Adult Dosing
Multiple myeloma
- Initial: 6 mg PO daily for 2 to 3 weeks. Then stop therapy for 4 wks and follow blood counts carefully
- Maint: 2 mg PO daily if WBC and platelet counts are rising
- Other protocols:
- 0.15 mg/kg/day PO for 7 days. Then stop therapy for at least 2 wks. Start maintenance therapy at 0.05 mg/kg/day when WBC and platelet counts are rising
- 0.25 mg/kg/day PO for 4 days. Repeat q4-6 wks if granulocyte and platelet counts have returned to normal
Epithelial ovarian cancer
- 0.2 mg/kg/day PO for 5 days, repeated q4-5 wks depending upon hematological status
Note: Multiple dosing protocols have been recommended. Adjust dosing according to the clinical condition, hematological status and tolerance for each individual patient
Pediatric Dosing
- Safety and effectiveness in pediatric population has not been established
[Outline]
- Melphalan must be administered in carefully adjusted doses under the supervision of a physician experienced in cancer chemotherapy
- Nitrogen mustard therapy may be associated with an increased incidence of secondary malignant tumors
- Therapy with nitrogen mustards may produce marked bone marrow depression. Observe patients closely for signs of myelosuppression, severe infections, bleeding, and symptomatic anemia
- Monitor CBC, platelet count, WBC with differential count at baseline and prior to each course of therapy. Frequent monitoring is necessary for accurate dosage adjustments and prevention of toxicity
- Carefully weigh anticipated benefits with expected risks. Use with extreme caution in patients whose bone marrow reserve may have been compromised by prior irradiation or chemotherapy
- Pulmonary toxicity characterized by pulmonary infiltrates and/or fibrosis, interstitial pneumonitis has been reported in patients receiving melphalan
- Reversible hepatotoxicity manifested by abnormal liver function tests, hepatitis and jaundice have been reported in some patients
- Gastrointestinal events including nausea, vomiting, diarrhea and oral ulceration may occur
- Safety and effectiveness in pediatric patients has not been established
- Concomitant use with live vaccines should be avoided
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Active infections
- Myelosuppression (extreme caution required)
- Myelosuppressive agent use
- CLL
- Elderly population
- Long term use (risk of leukemia, bone marrow dysplasia )
Pregnancy Category:D
Breastfeeding: Most sources consider breastfeeding to be contraindicated with antineoplastic therapy. Due to the potential to cause serious adverse events, it is recommended that patients receiving melphalan should not breastfeed
Pricing data from www.DrugStore.com in U.S.A.
- Alkeran 2 MG TABS [Bottle] (APO PHARMA USA)
50 mg = $425
150 mg = $1241.02
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
Drug Name: Alkeran 2 MG Oral Tablet
Ingredient(s): Melphalan
Imprint: GX;EH3;A
Color(s): White
Shape: Round
Size (mm): 7.00
Score: 1
Inactive Ingredient(s): colloidal silicon dioxide / crospovidone / hypromellose / polyethylene glycol 400 / magnesium stearate / cellulose, microcrystalline / titanium dioxide
Drug Label Author:
GlaxoSmithKline LLC
DEA Schedule:
Non-Scheduled
