Hepzato Kit melphalan hydrochloride injection, powder, lyophilized, for solution Kit — NDC 75833-0601-08 package photo
Label image from the product's FDA listing (DailyMed) — may show a different pack size or an older label revision.

Hepzato Kit melphalan hydrochloride injection, powder, lyophilized, for solution Kit — NDC 75833-601-08 (Billing 75833-0601-08)

by Delcath Systems, Inc. · 1 KIT in 1 BOX * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE * 2 BAG in 1 BOX / 250 mL in 1 BAG * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE

This is a package of Hepzato Kit melphalan hydrochloride injection, powder, lyophilized, for solution Kit from Delcath Systems, Inc., marketed since Dec 2023 and currently FDA-listed.

NDC 75833-0601-08
🏷️ FDA NDC (as labeled) 75833-601-08 billing pads the product segment with a zero
This package
Contains10 mL in 1 vial, single-use Pack sizes4 compare ↓
Rx only Brand On market Non-controlled 🛡 REMS ⇄ Compare with another NDC
🗂️ FDA directory synced Oct 1, 2026 · this listing last changed Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

NDC database record

One package, one record: these facts belong to NDC 75833-601-08 alone.

Record
FDA NDC Directory package listing · Human prescription drug
Code segments
75833 labeler · 601 product · 08 package
Package marketed since
Dec 4, 2023
Sample package
Yes — professional sample, not for sale
Listing certified through
Dec 31, 2027
Barcode (UPC)
0375833700015, 0375833800012
FDA record last changed
Jul 24, 2026

Identity & classification

Regulatory identifiers FDA, NLM and CMS codes for this package

FDA NDC (as labeled) 75833-601-08
Product NDC 75833-601
11-digit billing NDC 75833060108
RxCUI 311487, 2671196
UPC 0375833700015, 0375833800012
Application # NDA201848
SPL Set ID 4f83c8f7-4cc0-4219-88d5-7cfddce91198
DEA schedule Non-controlled
Marketing category NDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2023-12-04
Route INTRA-ARTERIAL
Dosage form KIT

Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification

GPI-14 21101040102112
GCN Seq No 085170
GCN 48367
HICL code 003895
Ingredient (HICL) Melphalan Hcl
HIC1 code V
Therapeutic class — broad (HIC1) Neoplasms
HIC2 code V1
Therapeutic class — intermediate (HIC2) Antineoplastic Drugs
HIC3 code V1A
Therapeutic class — specific (HIC3) Antineoplastic - Alkylating Agents
AHFS code 10:00.00.00
AHFS class Antineoplastic Agents
FDB label name HEPZATO 50 MG X5 KIT-62MM CATH
FDB brand name Hepzato
Legend status F — Federal legend — prescription drug or device
Quick answers
  • GSN (GCN sequence number): 085170
  • GCN: 48367
  • GPI-14 (Medi-Span): 21101040102112
  • HICL (First Databank): 003895
  • AHFS class code: 10:00.00.00
  • RxCUI (RxNorm): 311487
Why two NDCs? The FDA registers this code as 75833-601-08 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 75833-0601-08. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

RxNorm drug class

This medicine belongs to the Alkylating Drug class.

Pharmacologic class Alkylating Drug
Drug family (ATC) Nitrogen mustard analogues
How it works Alkylating Activity
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

Clinical

Label name HEPZATO 50 MG X5 KIT-62MM CATH Ingredient Melphalan Hcl
📖 What it is MedlinePlus · NLM

Melphalan injection is used to treat multiple myeloma (a type of cancer of the bone marrow) in people who are unable to take melphalan by mouth. Melphalan injection is also used to destroy bone marrow and cancer cells in preparation for a bone marrow transplant in people with multiple myeloma. Melphalan is in a class of medications called alkylating agents. It works by stopping or slowing the growth of cancer cells in your body.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • Evomela, an IV melphalan product, is used before a stem cell transplant in people with multiple myeloma. It is high-dose chemotherapy that prepares your body for the transplant.
  • It is given through a vein by a healthcare professional. Sometimes a central line is used to protect your veins and surrounding tissue. Your team will follow your prescriber's plan...
  • Common ones are low blood counts, nausea, vomiting, diarrhea, tiredness, low potassium and mouth sores. Your team may give you medicines to help with nausea and diarrhea.
  • Call right away for fever or signs of infection, unusual bleeding or bruising, severe diarrhea or vomiting, or yellowing of your skin or eyes. Get emergency help for hives, swellin...
📖 Read our full Melphalan Injection guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eachPer package
Retail pharmacies payNADAC · weekly Not in the retail survey — common for institutional, discontinued, or low-volume packs.
Medicaid paysCMS SDUD · 12 mo No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data.
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
ℹ️
No price is published for this exact package yet. CMS surveys NADAC per package size, so a different pack of the same drug often has one.
Try another pack size: 10 mL 10 mL 10 mL
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

Packaging — all sizes for this product

Package NDCDescription Marketing startMarketing endStatus
75833-0601-01 75833-601-01 Main listing 1 KIT in 1 BOX * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE * 2 BAG in 1 BOX / 250 mL in 1 BAG * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE 2023-12-04 — Active
75833-0601-02 75833-601-02 1 KIT in 1 BOX * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE * 2 BAG in 1 BOX / 250 mL in 1 BAG * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE 2023-12-04 — Active
75833-0601-07 75833-601-07 1 KIT in 1 BOX * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE * 2 BAG in 1 BOX / 250 mL in 1 BAG * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE Sample 2023-12-04 — Active
75833-0601-08 You're viewing this 1 KIT in 1 BOX * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE * 2 BAG in 1 BOX / 250 mL in 1 BAG * 5 VIAL, SINGLE-USE in 1 BOX / 10 mL in 1 VIAL, SINGLE-USE Sample 2023-12-04 — Active

Pack size FAQ

What quantity is in this package?
This package is listed by the FDA — 1 kit in 1 box * 5 vial, single-use in 1 box / 10 ml in 1 vial, single-use * 2 bag in 1 box / 250 ml in 1 bag * 5 vial, single-use in 1 box / 10 ml in 1 vial, single-use.
What NDC number is used to bill for this package of Hepzato Kit melphalan hydrochloride injection, powder, lyophilized, for solution Kit?
Use the 11-digit billing form listed in the identifiers section of this page. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Melphalan hydrochloride 23155-0355-41 Heritage 1 kit — AP FDA listed —
Melphalan Hydrochloride 25021-0258-61 Sagent 1 kit — AP FDA listed —
Melphalan Hydrochloride 31722-0362-31 Camber 1 kit — AP FDA listed —
Melphalan Hydrochloride 43598-0392-48 Dr.Reddy's 1 kit — AP FDA listed —
Melphalan hydrochloride 54288-0109-02 BPI 1 kit — AP FDA listed —
Melphalan 63323-0760-20 Fresenius 1 kit — AP FDA listed —
Melphalan Hydrochloride 67184-0618-02 Qilu 1 kit — AP FDA listed —
Melphalan Hydrochloride 67457-0195-01 Mylan 1 kit — AP FDA listed —
Melphalan hydrochloride 68083-0259-01 Gland 1 kit — AP FDA listed —
Melphalan hydrochloride 71288-0132-90 Meitheal 1 kit — AP FDA listed —
Melphalan hydrochloride 72266-0128-01 Fosun 1 kit — AP FDA listed —
Evomela 50 mg/10mL 72893-0001-01 Acrotech 1 vial — — FDA listed —
Hepzato Kitthis 75833-0601-08 Delcath 1 kit — — FDA listed —
Melphalan Hydrochloride 75907-0112-11 Dr.Reddy's 1 kit — AP FDA listed —
Melphalan Hydrochloride 83634-0202-61 Avenacy 1 kit — AP FDA listed —
Melphalan Hydrochloride 84679-0001-01 Arthur 1 kit — AP FDA listed —
About this product: this is the brand-name version. We did not find an FDA-approved generic match for this exact strength, form and route.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2023
First FDA approval
Aug 2023
📍
2026
Currently FDA-listed
3 years listed
🛡️
2034
Latest patent/protection listed
not a guaranteed launch date
🔒No FDA-approved generic found

We did not find an FDA-approved generic match for this exact strength, form and route. Patent/protection dates below may affect future generic timing.

