Drug reference

Melphalan

Alkylating Agent · Antineoplastic

Alkylating AgentAntineoplastic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

and reproductive function in

FDA category + note

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Mechanism

Alkylating drugs act by damaging DNA, thus interfering with cell replication.

Indications

multiple myelomapolycythaemia verachildhood neuroblastomaadvanced ovarian adenocarcinomaadvanced breast cancerregional arterial perfusion in localised malignant melanoma of the extremitieshigh-dose chemotherapy with marrow transplantationAdvanced ovarian cancerMalignant melanoma (regional perfusion)

Dosing

Adult: ▶ BY INTRAVENOUS INFUSION Adult: 16 mg/kg once weekly for weeks 1 to 9, for week 1, dose can alternatively be divided over 2 consecutive days, then 16 mg/kg every 3 weeks for weeks 10 to 24, then 16 mg/kg every 4 weeks for week 25 onwards until disease progression, for dose interruption or infusion rate reduction due to infusion-related reactions or side-effects—consult product literature Newly di…

Pharmacokinetics

Onset

not specified

Peak effect

not specified

Bioavailability

inconsistent oral absorption; usually given intravenously

Protein binding

not specified

Contraindications

acute infection
severe bone-marrow suppression

Side effects

Common

bone-marrow suppressionreversible hair losshematological toxicitynausea (less frequent)vomiting (less frequent)alopecia (less than other alkylators)renal dysfunction (rarely)hepatic dysfunction (rarely)myelosuppression (leukopenia nadir 6-10 days, recovery 14-21 days)InfectionsDiarrhoeaPancreatitis

Serious