IVRA Dosage

Recommended Dosage

The recommended dosage is 16 mg/m2 intravenously over 15 to 20 minutes at 2-week intervals for 4 doses, then at 4-week intervals until unacceptable toxicity.

Administer prophylactic antiemetics.

Dosage Modifications for Adverse Reactions

See Table 1 for dosage modifications for adverse reactions related to bone marrow suppression.

Table 1. Dosage Modifications for Adverse Reaction: Bone Marrow Suppression

Dosage Modifications for Renal Impairment

Consider a dosage reduction of up to 50% in patients with renal insufficiency (BUN ≥30 mg/dL).

Preparation and Administration

Preparation

• IVRA is a hazardous drug. Follow applicable special handling and disposal procedures1.
• Parenteral drug products should be visually inspected for particulate matter and discoloration prior to administration whenever solution and container permit. If either occurs, do not use this product.
• IVRA is light sensitive. After first use, store the partially used vial refrigerated at 2°C to 8°C [36°F to 46°F] in the original carton for use within 28 days and then discard the remaining contents. Retain vial in original carton until contents are used.
• Do not mix IVRA with other melphalan hydrochloride drug products.

Dilution

• Calculate the required volume of IVRA needed for a patient’s dose and withdraw that volume from the vial(s).
• Add the required volume of IVRA to the appropriate volume of 0.9% Sodium Chloride Injection to obtain a solution with a concentration not greater than 0.45 mg/mL. Immediately mix the contents of infusion vigorously by manual rotation. The diluted product is stable for 1 hour at room temperature.

Administration

• Infuse over 15 to 20 minutes via an injection port or central venous catheter. Complete administration within 60 minutes of dilution.
• IVRA may cause local tissue damage should extravasation occur. Administer IVRA only by injecting slowly into a fast-running intravenous infusion via an injection port or, central venous access line.