🛡️ Latest patent/protection date listed: FDA patent/protection data lists protections through Sep 2034. This may affect when a full generic version becomes widely available, but it is not a guaranteed launch date.
📅 FDA approved Aug 14, 2023 RLD RS ⏳ ~7.9 yr to latest listed protection

Why the date isn’t exact: Generic timing can change because patents may be challenged, settled, licensed, added, removed, or worked around with a narrower label — and FDA approval does not always mean a pharmacy can get the generic today.

Patents & exclusivity — FDA Orange Book
US 11633528 — method of use (U-3675)
US 10569004 — method of use (U-3680)
US 10569004 — method of use (U-3683)
US 11833286 — drug product
US 10369264 — drug product
US 10098997 — drug product
US 11083831 — drug product
US 10195334 — drug product
US 11241522 — drug product
US 9314561 — drug product
US 9707331 — drug product
Exclusivity NP
Exclusivity ODE-438
2023 2025 2027 2029 2031 2033
Today
LOE
Substance patent Formulation patent Method-of-use patent Exclusivity Pediatric +6mo
🏛️FDA exclusivity
FDA-granted marketing protection. It’s separate from patents and may be shorter than patent protection.
🧪Product / substance patents
Patents covering the active ingredient, product, formulation, or related drug features.
🎯Method-of-use patents
Patents covering specific approved uses. These can sometimes be carved out with a “skinny label,” but not always.
🛈 What do these terms mean?
Patent
Legal protection listed in the Orange Book that may delay generic approval or launch. Issued by the U.S. Patent & Trademark Office.
Substance patent
Covers the active drug molecule itself — the hardest to design around. A generic generally can’t launch until it expires.
Formulation (product) patent
Covers a specific formulation or dosage form. A generic can sometimes work around it with a different formulation.
Method-of-use patent
A patent covering one specific approved use of the drug — not necessarily the whole molecule. A generic can sometimes launch with a “skinny label” that carves out the protected use and keeps the others.
Skinny label
A generic label that omits a still-patented use when the FDA allows it — letting a generic reach the market for the unprotected uses.
Exclusivity
FDA-granted marketing protection, separate from patents — e.g. 5-yr new chemical entity, 7-yr orphan drug, or a +6-month pediatric extension.
Paragraph IV
A generic applicant’s formal challenge to a listed patent. It can potentially lead to earlier generic entry, but often involves litigation or a settlement.
RLD / RS
Reference Listed Drug — the brand product the FDA uses as the reference for generic applications. Reference Standard — the product the FDA expects generics to compare against in bioequivalence testing.
TE / AB rating
FDA therapeutic-equivalence rating. An AB rating generally means the FDA considers a generic therapeutically equivalent to — and substitutable for — the brand.
LOE (loss of exclusivity)
The latest patent or exclusivity currently listed — the loss-of-exclusivity / latest-listed-protection date shown on this page. Paragraph-IV challenges and settlements can move the real date earlier; FDA approval and a manufacturer’s decision to market can move it later.

Built from the FDA Orange Book. The bars above are scaled to each protection’s expiry; the red LOE marker is the last one to lapse.

Listed patents (11)
PatentTypeUse codeExpires
US 11633528 ↗ Method of use U-3675 Nov 7, 2032
US 10569004 ↗ Method of use U-3680 Nov 7, 2032
US 10569004 ↗ Method of use U-3683 Nov 7, 2032
US 11833286 ↗ Drug product — Dec 30, 2032
US 10369264 ↗ Drug product — Nov 7, 2032
US 10098997 ↗ Drug product — Nov 7, 2032
US 11083831 ↗ Drug product — Dec 30, 2032
US 10195334 ↗ Drug product — Jan 16, 2033
US 11241522 ↗ Drug product — Nov 7, 2032
US 9314561 ↗ Drug product — Feb 7, 2034
US 9707331 ↗ Drug product — Sep 17, 2034
FDA exclusivity
CodeWhat it grantsExpires
NPNew ProductAug 14, 2026
ODE-438Orphan Drug Exclusivity (7-year)Aug 14, 2030
Common questions
Is there a generic version of HEPZATO 50 MG X5 KIT-62MM CATH?
No FDA-approved generic equivalent is currently listed in the FDA Orange Book for HEPZATO 50 MG X5 KIT-62MM CATH. Based on the patents and exclusivity currently listed, the Orange Book estimate is that full-label generic entry may be delayed until Sep 2034 — an estimate, not a guaranteed launch date.
The FDA approved a generic — why can’t I get it at my pharmacy yet?
FDA approval and pharmacy availability are two different things. The FDA can approve a generic years before it actually reaches pharmacies, because the brand company may still hold patents or have a settlement that delays the launch. A manufacturer also has to choose to make and sell it, and have supply ready. So a drug can be “FDA-approved generic exists” and still be brand-only at the counter today.
Why do different websites show different generic release dates?
Generic availability is not based on one single date. Some sources use the first exclusivity expiration, some use the last product patent, and others use the latest method-of-use patent. Patent challenges, settlements, licenses, and label carve-outs can also change the real-world launch date. This page shows the underlying Orange Book dates so you can see why estimates may differ.
What does “FDA listed” mean?
It means the product appears in the FDA’s official NDC directory. That’s a good sign a product exists and is intended for the U.S. market, but on its own it does not confirm a pharmacy can fill it today. Where we have recent retail pricing data (NADAC) for a product, we label it “Availability likely” instead.
What does a patent or protection date mean here?
It’s the latest date currently listed in the FDA Orange Book for a patent or exclusivity on the brand product. It can affect when a full generic version becomes widely available — but it is not a guaranteed generic launch date. Generics sometimes arrive earlier (through a settlement or patent challenge) or later (a manufacturer still has to make and sell one).
What does “current Orange Book estimate” mean?
It means we are using the latest patent and exclusivity dates currently listed in the FDA Orange Book. It is not a guaranteed launch date.
Can a generic come out before the last patent expires?
Sometimes. A generic company may challenge a patent, settle with the brand manufacturer, receive a license, or obtain approval with a narrower label that avoids a patented use. In other cases, the last listed protection may delay full-label generic competition.
Can a generic come out after the listed dates?
Yes. Even after patents or exclusivity expire, a generic still needs FDA approval and a manufacturer must choose to market it. Supply, litigation, business decisions, or regulatory issues can delay actual availability.
What is the difference between patents and exclusivity?
Patents are legal protections usually issued by the U.S. Patent and Trademark Office. FDA exclusivity is marketing protection granted by the FDA. They are separate, and either one can affect generic timing.
Why are there multiple patent dates?
One drug can have several patents covering different things: the active ingredient, a formulation, a manufacturing process, or a specific approved use. That is why a page may show several expiration dates instead of one simple generic date.
Built from FDA Orange Book patent and exclusivity data. Dates are refreshed from public FDA data when available; the marker is max(latest patent expiry, latest exclusivity expiry). Paragraph-IV settlements and first-filer 180-day exclusivity can shift the real date; a method-of-use patent may allow an earlier skinny-label generic for non-protected indications. Generic launch timing is an estimate, not a guarantee.
Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

🧪 Avoiding an ingredient? See Melphalan Injection inactive ingredients by manufacturer: every current product's list side by side, so you can ask your pharmacy for the version that does not list it.

