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melphalan |
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melphalan /mel·pha·lan/ (mel´fah-lan) a cytotoxic alkylating agent derived from mechlorethamine, used as an antineoplastic.
melphalan [mel′fəlan] an antineoplastic alkylating agent. indications It is prescribed in the treatment of malignant neoplastic diseases, including palliative treatment of multiple myeloma and nonresectable ovarian carcinoma. contraindications Pregnancy, recent exposure to antineoplastic medication or to radiation, or known hypersensitivity to this drug prohibits its use. adverse effects Among the more serious adverse effects are bone marrow depression, nausea, and vomiting. melphalan [mel´fah-lan] a cytotoxic alkylating agent derived from nitrogen mustard, used as an antineoplastic agent, primarily for treatment of multiple myeloma; administered orally or intravenously.
melphalan (mel´f
n brand name: Alkeran; drug class: antineoplastic; action: responsible for cross-linking DNA strands, which leads to cell death; uses: palliative treatment of multiple myeloma and nonresectable epithelial carcinoma of the ovary. melphalan a cytotoxic nitrogen mustard alkylating agent used as an antineoplastic.
melphalan (L-PAM, L-phenylalanine mustard, L-sarcolysin) Warning - Hazardous drug! Alkeran Pharmacologic class: Alkylator Therapeutic class: Antineoplastic Pregnancy risk category D FDA Boxed Warning• Give under supervision of physician experienced in cancer chemotherapy, in facility with adequate diagnostic and treatment resources. ActionForms cross-links between strands of cellular DNA, disrupting DNA and RNA transcription and causing cell death AvailabilityPowder for injection (melphalan hydrochloride): 50 mg Tablets: 2 mg ⊘Indications and dosages ➣ Multiple myeloma Adults: Initially, 6 mg P.O. daily for 2 to 3 weeks, then discontinue drug for up to 4 weeks or until white blood cell (WBC) and platelet counts increase; then give maintenance dosage of 2 mg/day or 0.15 mg/kg/day P.O. for 7 days or 0.25 mg/kg for 4 days, repeated q 4 to 6 weeks. For those who can't tolerate oral therapy, 16 mg/m2 by I.V. infusion over 15 to 20 minutes at 2-week intervals for four doses (usually with prednisone); I.V. dose can be repeated q 4 weeks after recovery from toxicity. ➣ Nonresectable advanced ovarian cancer Adults: 0.2 mg/kg/day P.O. for 5 days q 4 to 5 weeks Dosage adjustment• Renal impairment Contraindications• Hypersensitivity to drug PrecautionsUse cautiously in: Administration• Before starting therapy, obtain CBC with white cell differential and platelet count. Repeat periodically before each course.
Adverse reactionsCV: hypotension, tachycardia, vasculitis GI: nausea, vomiting, diarrhea, oral ulcers, stomatitis GU: hyperuricemia, amenorrhea, gonadal suppression, infertility Hematologic: anemia, purpura, bone marrow depression, leukopenia, thrombocytopenia Hepatic: hepatotoxicity Metabolic: hyperuricemia Respiratory: dyspnea, interstitial pneumonitis, bronchospasm, fibrosis Skin: rash, urticaria, pruritus, alopecia, sweating Other: edema, extravasation at I.V. site, allergic reactions including anaphylaxis InteractionsDrug-drug. Carmustine: increased pulmonary toxicity Cimetidine: decreased GI absorption of melphalan Cisplatin: increased risk of renal dysfunction, decreased melphalan clearance Cyclosporine: increased risk of nephrotoxicity, severe renal failure Interferon alfa: decreased melphalan blood level Live-virus vaccines: decreased antibody response to vaccine Myelosuppressants: additive toxicity Nalidixic acid: increased risk of severe hemorrhagic necrotic enterocolitis (in children) Drug-diagnostic tests. Hemoglobin, platelets, red blood cells, WBCs: decreased values Nitrogenous compounds: increased levels Drug-food. Any food: decreased absorption of oral melphalan Patient monitoring☞ Monitor patient for thrombocytopenia and leukopenia. If platelet count exceeds 100,000/mm3 or WBC count is below 3,000/mm3, discontinue drug until peripheral blood counts recover. Patient teaching• Tell patient to take oral tablets without food, because food may decrease drug absorption. melphalan Alkeran® Oncology An oral alkylating anticancer nitrogen mustard agent used to treat ovarian CA and myeloproliferative disease Adverse effects Myelosuppression, mutagenesis Want to thank TFD for its existence? Tell a friend about us, add a link to this page, add the site to iGoogle, or visit the webmaster's page for free fun content. |
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