WARNING

Evomela Injection, also known as Melphalan, is a chemotherapy drug used to treat certain types of cancer, such as multiple myeloma and ovarian cancer. Like many chemotherapy medications, Evomela carries several risks and potential side effects, including:

• Bone Marrow Suppression: Evomela can suppress the bone marrow’s ability to produce blood cells, leading to an increased risk of infection, anemia, and bleeding.
• Nausea and Vomiting: Many patients experience nausea and vomiting as side effects of Evomela treatment, which can impact their quality of life.
• Hair Loss: Chemotherapy drugs like Evomela can cause temporary hair loss, though the extent varies from person to person.
• Risk of Infection: With decreased white blood cell counts, patients are more susceptible to infections, which can be severe.
• Risk of Secondary Cancers: Long-term use of chemotherapy drugs like Evomela may slightly increase the risk of developing secondary cancers later in life.
• Gastrointestinal Issues: Evomela can cause gastrointestinal side effects such as diarrhea, constipation, and mucositis (inflammation of the mucous membranes).
• Allergic Reactions: Some patients may experience allergic reactions to Evomela, which can manifest as rash, itching, difficulty breathing, or swelling of the face, lips, or tongue.
• Impact on Fertility: Evomela can impair fertility in both men and women, potentially causing temporary or permanent infertility.

It’s important for patients receiving Evomela to be closely monitored by their healthcare team to manage these risks effectively and mitigate any potential complications.

Why is this medication prescribed?

Evomela Injection, or Melphalan, is prescribed for various types of cancer, primarily:

• Multiple Myeloma: It’s often used as part of high-dose chemotherapy regimens followed by stem cell transplantation in patients with multiple myeloma.
• Ovarian Cancer: Evomela may be used in combination with other chemotherapy drugs for the treatment of advanced ovarian cancer.
• Other Cancers: It may also be prescribed for other cancers like neuroblastoma, breast cancer, and certain types of lymphoma.

How should this medicine be used?

Here’s a general guideline for the use of Evomela Injection:

• Dosage: The dosage of Evomela varies depending on factors such as body surface area and the specific cancer being treated. It’s determined by the prescribing healthcare provider.
• Administration: Evomela is typically administered as an intravenous infusion. The infusion may take several minutes to complete.
• Frequency: The frequency of Evomela administration depends on the treatment regimen prescribed by the healthcare provider. It may be given as a single dose or as part of a multi-day treatment cycle.
• Precautions: Patients receiving Evomela should be closely monitored for potential side effects and complications, such as bone marrow suppression, infections, and gastrointestinal issues. Regular blood tests are often conducted to monitor blood cell counts and overall health status.
• Supportive Care: Patients may receive supportive care, such as anti-nausea medication or medications to stimulate white blood cell production, to help manage side effects and improve comfort during treatment.

It’s essential for patients to follow their healthcare provider’s instructions carefully and attend all scheduled appointments for monitoring and supportive care during Evomela treatment.

Other uses for this medicine

Some of these off-label uses may include:

• Autoimmune Diseases: In certain autoimmune diseases like systemic sclerosis (scleroderma), Evomela may be used as part of aggressive treatment regimens.
• Bone Marrow Disorders: Evomela may be used in the treatment of bone marrow disorders such as myelodysplastic syndromes (MDS) or as a conditioning regimen before bone marrow or stem cell transplantation.
• Eye Disorders: In ophthalmology, Evomela has been used as an intraocular injection for the treatment of proliferative vitreoretinopathy (PVR), a complication of retinal detachment surgery.

What special precautions should I follow?

Regarding special precautions for Evomela Injection, here are some important considerations:

• Pregnancy and Breastfeeding: Evomela can cause harm to a developing fetus, so it’s crucial to avoid pregnancy during treatment and for a period afterward. Breastfeeding is also not recommended while receiving Evomela.
• Blood Cell Counts: Evomela can cause significant bone marrow suppression, leading to low blood cell counts. Regular blood tests are necessary to monitor white blood cell, red blood cell, and platelet counts during treatment.
• Infections: Patients receiving Evomela are at an increased risk of developing infections due to suppressed immune function. It’s important to take precautions to avoid exposure to infectious agents and seek prompt medical attention if signs of infection develop.
• Kidney and Liver Function: Evomela is primarily eliminated from the body through the kidneys, so patients with impaired kidney function may require dosage adjustments. Liver function should also be monitored, as liver toxicity can occur with high doses of Evomela.
• Secondary Cancers: Long-term use of Evomela may slightly increase the risk of developing secondary cancers. Patients should undergo regular screenings for early detection of any potential complications.
• Allergic Reactions: Patients with a history of allergic reactions to Evomela or other chemotherapy drugs should inform their healthcare provider before starting treatment.
• Fertility: Evomela can impair fertility in both men and women. Patients of reproductive age should discuss fertility preservation options with their healthcare provider before starting treatment.