A current SPL was checked, but it does not contain a structured or narrative inactive-ingredient list for this product. This does not mean the product has no inactive ingredients.
Where does this data come from?
Source: official FDA Structured Product Labeling (SPL) via DailyMed and the openFDA label index. Structured IACT rows and label-wide narrative are kept separate; availability and product-level specificity depend on the submitted label.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

Manufacturer & labeler

LabelerDelcath Systems, Inc.
Application holderDELCATH SYSTEMS INC
FDA applicationNDA201848 (NDA)
Labeler code75833
First marketedDec 2023
Product typeHuman Prescription Drug
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Very long sections are excerpted here and marked; the full text is on DailyMed (linked in the sources below). Jump with a chip, search within the label, or expand everything.
🚨 Boxed Warning 211 words ▾

WARNING: PERI-PROCEDURAL COMPLICATIONS, MYELOSUPPRESSION Severe peri-procedural complications including hemorrhage, hepatocellular injury, and thromboembolic events may occur via hepatic intra-arterial administration of HEPZATO. Assess patients for these adverse reactions during and for at least 72 hours following administration of HEPZATO [see Warnings and Precautions ( 5.1 )]. HEPZATO is available only through a restricted program under a Risk Evaluation and Mitigation Strategy called the HEPZATO KIT REMS [see Warnings and Precautions ( 5.2 )].

Myelosuppression with resulting severe infection, bleeding, or symptomatic anemia may occur with HEPZATO. Monitor hematologic laboratory parameters and delay additional cycles of HEPZATO therapy until blood counts have improved. [see Warnings and Precautions ( 5.1 )] WARNING: SEVERE PERI-PROCEDURAL COMPLICATIONS, MYELOSUPPRESSION See full prescribing information for complete boxed warning. Severe peri-procedural complications including hemorrhage, hepatocellular injury, and thromboembolic events may occur with intra-hepatic administration of HEPZATO.

Assess patients for these adverse reactions during and for 72 hours following administration of HEPZATO. ( 5.1 ) HEPZATO is available only through a restricted program under a Risk Evaluation and Mitigation Strategy called the HEPZATO KIT REMS. ( 5.2 ) Myelosuppression with resulting severe infection, bleeding, or symptomatic anemia may occur with HEPZATO.

Monitor hematologic laboratory parameters and delay additional cycles of HEPZATO therapy until blood counts have improved.( 5.3 )

🎯 Indications and Usage 114 words ▾

1 INDICATIONS AND USAGE HEPZATO for injection, as a component of the HEPZATO KIT, is indicated as a liver-directed treatment for adult patients with uveal melanoma with unresectable hepatic metastases affecting less than 50% of the liver and no extrahepatic disease or extrahepatic disease limited to the bone, lymph nodes, subcutaneous tissues, or lung that is amenable to resection or radiation. HEPZATO is an alkylating drug indicated as a liver-directed treatment for adult patients with uveal melanoma with unresectable hepatic metastases affecting less than 50% of the liver and no extrahepatic disease, or extrahepatic disease limited to the bone, lymph nodes, subcutaneous tissues, or lung that is amenable to resection or radiation.( 1 )

⏱️ Dosage and Administration ~3 min read ▾

2 DOSAGE AND ADMINISTRATION HEPZATO, a component of the HEPZATO KIT, is administered by intra-arterial infusion into the hepatic artery (see instructions for use [IFU]). The recommended dose is 3 mg/kg based on ideal body weight (see Table 1 ), with a maximum absolute dose of 220 mg during a single HEPZATO treatment. ( 2.2 ).

The drug is infused over 30 minutes followed by a 30-minute washout period (see IFU). Treatments should be administered every six (6) to eight (8) weeks but can be delayed until recovery from toxicities and as per clinical judgement. ( 2.3 )

2.1Important Pre-Treatment and Administration Information HEPZATO is a component of the HEPZATO KIT Hepatic Delivery System [HDS]. Refer to the HEPZATO KIT Hepatic Delivery System Instructions for Use (IFU) for additional instructions including pre-infusion evaluation, hydration, premedication, anticoagulation, and supportive care. Caution: The double balloon catheter component of the HDS contains natural rubber latex which may cause allergic reactions [see Contraindications ( 4 ) ].

Healthcare providers must complete the required HEPZATO KIT REMS training prior to administration of the HEPZATO KIT [see Warnings and Precautions ( 5.2 )]. Discontinue oral anticoagulation and drugs affecting platelet function prior to the procedure [see Warnings and Precautions ( 5.1 )]. Discontinue ACE-inhibitors, calcium channel blockers, or alpha-1-adrenergic blockers prior to the procedure [see Warnings and Precautions ( 5.1 )].

Conduct baseline hematologic testing. Administer intra-hepatic HEPZATO with the HEPZATO KIT only to patients with the following [see Warnings and Precautions ( 5.3 )]. Hemoglobin ≥ 10 g/dL Platelets ≥ 100,000/microliter Neutrophils > 2000/microliter

2.2Recommended Dosage Administer HEPZATO via the HEPZATO KIT Hepatic Delivery System only to patients weighing 35 kg or greater due to potential size limitations with respect to percutaneous catheterization. HEPZATO, a component of the HEPZATO KIT, is administered by infusion into the hepatic artery (see IFU) every 6 to 8 weeks for up to 6 total infusions. The recommended HEPZATO dose is 3 mg/kg based on ideal body weight (IBW), as calculated per Table 1 below, with a maximum of 220 mg during a single treatment.

Table 1: Calculation of IBW for HEPZATO Dosing Height Ideal Body Weight Men ≥ 152 cm 52 kg + (0.75 kg/cm of height greater than 152 cm) < 152 cm 52 kg – (0.75 kg/cm of height less than 152 cm) Women ≥ 152 cm 49 kg + (0.67 kg/cm of height greater than 152 cm) < 152 cm 49 kg – (0.67 kg/cm of height less than 152 cm)

2.3Dosage Modifications for Adverse Reactions A dosage reduction to 2 mg/kg is recommended for subsequent treatments for the following reasons: Grade 4 neutropenia of > 5 days duration despite growth factor support or associated with neutropenic fever; Grade 4 thrombocytopenia of > 5 days duration or associated with a hemorrhage that required a transfusion; HEPZATO administered with the HEPZATO KIT should be discontinued if patients have life threatening or HEPZATO-related persistent toxicity that has not resolved to Grade 2 or less by 8 weeks following treatment.

2.4Preparation and Administration Refer to the HEPZATO KIT Hepatic Delivery System IFU for further details and instructions. Reconstitute and dilute melphalan immediately prior to beginning intra-arterial infusion. Reconstituted and diluted solutions of HEPZATO are unstable.

No more than 60 minutes should elapse from reconstitution and completion of the intra-hepatic infusion of the diluted HEPZATO solution. A citrate derivative of melphalan has been detected in reconstituted HEPZATO in 30 minutes, and nearly 1% of labeled strength of melphalan hydrolyzes every 10 minutes when reconstituted HEPZATO is further diluted in 0.9% Sodium Chloride. A precipitate forms if the reconstituted solution is stored at 5°C.

Do not refrigerate HEPZATO once reconstituted. HEPZATO is a hazardous drug 1 . Follow applicable special handling and disposa… [Excerpted — this section continues on DailyMed.]

