Melphalan

Ovarian Neoplasms, Rhabdomyosarcoma ... show more

Drug Status

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Government Approvals

US(FDA), UK(BNF)

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WHO Essential Medicine

YES

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Known Teratogen

Definite

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Pharmaceutical Class

Alkylating Drug

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Controlled Drug Substance

NO

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Drug Ingredient

Melphalan

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Summary

  • Melphalan is used to treat multiple myeloma, a type of cancer of the bone marrow, and certain types of ovarian cancer. It can also be used to treat advanced breast cancer and amyloidosis, a disease where abnormal proteins build up in tissues and organs.

  • Melphalan is a bifunctional alkylating agent. It works by forming crosslinks between DNA strands, which prevents cancer cells from replicating. This action stops or slows the growth of cancer cells, helping to control the spread of the disease.

  • For adults, the typical oral dosage for multiple myeloma is 0.15 mg/kg body weight/day in divided doses for 4 days, repeated at intervals of six weeks. For ovarian adenocarcinoma, a typical regimen is 0.2 mg/kg body weight/day orally for 5 days, repeated every 4-8 weeks. Always follow your doctor's instructions for dosage.

  • Common side effects of Melphalan include nausea, vomiting, diarrhea, and loss of appetite. It can also cause weight loss, excessive tiredness, and can interfere with the normal menstrual cycle in women. It may temporarily or permanently stop sperm production in men, potentially causing infertility.

  • Melphalan should not be used during pregnancy or breastfeeding, as it can harm the fetus or nursing infant. It should not be used with live vaccines or in combination with certain other medications due to risk of harmful interactions. It can cause a severe decrease in blood cells, increasing the risk of infection or bleeding, and may also increase the risk of developing other cancers. Patients should not take Melphalan if they are allergic to it or have had a poor response to it previously.

Indications and Purpose

What is Melphalan used for?

Melphalan is indicated for the treatment of multiple myeloma, a type of cancer of the bone marrow, and certain types of ovarian cancer. It is also sometimes used to treat advanced breast cancer and amyloidosis, a disease where abnormal proteins build up in tissues and organs.

How does Melphalan work?

Melphalan is a bifunctional alkylating agent that works by forming cross-links between DNA strands, preventing cancer cells from replicating. This action stops or slows the growth of cancer cells, helping to control the spread of the disease.

Is Melphalan effective?

Melphalan is an alkylating agent used to treat multiple myeloma and certain types of ovarian cancer. It works by stopping or slowing the growth of cancer cells. Clinical studies and medical literature support its effectiveness, particularly when used in combination with other drugs like prednisone. However, the response can vary based on individual patient factors and the specific cancer being treated.

How does one know if Melphalan is working?

The benefit of Melphalan is evaluated through regular laboratory tests ordered by your doctor. These tests monitor the effect of the drug on your blood cells and overall response to treatment. It's important to keep all appointments with your doctor and the laboratory to ensure the medication is working effectively and to adjust the dosage if necessary.

Directions for Use

What is the usual dose of Melphalan?

For adults, the typical oral dosage schedule for multiple myeloma is 0.15 mg/kg bodyweight/day in divided doses for 4 days, repeated at intervals of six weeks. For ovarian adenocarcinoma, a typical regimen is 0.2 mg/kg bodyweight/day orally for 5 days, repeated every 4-8 weeks. Melphalan is very rarely indicated in children, and specific dosage guidelines for pediatric use are not provided. Always follow your doctor's instructions for dosage.

How do I take Melphalan?

Melphalan should be taken on an empty stomach, usually once a day. It's important to take it at the same time every day and follow your doctor's instructions carefully. Unless advised otherwise by your doctor, you can continue your normal diet without specific food restrictions.

For how long do I take Melphalan?

The duration of Melphalan treatment depends on the type of cancer being treated, the patient's response to the medication, and any side effects experienced. For multiple myeloma, treatment is often repeated at intervals of six weeks, and prolonging treatment beyond one year in responders does not appear to improve results. Always follow your doctor's guidance on the duration of treatment.

How long does it take for Melphalan to start working?

From all available and reliable information, there is no confirmed data on this. Please consult a doctor for personalized advice.

How should I store Melphalan?

Melphalan should be stored in the container it came in, tightly closed, and out of reach of children. It should be kept in the refrigerator and away from light. Unneeded medications should be disposed of through a medicine take-back program to ensure safety.

Warnings and Precautions

Who should avoid taking Melphalan?

Melphalan can cause a severe decrease in blood cells, increasing the risk of infection or bleeding. It may also increase the risk of developing other cancers. Patients should not take Melphalan if they are allergic to it or have had a poor response to it previously. Women who are pregnant or breastfeeding should avoid it, and reliable birth control should be used to prevent pregnancy. Regular blood tests are essential to monitor its effects.

Can I take Melphalan with other prescription drugs?

Melphalan should not be used with live organism vaccines due to the risk of infection in immunocompromised individuals. Nalidixic acid with high-dose intravenous Melphalan has caused deaths in children. Cyclosporin may impair renal function when used with high-dose Melphalan. Always inform your doctor about all medications you are taking to avoid harmful interactions.

Can I take Melphalan with vitamins or supplements?

From all available and reliable information, there is no confirmed data on this. Please consult a doctor for personalized advice.

Can Melphalan be taken safely while pregnant?

Melphalan should be avoided during pregnancy, especially in the first trimester, due to the potential risk to the fetus. It may cause harm, including congenital defects. Women of childbearing age should use reliable birth control during treatment and consult their doctor for personalized advice. There is no strong evidence from human studies, but the potential risks are significant.

Can Melphalan be taken safely while breastfeeding?

Women receiving Melphalan should not breastfeed, as the drug may pass into breast milk and harm the nursing infant. It's important to discuss alternative feeding options with your doctor if you are undergoing treatment with Melphalan.

Is Melphalan safe for the elderly?

There is no specific information available on the use of Melphalan in older patients. However, elderly patients may be more susceptible to side effects, and dosage adjustments may be necessary, especially in those with renal impairment. It's important for elderly patients to be closely monitored by their healthcare provider during treatment.

Is it safe to exercise while taking Melphalan?

Melphalan can cause side effects such as excessive tiredness and joint, muscle, or back pain, which may limit the ability to exercise. If you experience these symptoms, it's important to discuss them with your doctor. They can provide guidance on managing side effects and advise on safe levels of physical activity during treatment.

Is it safe to drink alcohol while taking Melphalan?

From all available and reliable information, there is no confirmed data on this. Please consult a doctor for personalized advice.