Patients should always communicate openly with their healthcare provider about any pre-existing medical conditions, medications, or concerns they may have before starting treatment with Evomela Injection.

What special dietary instructions should I follow?

Special dietary instructions for Evomela Injection are generally not required. However, it’s essential to maintain a well-balanced diet and stay hydrated during treatment. Patients should consult with their healthcare provider or a registered dietitian if they have any specific dietary concerns or nutritional needs.

What should I do if I forget a dose?

If a dose of Evomela Injection is missed, patients should contact their healthcare provider or oncology team immediately for guidance. It’s important not to double the dose to make up for a missed one, as this can increase the risk of side effects. The healthcare provider will determine the appropriate course of action based on the individual’s treatment plan and circumstances.

What side effects can this medication cause?

Evomela Injection, like many chemotherapy medications, can cause a range of side effects. These side effects can vary from person to person and depend on factors such as the individual’s overall health, the dosage of the medication, and the specific cancer being treated. Some common side effects of Evomela Injection include:

• Bone Marrow Suppression: Evomela can suppress the bone marrow’s ability to produce blood cells, leading to low white blood cell counts (neutropenia), low red blood cell counts (anemia), and low platelet counts (thrombocytopenia). This can increase the risk of infections, fatigue, and bleeding.
• Nausea and Vomiting: Many patients experience nausea and vomiting as side effects of Evomela treatment. These symptoms can usually be managed with anti-nausea medications prescribed by the healthcare provider.
• Hair Loss: Chemotherapy drugs like Evomela can cause temporary hair loss, though the extent varies from person to person. Hair loss may occur on the scalp, eyebrows, eyelashes, and other body hair.
• Gastrointestinal Issues: Evomela can cause gastrointestinal side effects such as diarrhea, constipation, abdominal pain, and mucositis (inflammation of the mucous membranes lining the digestive tract).
• Fatigue: Cancer treatment, including Evomela, can lead to fatigue, which may persist throughout the course of treatment and even after completion.
• Increased Risk of Infections: With decreased white blood cell counts, patients are more susceptible to infections. Fever or signs of infection should be reported promptly to the healthcare provider.
• Loss of Appetite: Some patients may experience a loss of appetite or changes in taste during treatment with Evomela.
• Skin Reactions: Evomela can cause skin reactions such as rash, dry skin, itching, or increased sensitivity to sunlight.
• Mouth Sores: Some patients may develop mouth sores (oral mucositis) as a side effect of Evomela treatment.
• Nerve Damage (Peripheral Neuropathy): Rarely, Evomela may cause peripheral neuropathy, which can result in symptoms such as numbness, tingling, or weakness in the hands and feet.

It’s important for patients to discuss potential side effects with their healthcare provider before starting treatment and to report any side effects promptly during treatment. Healthcare providers can provide supportive care and medications to help manage side effects and improve the patient’s quality of life during cancer treatment.

What should I know about storage and disposal of this medication?

When it comes to the storage and disposal of Evomela Injection, here’s what you should know:

Storage:

• Store Evomela Injection vials at room temperature between 20-25°C (68-77°F).
• Protect the vials from light and moisture.
• Keep Evomela Injection out of reach of children and pets.
• Follow any specific storage instructions provided by your healthcare provider or pharmacist.

Disposal:

• Evomela Injection vials should be disposed of properly according to local regulations for hazardous waste disposal.
• Do not dispose of Evomela Injection vials in household trash or pour them down the drain unless instructed to do so by your healthcare provider or pharmacist.
• Contact your healthcare provider, pharmacist, or local waste management authority for guidance on proper disposal methods.

In case of emergency/overdose

• If you suspect an overdose or experience severe side effects after receiving Evomela Injection, seek immediate medical attention.
• Contact your healthcare provider, local emergency services, or go to the nearest emergency room.
• Be prepared to provide information about the dosage and timing of the Evomela Injection, as well as any symptoms you are experiencing.

What other information should I know?

• Follow all instructions provided by your healthcare provider for the administration and monitoring of Evomela Injection.
• Inform your healthcare provider about any other medications, supplements, or herbal products you are taking, as they may interact with Evomela.
• Attend all scheduled appointments for blood tests and follow-up visits during treatment with Evomela to monitor your response to the medication and detect any potential complications.
• Report any new or worsening symptoms to your healthcare provider promptly, including signs of infection, unusual bleeding or bruising, or changes in mood or mental status.
• Discuss any concerns or questions you have about Evomela Injection with your healthcare provider or pharmacist.