💊 Dosage Forms and Strengths 72 words ▾

3 DOSAGE FORMS AND STRENGTHS HEPZATO (melphalan) is supplied in the HEPZATO KIT that contains the following: Melphalan for injection: 5 single dose, clear glass vials for injection, containing 50 mg white to pale yellow lyophilized powder, intended for reconstitution with the supplied diluents For injection: HEPZATO includes 50 mg freeze-dried (lyophilized) melphalan powder per vial in five (5) single dose vials, intended for reconstitution with the supplied diluents. ( 3 )

⛔ Contraindications ~1 min read ▾

4 CONTRAINDICATIONS HEPZATO and the HEPZATO KIT are contraindicated in patients with: Active intracranial metastases or brain lesions with a propensity to bleed Liver failure, portal hypertension, or known varices at risk for bleeding Surgery or medical treatment of the liver in the previous 4 weeks Uncorrectable coagulopathy Inability to safely undergo general anesthesia, including active cardiac conditions including, but not limited to, unstable coronary syndromes (unstable or severe angina or myocardial infarction), worsening or new-onset congestive heart failure, significant arrhythmias, or severe valvular disease History of allergies or known hypersensitivity to melphalan History of allergies or known hypersensitivity to a component or material utilized within the HEPZATO KIT including History of allergy to natural rubber latex History of allergy or hypersensitivity to heparin or presence of heparin-induced thrombocytopenia (HIT) History of severe allergic reaction to iodinated contrast not controlled by premedication with antihistamines and steroids Active intracranial metastases or brain lesions with a propensity to bleed Liver failure, portal hypertension, or known varices at risk for bleeding Surgery or medical treatment of the liver in the previous 4 weeks Active cardiac conditions including, but not limited to, unstable coronary syndromes (unstable or severe angina or myocardial infarction), worsening or new-onset congestive heart failure, significant arrhythmias, or severe valvular disease History of allergies or known hypersensitivity to melphalan or a component or material utilized within the HEPZATO KIT including natural rubber latex, heparin, and severe hypersensitivity to iodinated contrast not controlled by antihistamines and steroids ( 4 )

⚠️ Warnings and Cautions ~2 min read ▾

5 WARNINGS AND PRECAUTIONS Hypersensitivity reactions, including anaphylaxis, have occurred in patients who received an intravenous (IV) formulation of melphalan. Immediately terminate hepatic arterial melphalan infusion for hypersensitivity reactions and administer supportive care. ( 5.4 ) Gastrointestinal disturbances such as nausea and vomiting, abdominal pain and diarrhea are common.

( 5.5 ) Carcinogenic/Mutagenic effects: Secondary malignancies, including acute nonlymphocytic leukemia, myeloproliferative syndrome, and carcinoma, have been reported in patients with cancer treated with alkylating drugs (including melphalan). Melphalan has been shown to cause chromatid or chromosome damage in humans. ( 5.6 ) Embryo-fetal toxicity: Can cause fetal harm.

Advise females of reproductive potential and males with female partners of reproductive potential of the potential risk to a fetus and to use effective contraception. ( 5.7 , 8.1 , 8.3 ) Infertility: Melphalan-based chemotherapy regimens have been reported to cause suppression of ovarian function in premenopausal women and testicular suppression in men. ( 5.8 )

5.1Peri-Procedural Complications Hemorrhage, hepatocellular injury, and thromboembolic events have been observed when HEPZATO has been administered via hepatic intra-arterial administration. Administration of HEPZATO requires general anesthesia and extracorporeal bypass of circulation which may cause life threatening or fatal adverse effects. Ensure the patient is euvolemic but do not overhydrate the patient.

Monitor for these peri-procedural complications during the procedure and for at least 72 hours following the procedure. To mitigate the risk of thromboembolic events, administer anticoagulation as described in the IFU during the procedure. Due to the risk of bleeding, do not use in patients with uncorrectable coagulopathies and delay treatment with the HEPZATO KIT for at least 4 weeks after surgery or other medical procedure involving the liver.

Platelets and clotting factors may be removed during the HEPZATO KIT procedure. Monitor platelets and coagulation parameters as described in the IFU. If life-threatening bleeding occurs during the procedure, reverse anticoagulation as described in the IFU and correct coagulopathy as appropriate.

Discontinue anticoagulation with warfarin or other oral anticoagulants prior to the procedure; resume when hemostasis has been restored after the procedure, provided no bleeding complications have been observed. Refer to the Prescribing Information of the anticoagulant agent for bridging recommendations for anti-coagulation prior to surgical procedures. Discontinue drugs affecting platelet function such as aspirin, non-steroidal anti-inflammatory drugs, or other anti-platelet drugs one week before the procedure.

Patients with abnormal hepatic vascular (especially arterial supply) or biliary (especially re-implantation of bile duct) anatomy or gastric acid hypersecretion syndromes may be at increased risk of peri-procedural complications or other severe adverse reactions. Screen patients for a history of prior surgeries involving the bile duct to assess whether the patient is an appropriate candidate for HEPZATO KIT and monitor patients for adverse reactions following HEPZATO KIT administration. Procedure-related reductions in blood pressure including severe hypotension can occur during the HEPZATO KIT procedure.

Closely monitor blood pressure during the procedure. Patients may require fluid support and vasopressors. To reduce the risk of severe hypotension, assess hypothalamic-pituitary-adrenal axis function, and temporarily discontinue ACE-inhibitors, calcium channel blockers, or alpha-1-adrenergic blockers for at least 5 half-lives prior to treatment with the HEPZATO-KIT.

If necessary, use other short-acting antihypertensive drugs to manage blood pressure during the peri-procedure period.

5.2HEPZATO KIT REMS PROGRAM The HEPZATO KIT is only available through a restricted program… [Excerpted — this section continues on DailyMed.]

🤒 Adverse Reactions ~3 min read ▾

6 ADVERSE REACTIONS Below are adverse reactions associated with HEPZATO KIT. Additional adverse reactions related to the procedure and/or medical device are described in further detail in the HEPZATO KIT IFU. The following clinically significant adverse reactions are described elsewhere in the labeling: Peri-procedural complications [see Warnings and Precautions ( 5.1 )] Myelosuppression [see Warnings and Precautions ( 5.3 )] Hypersensitivity Reactions [see Warnings and Precautions ( 5.4 )] Gastrointestinal Adverse Reactions [see Warnings and Precautions ( 5.5 )] Secondary Malignancies [see Warnings and Precautions ( 5.6 )] Most common (≥20%) adverse reactions or laboratory abnormalities are thrombocytopenia, fatigue, anemia, nausea, musculoskeletal pain, leukopenia, abdominal pain, neutropenia, vomiting, increased alanine aminotransferase, prolonged activated partial thromboplastin time, increased aspartate aminotransferase, increased alkaline phosphatase, and dyspnea.

To report SUSPECTED ADVERSE REACTIONS, contact Delcath at 1-833-632-0458 and www.Delcath.com or FDA at 1-800-FDA-1088 or http://www.fda.gov/medwatch.

6.1Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug-device combination cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse drug reactions (ADRs) described in this section were identified from the FOCUS trial. FOCUS was a multicenter trial that evaluated HEPZATO (melphalan) administered via the HEPZATO KIT in patients with unresectable hepatic metastases from uveal melanoma.

In the FOCUS trial, a total of 95 patients were enrolled into the HEPZATO KIT arm, of which 91 patients received treatment with HEPZATO. Serious adverse reactions occurred in 45% of patients who received HEPZATO. Serious adverse reactions occurring in ≥ 2% of patients were thrombocytopenia (10%), neutropenia (8%), febrile neutropenia (7%), platelet count decreased (6%), leukopenia (4.2%), cardiac arrest (3.2%), neutrophil count decreased (2.1%), hypoxia (2.1%), pleural effusion (2.1%), pulmonary edema (2.1%), and deep vein thrombosis (2.1%).

Fatal adverse reactions occurred in 3 (3.2%) patients who were treated with HEPZATO; these included cardiac arrest, acute hepatic failure and bacterial peritonitis. HEPZATO was permanently discontinued due to adverse reactions in 18% of patients with neutropenia being the most common adverse reaction (3.2%) requiring permanent discontinuation. Dose reductions due to an adverse reaction occurred in 14% of patients who received HEPZATO.

Adverse reactions which required dose reductions occurring in ≥ 2% of patients were platelet count decreased (6%), neutropenia (4.2%), anemia (2.1%), and thrombocytopenia (2.1%). Adverse reactions that required dosage interruption in ≥ 2% of patients who received HEPZATO were platelet count decreased (6%), neutropenia (5%), thrombocytopenia (3.2%), anemia (3.2%) and febrile neutropenia (2.1%). The most common (≥20%) adverse reactions or laboratory abnormalities reported in patients treated with HEPZATO were thrombocytopenia (65%), fatigue (65%), anemia (63%), nausea (57%), musculoskeletal pain (46%), leukopenia (46%), abdominal pain (39%), neutropenia (35%), vomiting (35%), increased alanine aminotransferase (32%), prolonged activated partial thromboplastin time (28%), increased aspartate aminotransferase (28%), increased blood alkaline phosphatase (27%), and dyspnea (23%).

