MELPHALAN

COMMON BRAND NAME(S): Alkeran

GENERIC NAME(S): MELPHALAN

 

Description: Melphalan, a mechlorethamine derivative, is an alkylating antineoplastic agent. It forms carbonium ions, resulting in DNA and RNA synthesis inhibition. It cross-links DNA strands and acts on both resting and rapidly dividing tumour cells.

Pharmacokinetics:

Absorption: Variable absorption from the GI tract; absorption reduced by food (oral).

Distribution: Rapid throughout body water. Protein-binding: 50-60%, mainly to albumin.

Metabolism: Inactivated by hydrolysis.

Excretion: Via urine (10%, as unchanged drug); 30-150 min (terminal half-life).

This medication is used to treat certain types of cancer (multiple myeloma, ovarian cancer). Melphalan belongs to a class of drugs known as alkylating agents. It works by slowing or stopping the growth of cancer cells.

How to use melphalan

Take this medication by mouth, usually once a day as directed by your doctor. Your doctor may direct you to take this medication on an empty stomach. Follow your doctor’s directions closely.

The dosage is based on your medical condition, response to treatment, and blood counts. The dosing of this medication is different for everyone. Your doctor may direct you to take it daily for several weeks, followed by several weeks of not taking the drug, and then direct you to take it daily again. Other patients may take it for only a few days, and then repeat the treatment every few weeks. Ask your doctor or pharmacist if you have any questions about this medication. It is very important that you understand exactly how to take this medication to get the most benefit and to lower your chance of serious side effects.

Unless your doctor instructs you otherwise, drink plenty of fluids while taking this medication. This helps your kidneys to remove the drug from your body and avoid some of the side effects.

Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased. Do not stop taking this medication without talking with your doctor, even if you feel nauseated or experience vomiting. If you vomit shortly after a dose, or if you miss a dose, contact your doctor immediately.

It may take several months before you see a benefit from this drug.

Since this drug can be absorbed through the skin and lungs, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the tablets. All people should wash their hands carefully after handling this drug.

Melphalan may cause serious blood disorders (decreased bone marrow function leading to low number of white blood cells/platelets and anemia). It can lower your body’s ability to fight an infection and increase your risk of bleeding. Higher doses and taking this medication more frequently increase the chance of these side effects. Your doctor will monitor you and perform blood tests, usually weekly at first. Your dose and any further treatment will be based on your blood tests. Keep all medical/lab appointments.

Tell your doctor immediately if you develop easy bleeding or bruising, unusual tiredness, or signs of an infection (e.g., persistent sore throat, fever).

Melphalan may increase your risk of certain cancers (e.g., leukemia, carcinoma). Your doctor will monitor you carefully.

Melphalan has caused birth defects in unborn babies. Women of child-bearing age must avoid becoming pregnant while taking this medication. (See also Precautions section.)

Nausea, vomiting, diarrhea, lip/mouth sores, and loss of appetite may occur. Nausea and vomiting can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If these effects persist or worsen, tell your doctor or pharmacist promptly.

Temporary hair loss may occur. Normal hair growth should return after treatment has ended.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Follow your doctor’s orders and keep all medical/lab appointments to lower your risk of serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: easy bruising/bleeding, bloody/black/tarry stools, lower back or side pain, decreased or missed menstrual periods, decreased sexual function, pinkish urine, painful/difficult urination, unusual weight loss, vomit that looks like coffee grounds.

This medication can lower the body’s ability to fight an infection. Tell your doctor promptly if you develop any signs of an infection such as fever, chills, or persistent sore throat.

Tell your doctor immediately if any of these rare but very serious side effects occur: painful/difficult breathing, chest pain, coughing up blood, persistent cough, unusual lumps/masses under the skin, pain/redness/swelling of the arms/legs, stomach/abdominal pain, yellowing eyes/skin, dark urine, unusual tiredness.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Before taking melphalan, tell your doctor or pharmacist if you are allergic to it; or to chlorambucil; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (e.g., bone marrow depression), previous cancer chemotherapy, kidney problems, radiation treatment.

Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.

To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Wash your hands well to prevent the spread of infection.

This drug should not be used during pregnancy. It may harm the unborn baby. If you become pregnant or think you may be pregnant, tell your doctor immediately. Talk with your doctor about effective forms of birth control.

It is not known whether this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

 

Interactions:

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medication because very serious interactions may occur: nalidixic acid.

If you are currently using the medication listed above, tell your doctor or pharmacist before starting melphalan.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: cimetidine, cyclosporine.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (e.g., complete blood count, liver function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

Contact your doctor or pharmacist immediately for advice if you miss a dose.

Storage

Store in the refrigerator between 36-46 degrees F (2-8 degrees C) away from light and moisture. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

 

Brands:

Available Brands:

Alkeran [ Aspen ]

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