Monograph Details

Neoplasms > Alkylating agents
ALKERAN
Manufacturer
GlaxoSmithKline Pharmaceuticals
Legal Classification
Rx
Pharmacological Class
Nitrogen mustard derivative.
Generic Name
Melphalan 2mg; scored tabs.
Also
ALKERAN FOR INJECTION
Indications
Palliative treatment for multiple myeloma and non-resectable epithelial ovarian cancer.
Children
Not recommended.
Adults
Multiple myeloma: 6mg once daily for 2–3 weeks; stop for up to 4 weeks, maintenance 2mg per day. Ovarian cancer: 0.2mg/kg per day for 5 days; repeat course every 4–5 weeks. Both: continue treatment as hematological recovery permits (esp. WBCs and platelets); for other regimens: see literature.
Contraindications
Prior resistance to melphalan.
Precautions
Prior irradiation or chemotherapy. Bone marrow suppression. Azotemia. Monitor platelets, hemoglobin, WBC and differential at start of therapy and prior to each course; discontinue if WBC <3,000cells/µL or platelets <100,000cells/µL. Moderate to severe renal impairment. Elderly. Pregnancy (Cat.D), nursing mothers: not recommended.
Interactions
Radiotherapy potentiates antineoplastic effect. For IV: caution with cyclosporine, cisplatin, BCNU, nalidixic acid.
Adverse Reactions
Bone marrow suppression, GI upset, hepatic dysfunction, anemia, blood dyscrasias, secondary malignancies (eg, nonlymphocytic leukemia), rash, alopecia, pulmonary fibrosis, interstitial pneumonitis, gonadal toxicity (amenorrhea, infertility); hypersensitivity reactions, cardiac arrest (rare).
How Supplied
Tabs—50
Single-use vial—1 (w. diluent)
Additional Resources
Related Prescribing Note