Table 2 and Table 3 summarize adverse reactions and laboratory abnormalities, respectively, that occurred in FOCUS. Table 2 All Adverse Reactions Observed at a Frequency of >10% in Patients Treated with HEPZATO 1 Represents a composite of multiple, related preferred terms All Adverse Reactions N=95 All Grades (%) Grades 3 or 4 (%) Gastrointestinal disorders Nausea 57 0 Abdominal Pain 1 39 1 Vomiting 1 35 0 D… [Excerpted — this section continues on DailyMed.]

👥 Use in Specific Populations ~2 min read ▾

8 USE IN SPECIFIC POPULATIONS HEPZATO should not be used in patients < 35 kg. ( 2.2 ) Lactation: Advise not to breastfeed ( 8.2 )

8.1Pregnancy Risk Summary Based on animal studies and its mechanism of action, melphalan can cause fetal harm when administered to a pregnant woman, including teratogenicity and/or embryo-fetal lethality [see Clinical Pharmacology ( 12.1 ) ]. Melphalan is a genotoxic drug and can cause chromatid or chromosome damage in humans [see Nonclinical Toxicology ( 13.1 ) ]. In animal studies, melphalan was embryolethal and teratogenic in rats at doses below the recommended clinical doses [see Data ].

Advise a pregnant woman of the potential risk to a fetus. The background risk of major birth defects and miscarriage for the indicated populations are unknown. However, the background risk in the United States general population of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies.

Data Animal Data Adequate animal studies have not been conducted with IV melphalan. Melphalan was embryolethal and teratogenic in rats following oral administration of 6 to 18 mg/m 2 /day for ten (10) days (0.05 to 0.16 times the recommended clinical dose of 3 mg/kg or 111 mg/m 2 /day) and intraperitoneal administration of 18 mg/m 2 (0.16 times the highest recommended clinical dose). Malformations resulting from melphalan administration included alterations of the brain (underdevelopment, deformation, meningocele, and encephalocele) and eye (anophthalmia and microphthalmos), reduction of the mandible and tail, and hepatocele (exomphaly).

8.2Lactation Risk Summary It is not known whether melphalan is present in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing children from melphalan, breastfeeding is not recommended during treatment with melphalan and for one week after the last dose.

8.3Females and Males of Reproductive Potential Melphalan can cause fetal harm when administered to a pregnant woman. Verify the pregnancy status of females of reproductive potential prior to initiating HEPZATO [see Use in Specific Populations ( 8.1 )] . Contraception Females Advise females of reproductive potential to use effective contraception during treatment with HEPZATO and for 6 months after the last dose.

Males HEPZATO administration may damage spermatozoa and testicular tissue, resulting in possible genetic fetal abnormalities. Advise males with female partners of reproductive potential to use effective contraception during treatment with HEPZATO and for 3 months after the last dose [see Nonclinical Toxicology ( 13.1 ) ]. Infertility Females Melphalan causes suppression of ovarian function in premenopausal women, resulting in amenorrhea in a significant number of patients.

Males Reversible and irreversible testicular suppression has been reported in male patients after administration of melphalan.

8.4Pediatric Use The safety and effectiveness in pediatric patients have not been established.

8.5Geriatric Use Clinical studies of HEPZATO did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In the FOCUS trial, 30 of the 91 patients (33%) were 65 years and older.

🤰 Pregnancy ~1 min read ▾

8.1Pregnancy Risk Summary Based on animal studies and its mechanism of action, melphalan can cause fetal harm when administered to a pregnant woman, including teratogenicity and/or embryo-fetal lethality [see Clinical Pharmacology ( 12.1 ) ]. Melphalan is a genotoxic drug and can cause chromatid or chromosome damage in humans [see Nonclinical Toxicology ( 13.1 ) ]. In animal studies, melphalan was embryolethal and teratogenic in rats at doses below the recommended clinical doses [see Data ].

Advise a pregnant woman of the potential risk to a fetus. The background risk of major birth defects and miscarriage for the indicated populations are unknown. However, the background risk in the United States general population of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies.

Data Animal Data Adequate animal studies have not been conducted with IV melphalan. Melphalan was embryolethal and teratogenic in rats following oral administration of 6 to 18 mg/m 2 /day for ten (10) days (0.05 to 0.16 times the recommended clinical dose of 3 mg/kg or 111 mg/m 2 /day) and intraperitoneal administration of 18 mg/m 2 (0.16 times the highest recommended clinical dose). Malformations resulting from melphalan administration included alterations of the brain (underdevelopment, deformation, meningocele, and encephalocele) and eye (anophthalmia and microphthalmos), reduction of the mandible and tail, and hepatocele (exomphaly).

🧒 Pediatric Use 14 words ▾

8.4Pediatric Use The safety and effectiveness in pediatric patients have not been established.

🧓 Geriatric Use 42 words ▾

8.5Geriatric Use Clinical studies of HEPZATO did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In the FOCUS trial, 30 of the 91 patients (33%) were 65 years and older.

🧬 Clinical Pharmacology ~1 min read ▾

12 CLINICAL PHARMACOLOGY

12.1Mechanism of Action Melphalan is an alkylating drug of the bischloroethylamine type. As a result, its cytotoxicity appears to be related to the extent of its interstrand cross-linking with DNA, probably by binding at the N7 position of guanine. It is active against both resting and rapidly dividing tumor cells.

12.2Pharmacodynamics Exposure-Response Melphalan exposure-response relationships and the time course of pharmacodynamic response following administration of HEPZATO via the Hepatic Delivery System are not fully characterized.

12.3Pharmacokinetics Geometric mean of systemic melphalan maximum concentration (C max ) is 2.4 (%CV 3.0) mcg/mL and the AUC 0-last was 1.8 (%CV 1.1) mcg*hr/mL. The melphalan median (range) time to C max (T max ) is 0.57 (0.05 – 1.18) hours following administration of HEPZATO. Distribution The melphalan plasma protein binding is approximately 78% following administration of HEPZATO.

Serum albumin accounts for approximately 40% to 60% and α 1 -acid glycoprotein approximately 20% of the plasma protein binding. Elimination The median terminal elimination phase half-life of 1.07 hours that is consistent with IV melphalan administration. Metabolism: Melphalan is primarily metabolized by hydrolysis to inactive metabolites.

Excretion: Liver uptake and removal of melphalan by isolation of hepatic venous blood and subsequent filtration by HDS are the two main processes for reducing the amount of melphalan that is available systemically following administration of HEPZATO. HDS reduced systemic melphalan exposure with a mean (SD) filter efficiency of 82.7% (14.4%) for the total filtration period. Systemic melphalan is eliminated by renal excretion of parent drug and metabolites.

Specific Populations No clinically significant differences in the pharmacokinetics of melphalan were observed based on body weight (43 - 150 kg), creatinine clearance (> 50 mL/min), or hepatic parameters (ALT (7 - 157 IU/L), AST (11 - 90 IU/L), or bilirubin (0.06 - 1.5 mg/dL) following administration of HEPZATO KIT.

🧬 Mechanism of Action 51 words ▾

12.1Mechanism of Action Melphalan is an alkylating drug of the bischloroethylamine type. As a result, its cytotoxicity appears to be related to the extent of its interstrand cross-linking with DNA, probably by binding at the N7 position of guanine. It is active against both resting and rapidly dividing tumor cells.

📦 How Supplied / Storage and Handling ~1 min read ▾

16 HOW SUPPLIED/STORAGE AND HANDLING How Supplied The HEPZATO KIT includes the HEPZATO 5 x 5 Drug Pack and the Hepatic Delivery System (HDS). Each 5 x 5 HEPZATO KIT Drug Pack includes HEPZATO (melphalan) and diluents for reconstitution and dilution: Each vial of HEPZATO contains 50 mg melphalan for injection supplied as a sterile, nonpyrogenic, freeze-dried cake/powder in a carton containing 5 single-dose, glass vials (NDC 75833-800-01). Each vial of sterile diluent contains sodium citrate 0.2 g, propylene glycol 6.0 mL, ethanol (96%) 0.52 mL, and water for injection to a total of 10 mL in a carton containing 5 single-dose, glass vials for reconstitution (NDC 75833-700-01).

