Melphalan Warning and Precautions

1. Melphalan (Alkacel) 50mg Injection is a chemotherapy pharmaceutical medicinal product and a class of drugs called alkylating agents. The medicine melphalan hydrochloride is known as an active constituent. It is used for the treatment of multiple myeloma (a type of blood cancer that occurs in bone marrow cells, that helps the body fight infection), skin cancer, advanced ovarian cancer, and soft tissue sarcoma (cancer of soft tissues that is mostly found in chest, legs, abdomen). Melphalan: Warning and Precautions Melphalan can also be used for the treatment of childhood neuroblastoma, cancer that occurs in immature nerve tissue. It can develop in the neck, adrenal glands, chest, abdomen or spine. Let your physician know if you have kidney/liver disorders, blood clot problems, epilepsy, have had radiotherapy, chemotherapy, or vaccination recently or are about to have any vaccines prior to receiving melphalan 50 mg Injection.

2. • Bone Marrow Suppression: For those receiving Melphalan as part of a conditioning regimen, myeloablation appears in all patients. Do not start the conditioning regimen in case a stem cell product does not exist for rescue. Complete blood counts (CBCs) need to be monitored. Provide supportive care for infections, anemia and thrombocytopenia until there is apt hematopoietic recovery. Warnings and Precautions • Hypersensitivity: Acute hypersensitivity reactions, including anaphylaxis, may occur in about 2 percent of patients who received melphalan injection. Symptoms may include pruritus, edema, urticaria, and skin rashes and, in some patients, bronchospasm, tachycardia, dyspnea, and hypotension. Discontinue treatment for serious hypersensitivity reactions. • Hepatotoxicity: Certain hepatic disorders that range from abnormal liver function tests to clinical manifestations such as jaundice and hepatitis may occur after treatment with the medicine melphalan. Hepatic veno-occlusive disease has also been reported. Monitor liver chemistries. • Infertility: Melphalan-based chemo regimens may cause suppression of ovarian function in premenopausal women, resulting in persistent amenorrhea in around 9% of patients. Reversible/irreversible testicular suppression may also occur.

3. Adverse Events For myeloablative conditioning in MM patients undergoing ASCT, twelve (20 percent) patients experienced serious side effects while on study. The most common serious side effects (>1 patient, 1.6 percent) were hematochezia, pyrexia, febrile neutropenia, and renal failure. Treatment- related serious side effects reported in >1 patient were pyrexia (n=2, 3 percent), febrile neutropenia (n=2, 3 percent), and hematochezia (n=2, 3 percent). The most common melphalan side effects that occurred in at least 50 percent of patients with MM treated with melphalan were white blood cell count decreased, neutrophil count decreased, lymphocyte count decreased, diarrhea, platelet count decreased, nausea, fatigue, hypokalemia, anemia, and vomiting.

4. Price and Availability Please contact at 1800-889-1064 or send your enquiry to info@theindianpharma.com to find the best melphalan price in India. The Indian Pharma(TIP) is WHO GDP and ISO 9001 2015 Certified Pharmaceutical Wholesaler/ Supplier/ Exporter/ Importers from India of Melphalan Injection IP 50 mg which is also known as Alkacel and manufactured by Celon Laboratories Ltd. and available in a dosage strength of 50mg per mL. At TIP, all temperature-sensitive pharmaceutical medicinal products are transported under temperature-controlled conditions in order to maintain product integrity.