea, oral ulcers/stomatitis—managed symptomatically :contentReference[oaicite:21]{index=21}.
• Alopecia: Hair loss common at higher doses :contentReference[oaicite:22]{index=22}.
• Pulmonary: Rare but serious interstitial pneumonitis or pulmonary fibrosis :contentReference[oaicite:23]{index=23}.
• Hypersensitivity: Rash, pruritus, urticaria, and rare anaphylaxis or cardiac arrest :contentReference[oaicite:24]{index=24}.
• Secondary malignancies: Leukemia or MDS risk increases with cumulative dose :contentReference[oaicite:25]{index=25}.
• Other effects: Infertility, hepatic or renal dysfunction, muscle pain, and flushing :contentReference[oaicite:26]{index=26}.

Regular monitoring and symptom reporting are vital. Immediate attention is required for signs of severe infection, bleeding, or respiratory distress.

ALKERAN 2mg Contraindications ALKERAN 2mg

Melphalan is contraindicated in:

• Hypersensitivity: History of allergy to melphalan or related agents (e.g., chlorambucil) :contentReference[oaicite:27]{index=27}.
• Pregnancy and breastfeeding: Highly teratogenic and genotoxic—must avoid conception during and 6 months post-treatment :contentReference[oaicite:28]{index=28}.
• Bone marrow compromise: Active severe leukopenia or thrombocytopenia from other causes :contentReference[oaicite:29]{index=29}.
• Prior melphalan resistance: Avoid retreatment in known resistance :contentReference[oaicite:30]{index=30}.
• Live vaccines: Live vaccines contraindicated during immunosuppressive periods :contentReference[oaicite:31]{index=31}.

Storage of ALKERAN 2mg

Ensure drug integrity with proper storage:

• Temperature: Store in the original glass bottle at room temperature (20–25 °C), avoiding extremes :contentReference[oaicite:32]{index=32}.
• Protection: Keep away from direct light and moisture; keep the bottle tightly sealed.
• Child safety: Store out of reach of children due to high toxicity.
• Expiry: Discard unused or expired tablets per medical waste guidelines—do not flush.
• Labeling: Retain prescription label for dosing instructions and expiration date.