Each of two 250 mL plastic containers of 0.9% sodium chloride injection USP (NDC 0264-7800-20). HEPZATO (melphalan) for injection must only be administered with the HDS device supplied with the HEPZATO KIT and components specified by Delcath Systems, Inc, in the IFU [see Dosage and Administration ( 3 )]. Storage and Handling HEPZATO for injection and its associated diluents including 0.9% sodium chloride must be stored at controlled room temperature 20°C to 25°C (68°F to 77°F).

Temperature excursions are permitted between 15°C- 30°C (59°F-86°F) [see USP Controlled Room Temperature]. The Hepatic Delivery System components may be stored at room temperature. Melphalan is a hazardous drug.

Follow applicable special handling and disposal procedures. 1 HEPZATO is light sensitive. Retain in original carton until use.

HEPZATO (melphalan) for injection Manufactured for: Delcath Systems, Inc. Queensbury, NY 12804 by Mylan Institutional LLC Made in Italy HEPZATO KIT (melphalan for Injection/Hepatic Delivery System) Packaged and Distributed by: Delcath Systems, Inc. Queensbury, NY 12804

📦 Storage and Handling 110 words ▾

Storage and Handling HEPZATO for injection and its associated diluents including 0.9% sodium chloride must be stored at controlled room temperature 20°C to 25°C (68°F to 77°F). Temperature excursions are permitted between 15°C- 30°C (59°F-86°F) [see USP Controlled Room Temperature]. The Hepatic Delivery System components may be stored at room temperature.

Melphalan is a hazardous drug. Follow applicable special handling and disposal procedures. 1 HEPZATO is light sensitive.

Retain in original carton until use. HEPZATO (melphalan) for injection Manufactured for: Delcath Systems, Inc. Queensbury, NY 12804 by Mylan Institutional LLC Made in Italy HEPZATO KIT (melphalan for Injection/Hepatic Delivery System) Packaged and Distributed by: Delcath Systems, Inc.

Queensbury, NY 12804

📋 Description 151 words ▾

11 DESCRIPTION Melphalan, is a bifunctional alkylating drug that is active against selected human neoplastic diseases. Melphalan is available as melphalan hydrochloride salt. The chemical name of melphalan hydrochloride is 4-[bis(2-chloroethyl)amino]-L-phenylalanine hydrochloride.

The molecular formula is C 13 H 18 Cl 2 N 2 O 2 .HCl and the molecular weight is 341.67. Melphalan is practically insoluble in water and has a pKa1 of ~2.5. HEPZATO, for injection, is supplied as a sterile, nonpyrogenic, freeze-dried white to pale yellow freeze-dried cake/ powder.

Each single dose vial contains melphalan 50 mg, equivalent to 56 mg of melphalan hydrochloride and 20 mg povidone. HEPZATO (melphalan) is reconstituted using the sterile diluent provided. Each vial of sterile diluent contains sodium citrate 0.2 g, propylene glycol 6.0 mL, ethanol (96%) 0.52 mL, and water for injection to a total of 10 mL.

HEPZATO (melphalan) for use with the hepatic delivery system is administered intra-arterially. Figure

💬 Information for Patients ~2 min read ▾

17 Patient Counseling Information Advise patients or their caregivers of the following risks of the HEPZATO KIT: Peri-Procedural Complications Advise patients of the severe procedural risks associated with administration of melphalan using the HEPZATO KIT including hemorrhage, hepatic injury, and thromboembolic events. Advise patients that they will be monitored in a hospital setting following each treatment. Advise patients taking anti-coagulant and anti-hypertensive medications that these may need to be discontinued prior to treatment with HEPZATO KIT [see Warnings and Precautions ( 5.1 )].

Myelosuppression Advise patients to immediately contact their healthcare provider for a fever, bruising, or bleeding. Advise patients of the need for monitoring of blood counts [see Warnings and Precautions ( 5.3 )]. Hypersensitivity Inform patients of the signs and symptoms of hypersensitivity.

Advise patients to immediately report symptoms of hypersensitivity [see Warnings and Precautions ( 5.4 )]. Latex Allergy The double balloon catheter component of the HEPZATO KIT Hepatic Delivery System contains natural rubber latex which may cause allergic reactions in latex-sensitive individuals [see Contraindications ( 4 )]. Gastrointestinal Advise patients to report symptoms of nausea, vomiting and diarrhea, so that appropriate antiemetic and/or antidiarrheal medications can be administered [see Warnings and Precautions ( 5.5 )].

Secondary Malignancies Advise patients that treatment with HEPZATO has the potential long-term risk of secondary malignancy [see Warnings and Precautions ( 5.6 )]. Embryo-Fetal Toxicity Advise pregnant women of the potential risk to a fetus [see Warnings and Precautions ( 5.7 ) and Use in Specific Populations ( 8.1 )]. Advise females of reproductive potential to use effective contraception during treatment with HEPZATO and for 6 months after the last dose.

Advise females to contact their healthcare provider if they become pregnant, or if pregnancy is suspected, while taking HEPZATO [see Warnings and Precautions ( 5.7 ) and Use in Specific Populations ( 8.1 , 8.3 )]. Advise males with female partners of reproductive potential to use effective contraception during treatment with HEPZATO and for 3 months after the last dose [see Use in Specific Populations ( 8.3 )]. Lactation Advise women not to breastfeed during treatment with HEPZATO and for one week after the last dose [see Warnings and Precautions ( 5.7 ) and Use in Specific Populations ( 8.2 )] Infertility Inform both females and males of reproductive potential about the risk of infertility [see Warnings and Precautions ( 5.8 ) and Use in Specific Populations ( 8.3 )].

HEPZATO (melphalan) for Injection Manufactured for: Delcath Systems, Inc. Queensbury, NY 12804 by Mylan Institutional LLC Made in Italy HEPZATO KIT (melphalan for Injection/Hepatic Delivery System) Packaged and Distributed by: Delcath Systems, Inc. Queensbury, NY 12804 © Copyright, 2023 Delcath Systems, Inc.

All rights reserved. 120070.A

🧬 Pharmacokinetics ~1 min read ▾

12.3Pharmacokinetics Geometric mean of systemic melphalan maximum concentration (C max ) is 2.4 (%CV 3.0) mcg/mL and the AUC 0-last was 1.8 (%CV 1.1) mcg*hr/mL. The melphalan median (range) time to C max (T max ) is 0.57 (0.05 – 1.18) hours following administration of HEPZATO. Distribution The melphalan plasma protein binding is approximately 78% following administration of HEPZATO.

Serum albumin accounts for approximately 40% to 60% and α 1 -acid glycoprotein approximately 20% of the plasma protein binding. Elimination The median terminal elimination phase half-life of 1.07 hours that is consistent with IV melphalan administration. Metabolism: Melphalan is primarily metabolized by hydrolysis to inactive metabolites.

Excretion: Liver uptake and removal of melphalan by isolation of hepatic venous blood and subsequent filtration by HDS are the two main processes for reducing the amount of melphalan that is available systemically following administration of HEPZATO. HDS reduced systemic melphalan exposure with a mean (SD) filter efficiency of 82.7% (14.4%) for the total filtration period. Systemic melphalan is eliminated by renal excretion of parent drug and metabolites.

Specific Populations No clinically significant differences in the pharmacokinetics of melphalan were observed based on body weight (43 - 150 kg), creatinine clearance (> 50 mL/min), or hepatic parameters (ALT (7 - 157 IU/L), AST (11 - 90 IU/L), or bilirubin (0.06 - 1.5 mg/dL) following administration of HEPZATO KIT.

🧬 Pharmacodynamics 26 words ▾

12.2Pharmacodynamics Exposure-Response Melphalan exposure-response relationships and the time course of pharmacodynamic response following administration of HEPZATO via the Hepatic Delivery System are not fully characterized.

🔬 Clinical Studies ~2 min read ▾

14 CLINICAL STUDIES Study in Patients with Uveal Melanoma The efficacy of HEPZATO in hepatic-dominant metastatic uveal melanoma was based on the results from 91 patients who received HEPZATO via the HEPZATO KIT in the FOCUS Study (NCT02678572), a multicenter, open-label trial. To be eligible for enrollment, patients were required to have metastatic uveal melanoma with metastases predominately involving the liver (liver dominant). Limited extrahepatic disease in the bone, subcutaneous sites, lymph nodes, or lung was permitted if the life-threatening component of the uveal melanoma was in the liver and the extrahepatic disease was amenable to resection or radiation and had a defined treatment plan.

Patients with metastases in more ≥ 50% of the liver parenchyma, unable to undergo general anesthesia, ECOG ≥2, platelets < 100,000/microliter, absolute neutrophil count < 1,500/microliter, hemoglobin < 10 gm/dL, Child-Pugh Class B or C cirrhosis, or hepatitis B or C infection were excluded. Patients received 3 mg/kg of melphalan based on ideal body weight (IBW, maximum total dose of 220 mg) administered intraarterially using the Hepatic Delivery System (HDS) every 6-8 weeks for up to 6 infusions. The median number of infusions administered per patient was 4 (range: 1-6).

Thirty-seven percent (37%) of the 91 patients treated received the maximum of six infusions of treatment. The major efficacy outcome measures were objective response rate (ORR) and duration of response (DoR) using computed tomography (CT) or magnetic resonance imaging (MRI) assessed by an independent central review committee (IRC) using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. The median age of patients was 61 years (range 20 to 78), 52% were female, 95% were White, 5% unavailable, and all patients had Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

Ninety-five percent (95%) of enrolled patients had either 2 or 3 hepatic lesions. Seventy-nine percent (79%) of patients had <25% liver involvement. Thirty percent of the treated patients had extra-hepatic lesions, of which 20% had 1 extrahepatic lesion and 10% had 2 or more; overall 12% of patients had lung, 11% soft tissue/subcutaneous, 5% lymph node, and 4% had bone involvement.

Forty-three percent (43%) of patients underwent prior therapy for metastatic disease, including systemic therapy (25%), other surgeries or procedures (14%), and radiation (11%). The efficacy results of HEPZATO treatment are summarized in Table 4 . Table 4 Efficacy Results for Patients in FOCUS Trial 1 Clopper-Pearson method 2 Kaplan Meier method 3 Brookmeyer and Crowley method 4 Based on observed duration of response HEPZATO (N=91) Objective Response Rate ORR (95% CI) 1 36.3% (26.4, 47.0) Complete Response 7.7% Partial Response 28.6% Duration of response (months) Number of Responders n= 33 Median 2 (months) (95% CI) 3 14.0 (8.3, 17.7) % Responder with DoR≥6 months 4 70 % % Responder with DoR≥12 months 4 30 %

🧪 Nonclinical Toxicology 88 words ▾

13 NONCLINICAL TOXICOLOGY

13.1Carcinogenesis, Mutagenesis, Impairment of Fertility Adequate and well-controlled carcinogenicity studies have not been conducted in animals. However, intraperitoneal (IP) administration of melphalan in rats (5.4 to 10.8 mg/m 2 ) and in mice (2.25 to 4.5 mg/m 2 ) 3 times per week for 6 months followed by 12 months post-dose observation produced peritoneal sarcoma and lung tumors, respectively. Intramuscular administration of melphalan at 6 and 60 mg/m 2 produced structural aberrations of the chromatid and chromosomes in bone marrow cells of Wistar rats.

📄 Carcinogenesis, Mutagenesis, Impairment of Fertility 85 words ▾

13.1Carcinogenesis, Mutagenesis, Impairment of Fertility Adequate and well-controlled carcinogenicity studies have not been conducted in animals. However, intraperitoneal (IP) administration of melphalan in rats (5.4 to 10.8 mg/m 2 ) and in mice (2.25 to 4.5 mg/m 2 ) 3 times per week for 6 months followed by 12 months post-dose observation produced peritoneal sarcoma and lung tumors, respectively. Intramuscular administration of melphalan at 6 and 60 mg/m 2 produced structural aberrations of the chromatid and chromosomes in bone marrow cells of Wistar rats.

📚 References 8 words ▾

15 REFERENCES 1 OSHA Hazardous Drugs. OSHA. http://www.osha.gov/hazardous-drugs

📖 Instructions for Use ~3 min read ▾

120076.D Effective Date: 05-JUN-2026 ASSEMBLED SYSTEM – FIGURE 1 SUPPLIED DISPOSABLE COMPONENTS – FIGURE 2 HEPZATO KIT™ HEPZATO (melphalan) for Injection/ Hepatic Delivery System COMPLETE REQUIRED REMS TRAINING BEFORE USING THIS DEVICE FOR THE FIRST TIME. ENSURE YOU COMPLETELY READ AND UNDERSTAND THE INSTRUCTIONS FOR USE. DESCRIPTION OF SYSTEM COMPONENTS HEPZATO KIT™ consists of a closed circuit of catheters and drug-specific filters utilized to deliver Hepzato (melphalan) to the hepatic artery and to lower the concentration of melphalan in the blood before it is returned to systemic circulation.

A schematic overview of how the Hepatic Delivery System components work together is presented in Figure 1: Assembled System. The system is designed to be used with the extracorporeal blood pumping systems: • Medtronic Bio-Console ® 560 Speed Controller System with TX50P Flow Transducer connected to Disposable DP-38P Bio-Probe Flow Probe (1/4” Tubing) or • AMPTD, Inc. Anivia SG1000 Pump Console with Pump Drive PDM-003, Flow Bubble Sensor Module FBS-002 (1/4” Tubing), and Utah Medical Deltran I Disposable Pressure Transducer DPT-100 (Utah Medical Model GP-DT-01).

WARNING Only the components provided in the HEPZATO KIT or specified by Delcath Systems, Inc. in the “not included” box below are to be used to create the circuit. There should be no substitutions. The circuit has not been validated for use with other components.

Do not disassemble the components provided in the Hepatic Delivery System as this may damage the components. 1. Double Balloon Catheter (DBC) -- 16F (shaft) polyurethane double balloon catheter that is placed in the retro-hepatic inferior vena cava to isolate the hepatic venous blood and transport it to the Extracorporeal Hemofiltration Circuit for filtration.

The catheter has one large (central) drainage lumen and four accessory ports. Due to variation in the length of a patient's retro-hepatic segment of the inferior vena cava and relative positions of hepatic and renal veins, the Double Balloon Catheter is available in two different balloon configurations: 50 mm or 62 mm between the two balloons. Accessory Ports: Cephalad – superior – blue port Caudal – inferior – yellow port Drainage lumen – large translucent port Contrast – translucent port Over-the-wire (OTW) – white port Using pre-operative computed tomography (CT) imaging, or by performing an inferior vena cavogram prior to placement of the Double Balloon Catheter, estimate the length of the retro-hepatic segment of the inferior vena cava and the relative positions of hepatic and renal veins in order to determine the optimum Double Balloon Catheter balloon spacing: 50mm or 62mm.

Two of the accessory ports are used to inflate low-pressure occlusion balloons, which are inflated independently to occlude the inferior vena cava above and below the hepatic veins. When inflated, the Cephalad (superior – blue port) balloon obstructs the inferior vena cava above the hepatic veins and the caudal (inferior – yellow port) balloon obstructs the inferior vena cava below the hepatic veins, thus isolating hepatic venous blood in the fenestrated segment between the balloons. The large drainage lumen with a quick connect fitting is a conduit to the fenestrations between the two occlusion-balloons.

The fenestrations allow the hepatic venous blood to flow into the drainage lumen and exit the catheter at the proximal end. The third accessory (translucent) port labeled “CONTRAST” is for injections of iodinated contrast medium through the fenestrations, to check catheter position. The fourth accessory port (white) is used for over-the-wire (OTW) introduction and positioning of the catheter in the retro-hepatic inferior vena cava.

This lumen also has a small port opening along the catheter shaft positioned inferior to the caudal balloon and exits at the distal tip, to allow inferior vena cava blood, proximal to the caudal balloon, to bypass the occluded segment of the inferior vena ca… [Excerpted — this section continues on DailyMed.]

📄 Package Label / Principal Display Panel ~3 min read ▾

Principal Display Panel - Kit Label NDC 75833-601-02 HEPZATO KIT ™ (melphalan) for Injection/ Hepatic Delivery System (HDS) REF 601002 EXP: YYYY-MM-DD LOT: XXXXXXX Contents: 1 - Hepatic Delivery System, 62 mm Double Balloon Catheter 1 - HEPZATO™ 5 x 50 mg/vial* (melphalan) for Injection and (2) 250 mL, 0.9% Sodium Chloride Injection USP (secondary diluent): WARNING: Hazardous Drug SINGLE-DOSE VIAL Rx Only *HEPZATO Carton contains 5 vials of HEPZATO and 5 vials of sterile diluent: *Each vial contains sterile, non-pyrogenic, freeze dried melphalan 50 mg, equivalent to 56 mg of melphalan hydrochloride and 20 mg povidone.

Each vial of sterile, nonpyrogenic diluent containing 0.2 g sodium citrate, 6.0 mL propylene glycol, 0.52 mL ethanol (96%), and Water for Injection to a total of 10 mL. Must be reconstituted with accompanying diluent and further diluted with accompanying 0.9% Sodium Chloride Injection USP. See enclosed prescribing information for additional reconstitution and administration instructions.

Recommended Dosage: see Prescribing Information For intra-arterial infusion only Store at controlled room temperature 20° to 25°C (68° – 77°F). Temperature excursions are permitted between 15° to 30°C (59° – 86°F) [see USP Controlled Room Temperature] Protect from light. Retain in carton.

Consult the HEPZATO KIT™ Instructions for Use prior to use. Caution: This Double Balloon Catheter Contains Natural Rubber Latex Which May Cause Allergic Reactions. Delcath ® Packaged and Distributed by: Delcath Systems, Inc.

Queensbury, NY 12804 Principal Display Panel - Kit Label

Principal Display Panel – 50 mg Vial Label NDC 75833-800-01 Rx Only SINGLE-DOSE VIAL HEPZATO ™ (melphalan) for Injection 50 mg/vial* WARNING: Hazardous Drug *Each vial contains sterile, non- pyrogenic, freeze dried melphalan 50 mg, equivalent to 56 mg melphalan hydrochloride and 20 mg povidone For intra-arterial infusion only with the Delcath Hepatic Delivery System 90004.B Principal Display Panel – 50 mg Vial Label

Principal Display Panel – 10 mL Diluent Vial Label NDC 75833-700-01 Rx Only SINGLE-DOSE VIAL STERILE DILUENT for HEPZATO ™ (melphalan) for Injection For Drug Diluent Use Only Each vial contains 0.2 g sodium citrate, 6.0 mL propylene glycol, 0.52 mL ethanol (96%), and Water for Injection Nonpyrogenic 90003.B Principal Display Panel – 10 mL Diluent Vial Label

Principal Display Panel - 0.9 g/250 mL Container Label 0.9% Sodium Chloride Injection USP REF L8002 NDC 0264-7800-20 DIN 01924303 HK 22617 250 mL EXCEL ® CONTAINER Each 100 mL contains: Sodium Chloride USP 0.9 g; Water for Injection USP qs pH adjusted with HCl NF pH: 5.6 (4.5–7.0); Calc. Osmolarity:310 mOsmol/liter Electrolytes (mEq/liter): Na + 154; Cl – 154 Sterile, nonpyrogenic. Single dose container.

Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact.

WARNINGS: Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques.

Mix thoroughly. Do not store. Recommended Storage: Room temperature (25°C).

Avoid excessive heat. Protect from freezing. See Package Insert.

Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired.

Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc.

B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 www.bbraun.com In Canada, distributed by: B.

Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-223 LD-136-4 EXP LOT Principal Display Panel - 0.9 g/250 mL Container Label

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
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This drug has a REMS — HEPZATO KIT REMS. A Risk Evaluation & Mitigation Strategy is an FDA-required safety program. It is available only through a restricted program (certified prescribers/pharmacies, enrollment, or required monitoring). See the boxed warning & full label below, and REMS@FDA ↗.

About this NDC listing & data coverage

Finished prescription product Kit / multi-component package

Kit / multi-component package

This NDC identifies a kit — a package containing more than one component. Structured data (pricing, ingredients, equivalents) is often reported per component rather than for the kit NDC itself, which can make this page look thinner than the components' own pages.

What data is (and isn’t) available for this NDC — tap to expand
NDC identity (package / product / labeler codes) ✓ Available
Labeler ✓ Available
Product & package description ✓ Available
Marketing category & status ✓ Available
Active ingredient / dosage form / route ✓ Available
FDA label (SPL via DailyMed) ✓ Available
Package photos ✓ Available
Inactive ingredients (structured) — Not published for this NDC The labeler did not submit a structured excipient list, or no SPL is available.
NADAC pharmacy acquisition price (CMS) — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey.
Orange Book / therapeutic-equivalence data ✓ Available
HCPCS J-code billing crosswalk — Not published for this NDC Most self-administered / retail products have no J-code — that is normal.
Medicaid utilization (CMS SDUD) — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold.
“Not published” reflects what the public FDA / CMS / NLM sources provide for this exact package code — it is a property of the data feeds, not a judgment about the product.

Questions about this listing

Why is there no price listed?
The pricing shown on our NDC pages comes from CMS NADAC, a voluntary survey of retail community pharmacy invoices. CMS does not publish a NADAC for every NDC — packages outside the retail survey (institutional and hospital products, bulk packages, discontinued items, and many OTC items) may never receive one. A missing price reflects the survey's scope, not this product's actual cost, and does not mean the product is free or unavailable.
Is the NDC printed on the package the same as the 11-digit billing NDC?
Yes, they identify this exact package in different formats. The form printed on the packaging and shown on DailyMed is the one the FDA registered. Insurance claims use a fixed 11-digit 5-4-2 format, so the short segment is padded with a leading zero and the dashes are dropped. The Identity section at the top of this page lists each form of this code.
Is this package still being marketed?
Yes, per the latest FDA NDC Directory data on this page: this package is listed as actively marketed, with no marketing end date reported by Delcath Systems, Inc.. Listing status can change — the directory data on this page refreshes weekly.
Does this product come in other package sizes?
Yes — the FDA directory lists 3 other package presentations of this same product, including 1 kit (75833-0601-01), 1 kit (75833-0601-02), 1 kit (75833-0601-07). Each has its own NDC and its own page — see the package list near the top of this page.
Who lists this product with the FDA?
Delcath Systems, Inc. is the labeler of record for this NDC — the company under whose FDA-assigned code the package is listed. The labeler may be the manufacturer itself or a distributor marketing the product under its own code.
Do I need a prescription for this product?
This NDC is listed with FDA as a prescription product, so it is dispensed under a prescriber's order. Your pharmacist can tell you whether any over-the-counter forms of the same medication exist.
This page identifies an FDA-listed package (the NDC) and reports public regulatory and pricing data about the listing. It is reference information, not a medical recommendation — talk to your pharmacist or prescriber about your own medication.
Where does this data come from?
Listing facts (marketing category, packager status, marketing dates) from the FDA openFDA NDC Directory; label availability from DailyMed; pricing coverage from CMS NADAC; equivalence scope from the FDA Orange Book.
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.